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

When you tear, strain or pull a hamstring muscle, you injure some of the muscle cells. For the strain to heal, the body has to replace the injured cells with new ones and strengthen them to the pre-injury level.

The research has shown 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 when is it safe to start exercising and what should you be doing?

The Exakt Health app provides these answers

  • The app guides you safely from the moment you strain your hamstring all the way to when you’re able to make a full 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 you’re fully recovered, the maintenance program will help 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 hamstrings is a group of 3 muscles that run down the back of your thigh. They all originate from the sit-bone and attach at the back and sides of the knee. Two of them run along the inner part (medial) of the back of your thigh while the third one runs more to the outside (lateral).

Anatomy of the hamstring muscles.
Picture adapted from: Wikimedia

When you tear or strain a hamstring, you usually feel a sudden sharp pain in the back of your thigh which makes you pull up short.

If it’s a very mild strain, you may be able to continue your activity, but just at a much slower pace. If it’s a more severe strain, you will likely have to walk slowly while giving 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 normal for the rest of the muscle to also feel tight and stiff and it may be painful to sit on it.
  • It will likely be painful to walk or make big strides while walking.
  • It will be painful to stretch your hamstrings and in severe cases you may be unable to straighten your knee fully 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 and may even take a few days to show. When it does show, the bruise is often much lower than the tear because gravity pulls the dead blood towards the floor.

Most hamstring injuries can be treated at home using a conservative exercise-based treatment plan as 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. This can indicate a serious tear that involves the tendon of the hamstrings and may need a special treatment plan.
  • You think it’s a severe injury and have 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. This can indicate that you have a blood clot and it should be investigated 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. This can indicate that you’ve also injured a nerve and our treatment plan may not be right for you.
  • Your symptoms are getting worse.
  • Your injury is not healing as expected (see the expected the healing times below).

Against widespread believe, tight or inflexible hamstrings is not a main cause for hamstring strain. A good range of motion is desirable, but you don’t need super flexibility. Research has identified the following risk factors:

  • Increased sprint/intense running: If you do a lot of high intensity training, it causes your muscles to be more tired and strain more easily.
  • Fatigue: You are more likely to tear a hamstring towards the end of a hard 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, which makes them vulnerable to injury.
  • Weak hamstring muscles are prone to strain under forceful contractions during sprinting, hill running, jumping or kicking.
  • A previous hamstring strain, calf strain, ankle sprain, or knee injury predisposes you to straining your hamstrings – especially if you haven’t fully recovered from the initial injury.
  • Reduced strength and control in the muscles of the lower back and around the core are also important. A weakness in one of these areas can lead to an overload in the hamstrings.
  • Old age also increases your risk of a strain. To mitigate the muscle loss and decrease in strength associated with aging, regular strength training sessions are important.


When you strain or tear a hamstring muscle, you literally tear some of the muscle fibers or cells. In order to heal, your muscle has to go through its natural three-stage healing process:
  • First, your body gets rid of the injured cells through an inflammatory process (Stage 1).
  • Next, your body will start to create new muscle cells to replace the damaged ones (Stage 2).
  • Ultimately, your body will strengthen the new muscle cells, but only if you do the right exercises to stimulate this process (Stage 3).
Our treatment plan is aligned 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 important 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 recovers in between 15 and 21 days.
  • More severe strains can take between 20 to 60 days to fully recover.
  • 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 fully recover.
  • If you’ve neglected your hamstring strain for a while, tried to train on it and reinjured it a few times, it may take several months to heal.


Most of the research into hamstring strain prevention has been done on footballers, but some of it will apply to all running sports:
  • Eccentric hamstring strength training.
  • Including balance and proprioception exercises in your training plan.
  • Good core strength and control – as well as in the rest of your muscles
  • Race or match-day specific training such as kicking, tackling, sudden sharp sprinting or hill sprints to gradually expose the hamstrings to such high-risk activities.
  • Avoid sudden increases in running volumes or intensity. Your body needs time to adapt and grow stronger.
  • An adequate warm-up before you train, especially before intense training sessions.

The hamstring strain treatment plan consists of 6 stages

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

The aim of this stage is to allow your injury to settle and to limit the amount of swelling and internal bleeding. Follow the PRICE regime and avoid positions that stretch your hamstrings as that can make your injury worse. Proceed to the next stage when at least 48-72 hours have passed since you sustained your injury.

It’s time to start gentle strength training for your hamstrings. It’s best to carefully ease into the exercises as your strained muscle still needs some protection. Avoid strong hamstring stretches as this will make your injury worse. You can proceed to the next stage when you can walk for short distances at a slow pace and perform the prescribed hamstring workouts without pain.

Your aim during this stage is to restore full flexibility and build the strength needed for easy running. You’ll also improve the strength and control in your core and other leg muscles. Avoid all running, hopping and jumping activities. Proceed to the next stage when you can walk at a brisk pace for 30 minutes and can do the assigned strength exercises without increase in pain.

You’re now ready to start a return to running program. Your strength workouts will increase in intensity and their frequency will reduce as your running volume increases to allow recovery. Avoid high intensity running e.g. fast running or hill sessions. Progress to the next stage when you can jog 20 minutes at an easy pace and complete the strength workouts without increasing your symptoms.

The focus is now on regaining your previous running endurance in your hamstring and leg muscles. The strength workouts will maintain the strength that you’ve built in the previous stages. Avoid high intensity running e.g. tempo, sprint or hill sessions. 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 to train with increasing speed and intensity. You should continue with your weekly strength routine to support your running activities and reduce re-injury risk.

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.

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