Home
Injury resources
Get the App
4 min

Pulled hamstring: How to treat the bruise

Learn why you may get bruises from a hamstring injury.
Maryke Louw
Maryke Louw
Dec 19, 2023
Medically reviewed by
Sabrina Burkart
Find out why some pulled hamstrings bruise and others don't. I also share treatment tips that may help you get rid of the bruise more quickly.

We've also explained it in this video:

A quick recap on the anatomy and mechanism of a pulled hamstring

The main fleshy part of the hamstring muscles consists of thousands of muscle cells grouped in bundles.

These bundles are held together by a thin layer of fascia (that white, sinewy stuff in meat). One muscle contains lots and lots of these bundles. A layer of fascia also covers the muscle itself.

Blood vessels penetrate the fascial layer. The blood vessels divide until they are tiny enough to supply oxygen and nutrients to every cell.

Anatomical structure of the hamstring muscles.
Email icon
Stay up to date with our newsletter
Subscribe to newsletter
Two runners looking at the Exakt Health newsletter on their phone

Why do some hamstring strains bruise and others don't?

A bruise is an accumulation of dead or old blood under the skin. It forms whenever you injure a blood vessel. But you'll only see a bruise if the blood can get close to the skin - this can often take a few days.

For a bruise to disappear, the body has to absorb the dead blood and remove it via the lymph system.

When you strain your hamstring, you tear a few of the muscle cells and usually also some of the blood vessels. The infographic below lists the factors determining whether your hamstring strain will bruise.

Reasons a pulled hamstring bruises...or not

1
The size of the blood vessels
If the blood vessels you injure are tiny, there will be minimal bleeding, and it will stop quickly. So, you will likely not see much bruising. Tearing a bigger blood vessel will likely cause more bleeding and result in a larger bruise.
2
The fascia sheath
Sometimes, a person may tear a significant blood vessel, but all the bleeding is contained in the facia sheath that surrounds the muscle. In that case, the blood may not be able to move to the skin and will remain at that deeper level until it is absorbed. So, you may not see a bruise despite having a very painful hamstring strain.
3
What you do immediately post-injury
The amount of bleeding is also determined by what you do in the first 24 hours after injury. If you stop your activity immediately and follow the PRICE regime, you will limit the bleeding and have less bruising. If, however, you continue your activity, you will likely bruise more. Certain substances like alcohol and aspirin can also thin your blood and cause more bleeding.

We've previously explained how to use the PRICE method and have summarized the best evidence-based treatments for hamstring strains here.

Hamstring strain icon
Start your hamstring strain recovery today!
Download the app
Man using the Exakt Health app to treat his pulled hamstring.

Why bruising can occur lower down the leg

Are you wondering why your pulled hamstring bruise is so low down – around your knee or even in your calf? This is quite common because gravity pulls the old blood towards the floor.

When you pull a hamstring, the bruise often shows lower down the leg.
When you pull a hamstring, the bruise often shows lower down the leg.

How to get rid of the bruise from a pulled hamstring

Most bruises will disappear within 14 days without you doing anything to help it along. As it resolves, it usually turns from deep purple to green and finally yellow.

Bruises change color as the body absorbs them.
Bruises change color as the body absorbs them.

Getting rid of the bruise won't make your injury heal more quickly, so don't worry about it too much. However, if you want to get rid of the bruise more quickly, the following treatments may be useful.

1. Arnica oil

There is some evidence that applying a 20% Arnica solution may be beneficial. Solutions of 10% or less don't seem to work.

2. Kinesiology tape

Kinesiology tape is claimed to improve lymph drainage, which may improve how quickly your body can get rid of waste products (like dead blood).

There's currently a lack of research that supports this claim. Still, some very convincing real-life evidence suggests it may be worth trying.

If you google "k tape bruising", you'll see plenty more pictures like this one.

K-taping for hamstring bruising. Picture credit: @dr.davidlee on Instagram
K-taping for hamstring bruising. Picture credit: @dr.davidlee on Instagram

3. Contrast therapy

Some people use contrast therapy, alternating between applying heat and cold to the area. The idea is that it increases the blood flow, which may help to remove the dead blood more quickly.

Once again, no research supports or refutes this method, so it may or may not work.

However, please DON'T use contrast therapy in the first 72 hours after pulling your hamstring, as you can actually cause more bleeding and bruising by doing it before your injury has had time to settle.

Remember, while managing bruises can help the injury look better, it's not a direct indicator of the healing process of the underlying muscle injury. The most effective treatment identified in the research is combining rest with rehab exercises.

If you're looking for a structured and effective rehabilitation plan for your hamstring strain, consider downloading the Exakt Health app. The app offers personalized rehabilitation plans tailored to your specific injury and recovery needs. It's designed to guide you through your recovery journey with evidence-based exercises.

Hamstring strain icon
Evidence-based rehab plans for hamstring strains
Download the app
Woman using the rehab plan in the Exakt Health app to manage her hamstring strain.
More about hamstring strains
Maryke Louw
Maryke Louw
Maryke Louw is the Medical Lead at Exakt Health and a chartered physiotherapist. She has a BSc in Physiotherapy and an MSc in Sports Injury Management and has been working with athletes of all abilities and ages for more than 20 years. Maryke combines her extensive knowledge of sports injury treatment with the latest research to provide effective injury treatment and prevention advice.
More about hamstring strains
Email icon
Stay up to date with our newsletter
Subscribe to newsletter
Two runners looking at the Exakt Health newsletter on their phone
More about hamstring strains