Returning to running after a hamstring pull can be tricky. The hamstrings, made up of three distinct muscles that connect from your pelvis to the back of your knees, are constantly at work decelerating your legs as they swing forward during a run, making re-injury likely if you start back too fast. In addition, the muscles help to absorb the forces applied to the knees while you exercise. Multiple steps can be taken to ensure a safe return to running after this type of injury.
First Things First
Early on after a hamstring pull, it is best to completely stop running to allow the muscle to heal. Ice can be applied to the injured area for 15 to 20 minutes, two to three times each day. In addition, NSAIDS such as Ibuprofen or Naproxen may be helpful at alleviating your initial pain and inflammation.
During this phase, it is best to avoid stretching the injured muscle, as this can cause dense scarring to develop which can hinder your eventual recovery.
Next, Gentle Activation
When you can begin to walk around without increased hamstring pain, you are able to progress to the next phase of recovery. In this stage, gentle activation and strengthening of the pulled muscle is emphasized. While it is important to regain the flexibility in the hamstrings, end-range stretching is still not recommended as this can irritate your injured leg. In addition, NSAID use is typically discontinued as chronic use can lead to other health concerns.
Bridges are a good exercise for activating the hamstrings during this phase.
How To: Lie on your back with both knees bent at a 90-degree angle. Draw your abdominals in and lift your buttocks off the ground. Hold this position for 5 to 10 seconds before lowering back down again.
Do two to three sets of 10 repetitions each day. When this exercise gets too easy, progress by walking the legs outward until they are straight and back in again while the butt is still in the air.
When you are able to bend the knee against resistance without increased pain, you may be ready to move to the next stage of rehabilitation. During this phase, exercises that involve athletic motions such as cutting and jumping, called plyometrics, are introduced. These exercises are designed to mimic the stresses that running places on your injured hamstring. The grapevine drill is a good plyometric exercise for this phase of recovery.
How To: In a large space, cross your left leg in front of your right and then uncross the legs again by bringing the right leg out to the side. Bring the left leg in back of the right and once more uncross them. Continue to alternate this pattern for the length of the space.
Reverse the direction and use the right leg to cross in front and in back of the left. Begin at a slow pace and get quicker if you are able to do so without increased pain. Each day, do three grapevines lasting 1 minute apiece.
In addition to plyometrics, eccentric strengthening can also be utilized to further improve muscle strength during this phase of recovery. This type of exercise activates the muscle as it slowly increases in length. Not only does this help your hamstring get stronger, but it helps to regain any flexibility that was lost during the pull. Roman dead lifts are a great eccentric strengthening exercise for this muscle group.
How To: Stand on the injured leg and keep your knee completely straight. Slowly bend forward at the waist as you raise your uninjured leg straight behind you. Your leg and back should move together. When your waist is bent at a 90 degree angle, like you are forming the letter T, slowly return to the starting position. Complete three sets of 10 repetitions each day.
Return to Running
Once you have regained your normal flexibility and strength and are able to complete plyometric activities without increased pain, you may be ready to go for a run. Begin at a slow running pace and start with 25 to 30 percent of your pre-injury mileage. If you are able to complete this without increased pain, mileage can be increased by 10 percent each week.
Be sure to allow sufficient time for recovery by running a maximum of 3 times per week initially. This will help you avoid re-injuring the hamstring.
Warnings and Precautions
If you are unable to progress through the stages outlined above without persistent or increased pain, speak to your doctor. Attempting to run through your pain only lengthens the recovery process and can lead to more serious complications. Formal rehab with a physical therapist may be necessary to effectively recover from your injury and return to running.