Hamstring Strain Treatment Plan

Hamstring strain treatment plan

The Exakt Health App contains an exercise-based treatment plan for hamstring strains that adapts to your feedback. Here’s how it works.

The treatment plan is research-based

If you tear, strain, or pull a hamstring muscle, it means some muscle cells have been pulled apart and hurt. Your body has to replace the injured cells with new ones and strengthen them to your pre-injury level for the strain to be fully healed.

Research shows that the best treatment for a hamstring strain is a carefully graded exercise-based treatment plan that increases in intensity and difficulty as your injury heals.

But how do you know when it’s safe to start exercising and what you should and should not be doing?

The Exakt Health app provides these answers

  • The app guides you safely from the moment you strain your hamstring to when you can fully return to sport.
  • The hamstring strain treatment plan contains evidence-based exercises with clear guidance on reps, sets, and frequency.
  • The app adapts the program according to your feedback and specific needs.
  • It implements a walk/run program for a safe return to running.
  • Once your recovery is complete, the maintenance program helps keep you injury-free. 
Daily exercises for the hamstring strain treatment plan are shown in the activities dashboard.
A successful treatment plan for hamstring strain should always teach you about your injury.

The app teaches you about your hamstring strain injury

Understanding what caused your injury, how it heals, and when to see a doctor helps you better plan your recovery and prevent re-injury.

The hamstring muscles are a group of 3 muscles located at the back of your thigh. They all originate from your sit-bone and attach to the back and sides of your knee. Two of them run along the inner part (medial) of the back of your thigh, while the third runs more to the outside (lateral).

Anatomy of the hamstring muscles.
Picture adapted from Wikimedia

When you tear or strain a hamstring muscle, you usually feel a sudden sharp pain in the back of your thigh. This sensation can make you quickly pull your leg up into a shortened position, to try to protect it. 

If it’s a very mild strain, you may be able to continue your activity, albeit at a slower pace. However, if it’s a more severe strain, you will likely have to walk slower and with very short strides.

The severity of the symptoms that you experience in the next few days will depend on how badly you’ve injured your hamstring – they can include:

  • Moderate to severe pain in the area of the tear. It is common for the rest of the muscle to feel tight and stiff, and it may be painful to sit on it.
  • It will likely be painful to walk or take long strides.
  • It will be painful to stretch your hamstrings, and in severe cases, you may be unable to fully straighten your knee for a few days.
  • Running will hurt.
  • It will be painful to contract your hamstring against resistance.
  • You may see some swelling and bruising, but this is not present in all cases. It may even take a few days to show. In addition, the bruise often shows up much lower than the tear because gravity pulls the fluid in the injured tissues downwards. 

Most hamstring injuries can be treated at home using a conservative exercise-based treatment plan outlined in the app.

You should consider seeing a medical practitioner if you have any concerns about your injury, particularly if:

  • You heard or felt a pop when you injured your leg, especially if it was close to your sit-bone. It can indicate a more severe tear involving the hamstring tendon, and you may need a special treatment plan for it.
  • You think it’s a severe injury, and there is a lot of swelling and bruising.
  • Any part of your leg (thigh, calf, or foot) is very swollen, red, hot to touch, or throbs with pain. These can indicate a blood clot, and you should investigate it as soon as possible.
  • You have pain at night that keeps you awake or interrupts your sleep.
  • You feel pins and needles or tingling in your leg, indicating a nerve injury. In which case, our treatment plan may not be well-suited to you.
  • Your symptoms are getting worse.
  • Your injury is not healing as expected (see the anticipated healing times below).

Against widespread belief, tight or inflexible hamstrings are not the leading cause of hamstring strains.

Of course, a good range of motion is desirable, but you don’t need super flexibility to stay injury-free. Instead, research has identified the following hamstring injury risk factors:

  • Increased sprint/intense running: If you do a lot of high-intensity training, it causes your muscles to tire and strain more easily.
  • Fatigue: You are more likely to tear a hamstring towards the end of a high-level running or training session when your muscles are tired.
  • Sudden increases in running intensities and volume don’t allow your muscles enough time to adapt and grow stronger, making them vulnerable to injury.
  • Weak hamstring muscles are prone to strain under forceful contractions during sprinting, hill running, jumping, or kicking.
  • Previous hamstring, calf, ankle, or knee strains or injuries predispose you to a hamstring strain, even more, if you haven’t fully recovered from the initial injury.
  • Reduced strength and control in your lower back muscles and core can cause hamstring overload.
  • Older age also increases your risk of developing hamstring strains, as aging is associated with muscle and strength loss. Therefore, it’s essential to keep up your regular strength training.


Straining or tearing a hamstring muscle involves an injury to the muscle where some muscle fibers or cells pull apart. For your muscle to recover correctly, it must go through a natural three-stage healing process:

  • First, your body gets rid of the injured cells through an inflammatory process (Stage 1).
  • Next, your body will create new muscle cells to replace the damaged ones (Stage 2).
  • Finally, your body will strengthen the new muscle cells by doing the right exercises which stimulate this process (Stage 3).

Our treatment plan aligns with this natural healing process. The graduated strength exercises signal the body to build and strengthen new muscle cells.

Because we all heal at different rates, it is essential to progress through the exercise levels and stages at your own pace.

Healing time

To give you some guidance on how quickly you might recover from your strain, consider the following recovery times:

  • A very mild hamstring strain usually heals within 15 to 21 days.
  • More severe strains can take between 20 and 60 days to recover fully.
  • If you have a very severe strain involving a large part of the muscle or the tendons, it can take 90 days or longer to recover fully.
  • If you’ve neglected your hamstring strain for a while, tried to train on it, or reinjured it a few times, it may take several months to heal.


Most hamstring strain prevention research is football-based, but some findings apply to all running sports. Universal elements to add into hamstring injury prevention programs:

  • Eccentric hamstring strength training
  • Balance and proprioception exercises 
  • Core strength and control work, as well as whole-body strengthening 
  • Race or match-day specific training, such as kicking, tackling, and sudden sharp sprinting, in addition, hill sprints gradually expose the hamstrings to higher-risk activities.
  • Avoiding sudden increases in running volumes or intensity, allowing enough rest time to adapt and grow stronger
  • Adequate warm-ups before training, in particular, before intense training sessions

The hamstring strain treatment plan consists of 6 stages

The workout intensities have to increase as your hamstring heals to regain full strength. The app ensures that you progress correctly by setting clear targets for you at each stage.

This stage aims to allow your injury to settle and to limit the amount of swelling and internal bleeding. At this point, the PRICE regimen is beneficial for acute hamstring strains. 

Activities to avoid

  • Hamstring stretches: A hamstring strain is an overstretch injury, and stretching it will only worsen it
  • Running and jumping activities

When to progress

Proceed to the next stage when at least 48-72 hours have passed since you’ve injured your hamstring.

Hamstring specific exercises

It’s now time to start gentle strengthening of your hamstrings. The app will carefully guide you through a series of exercises that aim to activate your hamstrings and build strength in low-load positions during this stage. 

It also includes gentle mobility exercises, but you should still avoid all intense hamstring stretches.

Core and leg strength

The research shows that core and general leg strength and control can also affect your hamstrings. The app, therefore, also includes workouts to strengthen these areas.

Activities to avoid

For now, avoid:

  • Strong hamstring stretches
  • Running and jumping

When to progress

You can proceed to the next stage when:

  1. You can walk for short distances at a slow pace,
  2. and perform the prescribed hamstring workouts without pain.

Strength training

The aim during this stage is to restore the flexibility in your hamstrings and build the strength needed for easy running. You’ll also continue improving the strength and control in your core and other leg muscles.

During this stage, the app favors compound exercises that work for more than one muscle group at a time in positions resembling the running action.

Activities to avoid

Avoid all running, hopping, and jumping activities.

When to progress

You can move on to the next stage when you:

  1. Can walk at a brisk pace for 30 minutes, 
  2. and do the assigned strength exercises without your pain increasing.

Walk/run program

You’re now ready to start a return to running program, but your hamstring will not have the endurance to cope with continuous runs yet. You can develop this by following a walk/run program.

The app provides this program for you and helps you understand what level of pain or discomfort is acceptable and when you should take a step back and rest instead.

Strength training

Your strength workouts will increase in intensity, but their frequency will reduce as your running volume increases. In this way, your legs will have enough recovery time.

Activities to avoid

Avoid high intensity running, for example, fast running or hill sessions.

When to progress

You can progress to the next stage when you:

  1. Can jog 20 minutes at an easy pace for you, 
  2. and complete the strength workouts without increasing your symptoms.

The focus now is on regaining your previous running endurance in your hamstring and leg muscles. But, again, it’s best to do this slowly. Current research suggests that increasing your running volume by no more than 10% per week is a safe way to progress and avoid injury.

The strength workouts will maintain the strength you’ve built in the previous stages. Aim to do strength training on each muscle group twice per week.

Activities to avoid

Avoid high-intensity running. For example, tempos, sprints, or hill sessions, because your hamstrings will not have the capacity to cope with those activities yet. Instead, you first need to build a good endurance base.

When to progress

You can progress to the next stage when you’re able to run your normal weekly running volume at your regular easy running pace, pain-free.

You can now start training with increasing speed and intensity. It’s often best to start by adding one high-intensity workout to your week first, then slowly building from there.

In the long term, you can keep your body well-supported while running and reduce your re-injury risk by continuing with a weekly strengthening routine. The app helps you achieve this by providing a thorough maintenance program.

The hamstring strain treatment plan has 6 stages and the workouts increase in intensity as you grow stronger..
The Exact Health App contains treatment plans for common running injuries.

Recover faster. Now.

Download the App now and start the recovery with your tailored treatment plan. Adjusted to your specific needs.

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