From the Guidelines
The treatment for a pulled hamstring involves rest, ice, compression, and elevation (RICE) for the first 48-72 hours after injury, as recommended by the most recent guidelines 1. The main goal of treatment is to reduce pain, swelling, and inflammation, and to promote healing.
- Rest is essential to avoid further injury and allow the hamstring muscles to heal.
- Ice application can help reduce pain and swelling, and should be done for 20-30 minutes, 3-4 times daily, using a bag filled with ice and water surrounded by a damp cloth 1.
- Compression and elevation can also help reduce swelling. After the acute phase, gentle stretching and strengthening exercises should be gradually introduced, starting with simple range-of-motion movements and progressing to more challenging exercises as pain allows.
- A typical recovery program might include hamstring stretches held for 30 seconds and repeated 3-5 times daily, followed by progressive strengthening exercises. It's also important to avoid returning to full activity too quickly, as this increases the risk of re-injury 1. Additionally, incorporating injury prevention programs, such as neuromuscular training and strength and conditioning exercises, can help reduce the risk of future hamstring injuries 1. Overall, most mild to moderate hamstring strains heal within 2-6 weeks with proper care, though severe tears may require longer recovery or even surgical intervention.
From the FDA Drug Label
Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions The treatment for a pulled hamstring may include rest and physical therapy, with cyclobenzaprine hydrochloride tablets as an adjunct for relief of muscle spasm associated with acute, painful musculoskeletal conditions 2.
- Key points:
- Cyclobenzaprine hydrochloride tablets should be used only for short periods (up to two or three weeks)
- Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living
From the Research
Treatment for Pulled Hamstring
The treatment for a pulled hamstring typically involves a combination of rest, immobilization, and rehabilitation. According to 3, treatment includes rest and immobilization immediately following injury, followed by a gradually increasing program of mobilization, strengthening, and activity.
- Rest and immobilization to reduce pain and inflammation
- Gradually increasing program of mobilization, strengthening, and activity to improve flexibility, strength, and endurance
- Permission to return to athletic competition should be withheld until full rehabilitation has been achieved, including complete return of muscle strength, endurance, and flexibility, as well as coordination and athletic agility
Rehabilitation and Prevention
Rehabilitation of hamstring injuries is often prolonged and frustrating for the athlete and the sports medicine clinician, as noted in 4. A hamstring rehabilitation model should be based on the current understanding of the aetiological factors that contribute to hamstring muscle strain, including hamstring strength, flexibility, warm-up, and fatigue.
- Addressing aetiological factors such as hamstring strength, flexibility, warm-up, and fatigue in the rehabilitation and prevention of hamstring strains
- Proposing a hamstring rehabilitation model to guide treatment and preventative measures
Platelet-Rich Plasma (PRP) Injection
The use of PRP injection as a treatment option for hamstring injuries has been investigated in several studies, including 5 and 6. While some studies have shown benefits in various outcome measures with PRP, compared to rehabilitation alone, others have shown no benefits.
- PRP injection may be considered as a potential treatment option to accelerate healing of hamstring injury
- However, the current evidence is conflicting, and further research is needed to clarify the efficacy of PRP injection in reducing recovery time and reinjury rates
Nonoperative and Surgical Treatment
Nonoperative treatment options, such as activity modification and physical therapy, can be successful in managing many hamstring injuries, as noted in 7. Operative treatment, including endoscopic or open approaches, may be reserved for more severe injuries or those that do not improve with nonoperative management.
- Nonoperative treatment options, such as activity modification and physical therapy, can be effective in managing hamstring injuries
- Operative treatment may be considered for more severe injuries or those that do not improve with nonoperative management, and can be favorable in certain cases, such as acute surgical treatment of proximal hamstring injuries.