August 26, 2022

Hamstring tears are common injuries in sports involving sprinting, jumping, kicking and changing of direction. In this blog, we cover how hamstring injuries can happen, the different ways the hamstrings can be injured, injury severity, and what you can do to prevent hamstring injuries.

How do you injure the hamstrings?

The hamstrings consist of three muscles that act on both the hip and knee joints. This means they work together to extend/straighten the hip and flex/bend the knee.

Muscles are often strained or torn when they are excessively stretched under load. This means that the hamstring is most likely to be injured when the hip is flexed/bent and the knee is straight, such as when your leg swings through whilst kicking a ball. The reason why this occurs is that as your leg swings through, the hamstrings contract to limit how much it swings through, whilst the muscle is also being lengthened or stretched at the same time. This is what we call an eccentric muscle contraction, and it is this type of contraction that places the greatest load on the hamstring. This explains why hamstring tears typically occur when sprinting or kicking.

What are the things that increase your risk of hamstring injury?

Some risk factors for hamstring injuries include:

  • Older age
  • History of hamstring injury
  • Limited hamstring flexibility
  • Poor hamstring strength
  • Repetitive hamstring loading (e.g., sprinting and kicking)
  • Sports involving sudden change of direction

The different types of hamstring injuries

Hamstring tears are not all the same. The location and severity of the injury will influence how to best manage the injury, and the duration of your recovery.

Location of hamstring injuries

There are a few different parts of the hamstring that can be injured. These are:

  • Muscle belly – the big, fleshy part of the muscle that hardens when you tense it
  • Tendon – the connective tissue that connects the muscle to bone
  • Musculotendinous junction – where the muscle transitions into the tendon

The key difference between these areas is their blood supply. The muscle belly has a bright red and fleshy appearance, due to its rich blood supply. Having a rich blood supply means it has greater potential for healing. Meanwhile, the musculotendinous junction and tendon have a whiter, fibrous appearance due to their lack of blood supply, meaning they have poor potential for healing. Therefore, a tear here will take longer to heal than a tear in the muscle belly and must be managed very carefully.

The severity of hamstring injuries

The severity of a hamstring tear is divided into three grades. The greater the severity, the longer the recovery time.


Degree of damage

1 (mild)

A few muscle fibres may be overstretched or could have small tears

2 (moderate)

Partial tear of the muscle

3 (severe)

Complete tear of the muscle


Other sources of hamstring pain

In some cases, hamstring pain may not be originating from the hamstring itself. In fact, it’s possible for pain in the hamstring to be stemming from the spine or the hip.

The sciatic nerve is a nerve that runs from the lower part of the spine, and down the back of the thigh and calf. At the points where the sciatic nerve exits the lumbar spine, it is possible for the nerve to become impinged, which can result in referred pain to the hamstring. The sciatic nerve can also be impinged by the muscles at the back of the hip, which can again produce referred pain to the hamstring. In these cases, the hamstring is often structurally intact, and the source of the pain may be neural. It is important to recognise this, as the treatment for neural pain may be different to that of a hamstring injury.


With these variables in mind, we can better understand how important an accurate diagnosis is. If a severe hamstring tear, or involvement of the musculotendinous junction and/or tendon are suspected, an MRI may be valuable in guiding your management plan. Medical input, in addition to physiotherapy, may also be required.

Meanwhile, if a mild-moderate hamstring injury or neural-driven hamstring pain is suspected, a thorough physical assessment is often sufficient in guiding the management plan. A comprehensive strengthening and graded return to sport program may be all that is required.

Importance of hamstring length and strength

As discussed above, hamstring injuries often occur when the hamstring is stretched under load (i.e., eccentric contraction). Eccentric strength refers to how much force a muscle can produce whilst in a lengthened/stretched position, and it is these positions that place the greatest stress on a muscle. Therefore, it makes sense that performing eccentric strengthening exercises can boost the resilience of our hamstrings! Interestingly, research has shown that low levels of eccentric hamstring strength increase the risk of hamstring injuries. Meanwhile, higher levels of eccentric hamstring strength can mitigate the risk of injury, despite the presence of other risk factors such as older age. Furthermore, eccentric exercise can produce long-term improvements in muscle length and flexibility, whereas stretching may only provide short-term gains. Altogether, eccentric hamstring exercises are key to reducing your risk of hamstring injury! Some examples may include Nordic curls, Romanian deadlifts, and hamstring sliders.

If you’re looking to get your hamstrings in good shape, or you are recovering from a hamstring injury, come in and talk to one of our Physiotherapists for some guidance.

More Optimal Tips

Hip Bursitis - Why cortisone is not enough?!
Hip Bursitis - Why cortisone is not enough?!

April 12, 2024

"Your hip imaging report shows greater trochanteric bursitis, so I recommend you have a cortisone injection and see a physiotherapist to assess the situation more, understand your individual factors and build you a successful rehabilitation program” - this is the conversation we hope happens for all clients who have been diagnosed with hip bursitis. Check out this Optimal Tip to read why the injection is not enough as a standalone treatment plan.   

Continue Reading

In the Saddle: Unveiling Physiotherapists' Perspectives on the Therapeutic Marvels of Bike Riding
In the Saddle: Unveiling Physiotherapists' Perspectives on the Therapeutic Marvels of Bike Riding

December 05, 2023

There are many advantages of incorporating bike riding into your exercise regime. Physiotherapists recognise its therapeutic impact on joint health, emphasising range of motion and lubrication of the lower limb joints through low-impact motion. Bike riding is also a strength-building activity that engages major muscle groups and contributes to cardiovascular fitness. Additionally, the social and mental well-being aspects of cycling are highlighted, underscoring its role as a versatile and strategic tool in the physiotherapist's toolkit for a holistic approach to well-being.

Continue Reading

Bowled over by a shoulder injury? Here’s how you can restore your bowling performance to its pre-injury level.
Bowled over by a shoulder injury? Here’s how you can restore your bowling performance to its pre-injury level.

December 05, 2023

“When can I throw again?” is one of the most common questions asked by any overhead athlete post a shoulder injury or surgery. The answer to this question is multifaceted, as it depends on the timeframe from the injury, certain subjective and objective measures, as well as the athlete’s willingness. However, the simple answer is when the athlete is fully ready, and not before. This blog will highlight the prerequisites and the process of progressive return to bowling for cricketers after they’ve injured their shoulder.

Continue Reading