Recovery Insights Blog | Foundational Rehab

What Is a Hamstring Strain?

A hamstring strain is a tear in one or more of the three hamstring muscles at the back of your thigh.

Grades:

**Grade 1:** Mild strain, minor fiber damage

**Grade 2:** Partial tear, significant fiber damage

**Grade 3:** Complete rupture

Symptoms:

Sudden pain during activity

Pain at back of thigh

Bruising (may appear after days)

Weakness

Difficulty walking (severe strains)

Why Hamstrings Get Strained

High-Risk Activities

Sprinting (most common)

Kicking

Quick acceleration/deceleration

Overstretching

Risk Factors

Previous hamstring injury (biggest risk)

Muscle weakness

Poor flexibility (or too much flexibility)

Muscle imbalances

Inadequate warm-up

Fatigue

Treatment by Phase

Acute Phase (Day 0-5)

PRICE Protocol:

**P**rotect from further injury

**R**elative rest (not complete)

**I**ce: 15-20 min, several times daily

**C**ompression: Elastic bandage

**E**levation: When resting

Gentle Movement:

Pain-free walking

Gentle range of motion

Avoid stretching

Subacute Phase (Day 5 - Week 3)

Begin Loading:

Isometric Hamstring Holds

Lie face down

Curl heel toward buttock

Hold against light resistance

5-10 second holds

3 x 10

Prone Hamstring Curls (Light)

Lie face down

Curl heel up slowly

Control the lowering

Light resistance only

3 x 15

Bridges

Progress from double to single leg

3 x 15

Walking:

Increase duration

Maintain comfortable pace

Strengthening Phase (Week 3-8)

Eccentric Strengthening (Key!)

Nordic Curls (Assisted)

Kneel, partner holds ankles

Lower body forward slowly

Use arms to push back up

Progress by reducing assistance

3 x 6-8

Romanian Deadlifts

Hip hinge with weight

Feel hamstring stretch

3 x 10-12

Single Leg Romanian Deadlifts

Progress from double leg

3 x 8 each leg

Sliding Leg Curls

Lie on back, heels on sliders

Bridge up, curl heels in

Extend out slowly

3 x 10

Return to Sport Phase (Week 6-12)

Progressive Running:

1. Jogging: 50% speed

2. Striding: 70% speed

3. Running: 85% speed

4. Sprinting: 95%, then 100%

Agility Drills:

Cutting

Quick direction changes

Sport-specific movements

Criteria for Return:

No pain with full-speed sprinting

Strength within 10% of other leg

Full range of motion

Confidence in the leg

Sample Program

Week 1-2

Daily:

1. Ice: 3-4 times

2. Gentle walking

3. Isometric holds: 3 x 10 (when pain allows)

Week 3-4

Daily:

1. Prone curls (light): 3 x 15

2. Bridges: 3 x 15

3. Walking (increase duration)

3x Weekly:

4. Romanian deadlifts: 3 x 10

Week 5-8

3x Weekly:

1. Nordic curls (assisted): 3 x 6

2. Single leg RDL: 3 x 8 each

3. Sliding leg curls: 3 x 10

4. Hip thrust: 3 x 12

Week 8+

Continue strengthening 2x weekly

Progressive running program

Sport-specific drills

Nordic Curls: The Key Exercise

Research strongly supports Nordic curls for:

Hamstring rehabilitation

Hamstring injury prevention

Building eccentric strength

Why eccentrics matter: Most hamstring injuries occur during eccentric loading (muscle lengthening). Train eccentrically to prevent re-injury.

Stretching: Be Careful

Acute Phase

Don't stretch. Can worsen the injury.

Later Phases

Gentle stretching when pain-free:

Don't push into pain

Hold 20-30 seconds

After exercise, not before

Note: Flexibility is less important than strength for prevention.

Re-Injury Prevention

Hamstring re-injury rate is high (up to 30%). Prevent it with:

1. Complete rehab — Don't return too soon

2. Eccentric strengthening — Nordics, RDLs

3. Hip strengthening — Glutes support hamstrings

4. Proper warm-up — Dynamic, not static stretching

5. Gradual return — Progressive loading

6. Ongoing maintenance — Continue strengthening

Common Mistakes

1. Returning Too Soon

Problem: Re-injury

Fix: Meet all return criteria

2. Skipping Eccentrics

Problem: Weakness in lengthened position

Fix: Nordics are essential

3. Too Much Stretching

Problem: Doesn't prevent injury; may delay healing

Fix: Focus on strength

4. Ignoring Hip Strength

Problem: Hamstrings compensate for weak glutes

Fix: Strengthen entire posterior chain

Recovery Timeline

**Grade 1:** 1-3 weeks

**Grade 2:** 4-8 weeks

**Grade 3:** 3-6 months (may need surgery)

When to See a Doctor

Severe pain or weakness

Large bruising

Unable to walk

Pop or snap at time of injury

No improvement after 2 weeks

The Bottom Line

Hamstring strains require:

1. Early protection — Don't push acutely

2. Progressive loading — Gradual return to strength

3. Eccentric focus — Nordics are essential

4. Complete rehab — Don't rush return

5. Maintenance — Prevent re-injury

Strong hamstrings resist injury. Build them properly.

Foundational Rehab provides hamstring rehabilitation programs.

Hamstring Strain Exercises: Recovery and Prevention