The Hamstring Muscles

How Physical Therapy Works on a Hamstring Injury

Pain in hamstring muscles
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The hamstring muscles are a group of three muscles located on the back of your thigh. The three muscles are called the biceps femoris, the semimembranosus, and the semitendinosus. These three muscles work together to help bend your knee. They can also help with hip extension, when your hip and thigh move towards the back of your body.

The hamstring muscles all arise from a bone on the bottom of your pelvis called the ischial tuberosity. The muscles then course down the back of your thigh. The biceps femoris muscle attaches past your knee on the lateral, or outside, part of your leg. The semimembranosus and semitendinosus attach on the medial, or inside, aspect of your knee and shin bone.

Common Injuries to the Hamstring Muscles

Trauma, which may occur during sports participation, is a frequent cause injury to the hamstrings. This may cause partial or full tears through the muscles or tendons of the hamstrings. Occasionally, repetitive strain during walking or running may cause hamstring problems.

Injury to the hamstrings may include tears in the muscles or tendons referred to as strains. Sometimes the tearing occurs near the ischial tuberosity causing hip pain. Occasionally, hamstring problems are felt in the tendons near your knee and manifest as knee pain.

Signs and Symptoms of Hamstring Injury

Common signs and symptoms of a hamstring injury include but are not limited to:

  • Pain in the back of your hip
  • Pain in the inner or outer part of your knee
  • Tenderness and increased temperature in the back of your thigh
  • Bruising or discoloration on the back of your thigh
  • Difficulty when bending your knee or pain when bending your knee

Pain in the back of your thigh and leg may also be symptoms coming from your low back. Occasionally problems like sciatica can mimic a hamstring injury. If your hamstring pain was accompanied by a recent onset of low back pain, you may be experiencing sciatica and not a hamstring strain.

If you suspect that you have injured your hamstring muscles, you should consult with your physician. He or she can examine your injury and help provide the right treatment for your condition.

How Can Physical Therapy Help?

If you have had a hamstring injury, your doctor may refer you to physical therapy to help you regain normal function and mobility. Common impairments that your physical therapist may assess include:

Your treatment will typically focus on correcting the impairments that are found during your initial evaluation with your physical therapist. Your physical therapist will work with you to devise a plan of care to treat your hamstring injury to help you return to normal function.

Your physical therapist may choose to use various treatment techniques as a part of your rehabilitation. Ice may be used to control inflammation during the initial, or acute, phase of your injury. Heat may then be used to increase blood flow to the injured area and to help improve the elasticity of the injured hamstrings.

Occasionally, therapeutic modalities like ultrasound may be used to help provide deep heat to the injury site. Electrical stimulation like TENS may also be used to control pain. Caution should be used when being treated with these modalities. There is very little evidence that these kinds of treatments are beneficial to the overall healing of the body. Be sure to speak with your physical therapist to understand the rationale behind using such treatments, and be sure that you are also actively engaged in your rehabilitation.

If your hamstring muscle or tendon has partially torn, scar tissue may have developed over the site of injury. Your physical therapist may utilize scar massage and mobilization to help remodel the scar tissue and improve the elasticity of the injured hamstring muscle or tendon. A full thickness tear through a hamstring tendon may require surgery to fix. If you have had surgery, scar tissue massage may also be used to help improve the mobility of the surgical incision.

Active exercise has been proven to help improve the strength and flexibility of the hamstrings after an injury. Towel hamstring stretches can be done, or you can stretch the hamstrings with the help of another person. The standing hamstring stretch is another easy way to improve the flexibility of this muscle group.

Strength exercises may include knee curls while lying on your stomach and seated knee curls with an exercise machine. If you don't have access to a machine, you can use an exercise band or tubing around your ankle to provide resistance. The ball bridge with knee flexion is also a great exercise that you can perform to improve the strength of the hamstrings.

Other exercises that focus on balance, proprioception, and plyometrics may be beneficial to help you regain normal mobility and function after a hamstring injury. Be sure to consult with your doctor or physical therapist before starting any exercise program.

A Word From Verywell

The hamstrings are a big muscle group that cross over your hip joint and knee joint and are essential for normal function related to walking and running. Injury to these muscles can cause significant knee, thigh, or hip pain. By keeping the hamstrings flexible and strong, you may be able to quickly recover from a hamstring injury and prevent future problems with your hamstrings.

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