A pulled or strained hamstring can cause anything from mild discomfort to severe pain and muscle weakness, depending on the severity of your injury. Risk factors include muscle imbalances, fatigue and poor flexibility. Dehydration impairs muscle function and may also be a contributing factor. Consult your physician about physical therapy and rehabilitation.
Hamstring Strain
A hamstring strain or pull is categorized into a three grades based on severity. Grade I is a mild strain that stretches your hamstring muscle too far but does not cause any tears. Grade II is when a partial tear occurs, and Grade III is a complete rupture or tear of your hamstring muscle. The strain can occur either at the tendon where the hamstring attaches to your bone or somewhere in the muscle belly.
Cause and Risk Factors
Muscle overload is when your hamstring cannot do the workload it is required to do and therefore becomes strained. Eccentric contraction is often the mechanism or cause of that overload because it places your hamstrings in a loaded position while they are lengthening. For example, running downhill or decelerating or slowing down at the end of a run causes your hamstrings to eccentrically contract. Muscle fatigue and tightness increase your risk of pulling your hamstring muscle, especially during an eccentric contraction. Another risk factor is weak hamstring muscles, especially when they create a strength imbalance between your quadriceps or thigh muscles.
Dehydration
Dehydration does not directly lead to a muscle or hamstring strain but negatively impacts muscle function. Dehydration reduces blood flow to muscles and decreases muscle elasticity or flexibility and endurance, thereby resulting in muscle weakness and cramps, which increase your risk of muscle injuries such as a hamstring strain.
Treatment and Rehabilitation
Immediately stop running, ice and put a compression wrap around your hamstring and thigh, starting at your knee and wrapping up towards your hip. Drink sport beverages to rehydrate. The more dehydrated you are, the darker your urine will be, so rehydrate until your urine is light yellow. For additional pain management, take an over-the-counter pain medication such as acetaminophen. After the first 48 to 72 hours, apply heat in 20-minute increments at the beginning of the day and prior to exercises. Continue to ice in 20-minute increments following exercise, as well. Once pain subsides or in three to four days, start light stretches to regain normal flexibility. Perform strengthening exercises such as bridges, knee curls and walking backwards, but not until you regain normal flexibility. To maintain your cardio fitness, walk, bike or swim. Recovery may take between one week and six months, depending on severity.
Prevention
Do not start high-impact activities such as running and jumping until you are healed. Progress slowly back into running and other high-impact activities. For example, perform high-intensity exercises only a few days a week to allow adequate recovery and to see how your hamstring feels. Continue to perform strengthening exercises for your hamstring such as squats, lunges and deadlifts. Drink water or sport beverages during exercise to stay hydrated, and stretch after exercise to maintain flexibility and to prevent future hamstring strains.
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