What happens when you strain a hamstring? An orthopaedic doctor explains recovery

Chicago Bears star quarterback went down with a non-contact injury and was carted off the field as fans collectively held their breath on Sunday, Sept. 20. Caleb Williams’ unfortunate injury has everyone talking about hamstrings and wondering about recovery.

Endeavor Health orthopaedic surgeon and sports medicine expert Denis Williams, MD, breaks down this very common sports injury, how it is treated, and what realistic recovery timing looks like.

Common causes and types of hamstring tears

Hamstring injuries affect everyone from professional athletes to weekend warriors, and most come with an immediate flash of pain.

There are two main types of hamstring injuries, explained Dr. Williams.

1. The first and more common happens during explosive activities like sprinting or jumping when the muscle is lengthening and contracting at the same time. The hamstring tears at the myotendinous junction where the hamstring muscle connects to the tendon.
2. The other common hamstring injury happens when there is a sudden stretch of the muscle which typically happens in activities like dance, martial arts or when a person slips. These usually cause tears slightly higher up where the tendon joins the pelvis, said Dr. Williams.

If you suspect a hamstring injury and have pain in the back of your leg, it’s important to see a sports medicine or orthopaedic specialist who will use imaging to help confirm an accurate diagnosis and develop a tailored treatment plan. Find a doctor.

Personalized treatment with a professional physical therapist is vital to effective and efficient recovery, said Dr. Williams.

Grades and treatment progression

Hamstring strains are graded from 1 to 3, with a Grade 1 strain reflecting very mild tearing and a Grade 3 strain being a complete tearing of the musculature, said Dr. Williams.

The standard treatment for hamstring strains depends on the degree of the injury, but in general happens in three phases, he explained.

• Initial phase: Control pain and inflammation, minimize scarring, begin gentle range of motion exercises
• Second phase: Increase range of motion exercises, some neuromuscular activities
• Final phase: Incorporate strengthening exercises and neuromuscular control activities

Realistic recovery timelines

“Full recovery time depends on numerous factors, including the grade of the strain, the expertise of the physical therapist and treating team, the age of the patient, and any surrounding co-morbidities,” said Dr. Williams.

In a young, healthy individual with excellent care and a Grade 1 strain, a very early return to sport is possible depending on their progression through the stages of treatment.

For a Grade 2-3 strain, it can take 2-3 weeks before a cautious return to practicing and 4-6 weeks for a full return to competitive activities, explained Dr. Williams.

In older athletes, those recovery times are typically doubled.

“You have to be careful about a too rapid return to activities as it can easily result in reinjuring the hamstring,” said Dr. Williams. For athletes who go back to their sport too early there is a real risk of creating a worse injury that will take longer and be harder to heal.

Prevention strategies

“There is no way to prevent all hamstring injuries, but proper sport-specific conditioning combined with adequate warm-up and pre-game stretching can decrease the incidence and risk of hamstring strains,” said Dr. Williams.
                                         
Endeavor Health Orthopaedic Immediate Care can help with acute injuries, from sprains and strains to tears and broken bones. Learn more.