Hamstring injury
A hamstring injury involves an overload or tear of the muscles at the back of the thigh. It commonly occurs during sprinting or other activities in which the hamstrings are exposed to high and rapid loads.
Localized tenderness or mild pain at the back of the thigh, often during fast running or after high loading. Strength is usually only mildly affected.
The hamstrings are particularly heavily loaded when the hip is flexed while the knee extends. High running speed and rapid eccentric loading are common factors in football-related hamstring injuries.
Common risk factors and situations
- •Sprinting and maximal running speed
- •Rapid acceleration
- •A sudden increase in sprint or training load
- •Previous hamstring injury
- •Insufficient strength or load tolerance
- •Fatigue during training or matches
Preventive training should combine progressive sprint exposure with hamstring strengthening and gradual adaptation to match-like intensity.
- •Regular eccentric hamstring training
- •Gradual exposure to high sprint intensity
- •Strength training for the hip and trunk
- •Planned progression of training and match load
- •Adequate recovery between high-intensity sessions
- •Complete rehabilitation after previous hamstring injury
Stop sprinting and other painful activities. Reduce loading and avoid aggressive stretching or massage during the acute phase. Cold and compression may be used for symptom relief.
Early loading
Controlled movement and light hamstring loading are introduced within tolerance.
Goals
Reduce pain and maintain function.
Progression criteria
Daily activities and light strengthening can be performed without significant pain.
Strength and running
Gradually increase strength loading and introduce running from low to higher speeds.
Goals
Restore strength and tolerance to faster running.
Progression criteria
Fast running and progressive strengthening are tolerated without pain or post-exercise reaction.
Sprint and football
Progress to acceleration, high-speed running, changes of direction and football-specific activities.
Goals
Restore full sprint and football capacity.
Progression criteria
Maximal or near-maximal sprinting can be performed without pain or worsening afterward.
- Pain-free daily activities
- Adequate hamstring strength and control
- Full-intensity sprinting without pain
- Acceleration and changes of direction without symptoms
- Full football training without a reaction afterward
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Hamstring injury
A hamstring injury involves an overload or tear of the muscles at the back of the thigh. It commonly occurs during sprinting or other activities in which the hamstrings are exposed to high and rapid loads.
Mild — Ofta några veckor vid en lätt skada, men återhämtningen varierar beroende på skadans omfattning och individens progression.
Symptoms
Localized tenderness or mild pain at the back of the thigh, often during fast running or after high loading. Strength is usually only mildly affected.
Acute Treatment
Stop sprinting and other painful activities. Reduce loading and avoid aggressive stretching or massage during the acute phase. Cold and compression may be used for symptom relief.
Rehabilitation
Controlled movement and light hamstring loading are introduced within tolerance.
Goals
Reduce pain and maintain function.
Progression criteria
Daily activities and light strengthening can be performed without significant pain.
Gradually increase strength loading and introduce running from low to higher speeds.
Goals
Restore strength and tolerance to faster running.
Progression criteria
Fast running and progressive strengthening are tolerated without pain or post-exercise reaction.
Progress to acceleration, high-speed running, changes of direction and football-specific activities.
Goals
Restore full sprint and football capacity.
Progression criteria
Maximal or near-maximal sprinting can be performed without pain or worsening afterward.
Return to Play
- ☐ Pain-free daily activities
- ☐ Adequate hamstring strength and control
- ☐ Full-intensity sprinting without pain
- ☐ Acceleration and changes of direction without symptoms
- ☐ Full football training without a reaction afterward
Moderate — Ofta flera veckor, men tiden varierar betydligt beroende på skadans omfattning och lokalisation.
Symptoms
Clear pain at the back of the thigh, often following a sudden sprint or acceleration. Running is affected and strength may be clearly reduced. Swelling or bruising may occur.
Acute Treatment
Stop the activity and reduce load on the leg. Avoid sprinting, aggressive stretching and massage during the acute phase. Significant functional loss or suspected major tearing should be assessed by a healthcare professional.
Rehabilitation
Reduce hamstring loading while maintaining pain-free movement and light muscle activation.
Goals
Reduce pain and restore basic function.
Progression criteria
Walking and light strengthening are tolerated without significant symptom aggravation.
Progress hamstring strength through controlled and then more demanding loading.
Goals
Restore strength, endurance and load tolerance.
Progression criteria
Heavy strengthening and faster movements are tolerated without pain or post-exercise reaction.
Gradually progress running speed from easy running to high and then maximal intensity.
Goals
Restore capacity for high sprint loads.
Progression criteria
Near-maximal sprinting can be performed without pain or worsening.
Return to Play
- ☐ Adequate strength compared with the uninjured side
- ☐ Pain-free high-speed running
- ☐ Near-maximal or maximal sprinting
- ☐ Football-specific movements without symptoms
- ☐ Full training without significant reaction afterward
Severe — Ofta flera veckor till månader beroende på skadans omfattning. Större bristningar och skador nära senfästet kan kräva längre rehabilitering.
Symptoms
Sudden severe pain, sometimes described as a sharp sensation or feeling of something tearing. Continuing to run or bear weight may be difficult, and significant bruising or swelling may develop.
Acute Treatment
Stop the activity and reduce load on the leg. Avoid stretching, massage and repeated testing of the muscle during the acute phase. Suspected significant tearing should be assessed by a healthcare professional.
Rehabilitation
Protect the injured area and adjust loading according to pain and function.
Goals
Reduce pain and restore basic movement.
Progression criteria
Walking and controlled movements can be performed without significant worsening.
Progressive rehabilitation with gradually increasing hamstring loading.
Goals
Restore full strength and load tolerance.
Progression criteria
Heavy strengthening and explosive movements are tolerated without symptoms.
Gradual return to high-speed running, maximal sprinting and full football loading.
Goals
Restore full capacity for match-like loading.
Progression criteria
Maximal sprinting and full football training can be completed without pain or post-exercise reaction.
Return to Play
- ☐ Medical assessment when a significant tear is suspected
- ☐ Adequate strength and function
- ☐ Maximal sprinting without pain
- ☐ Football-specific activities at full intensity
- ☐ Full training and match-like loading without post-exercise reaction
When to Seek Medical Care
Seek medical care for severe pain, significant functional loss or suspected major hamstring injury.
- Difficulty walking or bearing weight
- Extensive or rapidly developing bruising
- Significant swelling
- Marked loss of strength
- Feeling of a significant tear
- Symptoms that recur despite rehabilitation
References
- Hamstring injuries — Aspetar (https://www.aspetar.com/en)