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Q&A: How to Treat a Hamstring Strain

What can I do to treat a hamstring strain? Can I continue running, or should I cross-train or rest?

A hamstring strain is an extremely common injury many runners have experienced at one point or another in their course of running. I tend to refer to this injury as the "sleeping giant" and here is why: After the initial injury, most runners take time off to rest the muscle.

The RICE method (Rest, Ice, Compression, and Elevation) is implemented, along with NSAIDs, and after two weeks or so, most daily functioning (i.e., walking, stairs, and squatting) returns to normal. This is where most runners make the mistake of trying to run when not completely healed. The injury then re-emerges and most runners become discouraged that the pain is still present even though they have rested.

The real key to healing a hamstring strain is time and patience

When it comes to a hamstring strain, it is important to be mindful of a few things:

  • Is the pain coming from the hamstring or your lower back? The hamstring is a common site for referred pain originating from the lumbar spine. Seek out a physical therapist or a physician if you are unsure of your pain origin.

  • What caused the injury in the first place? Does your warm-up contain a light form of cardio, dynamic movements, and foam rolling or hip/core activation exercises? Or did the injury occur from a muscle imbalance or weakness? Typically a hamstring-to-quadriceps ratio should be approximately 50–80%.

  • Is your footwear up to date and the appropriate fit? Having too flexible of a shoe doesn’t allow for adequate support to the foot structure, which could place the entire lower extremity at risk; as a result, potential additional injuries could occur.

If you are suffering from a strain initially, it is best to RICE, take NSAIDs, foam roll the affected area, and of course, stop running. Resist the urge to overstretch the area as this may delay the healing process.

Once the pain subsides, stretching can increase, along with progressive strengthening of the hamstrings; eccentric training generates more force than concentric training and therefore builds muscle at an increased rate.

Cross-training should be something incorporated into a runner’s workout, whether injured or not. It is best to keep the body guessing when it comes to workouts—even though running appears to be a uniplanar (one-directional) activity, rotational stability is just as crucial to a runner’s health.


Jason Mayerhofer

Jason Mayerhofer, PT, MSPT, MTC, CSCS, SFMA, USATF-1 is a clinical supervisor at the Hospital for Special Surgery Site Affiliated with American Express. He was a sprinter, long jumper, and triple jumper in high school and has completed countless 5K and 10K races. In 2015, Jason ran his first half-marathon and plans on competing in his first triathlon in April 2017 in Miami. He is currently working on completing his DPT and sports therapy certification through the University of St. Augustine.

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