From the Guidelines
Treating a hamstring injury involves immediate rest, ice, compression, and elevation (RICE protocol) for the first 48-72 hours, as recommended by the most recent guidelines 1. The RICE protocol is essential in reducing swelling and pain. Apply ice for 15-20 minutes every 2-3 hours to reduce swelling and pain. Take over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 4-6 hours) to manage pain and inflammation. After the acute phase, begin gentle stretching and strengthening exercises, gradually increasing intensity as pain allows. Start with simple hamstring stretches held for 30 seconds, 3-5 times daily, and progress to light resistance exercises after a week if pain permits. Some studies suggest that flywheel resistance training may be beneficial in reducing the likelihood of hamstring injuries and can be used as a rehabilitation tool following an injury 1. However, the current evidence is limited, and more research is needed to verify its effectiveness. Physical therapy is recommended for moderate to severe injuries, typically 2-3 sessions weekly for 4-6 weeks. Full recovery may take 3-8 weeks depending on injury severity. Avoid returning to sports until you can move without pain and have regained at least 90% of your strength compared to the uninjured leg. Hamstring injuries heal slowly due to the constant tension on the muscle and poor blood supply, making proper rehabilitation essential to prevent recurrence. It's also important to note that most patients with overuse tendinopathies, including hamstring injuries, fully recover within three to six months with relative rest, icing, and eccentric strengthening exercises 1.
Key points to consider:
- Rest, ice, compression, and elevation (RICE protocol) for the first 48-72 hours
- Gentle stretching and strengthening exercises after the acute phase
- Progress to light resistance exercises after a week if pain permits
- Physical therapy for moderate to severe injuries
- Avoid returning to sports until full recovery and strength are regained
- Proper rehabilitation is essential to prevent recurrence.
From the Research
Hamstring Injury Treatment Options
- Hamstring injuries are common among athletes and can be treated with various methods, including platelet-rich plasma (PRP) injections, rehabilitation programs, and surgery 2, 3, 4, 5, 6
- A study published in 2014 found that a single PRP injection combined with a rehabilitation program was significantly more effective in treating hamstring injuries than a rehabilitation program alone 2
- Another study published in 2024 highlighted the importance of evaluating and diagnosing hamstring injuries accurately to determine the best course of treatment, which may include nonoperative measures such as activity modification and physical therapy, or operative treatment such as endoscopic or open approaches 3
Efficacy of Platelet-Rich Plasma Injections
- A systematic review and meta-analysis published in 2021 found that PRP injection had no significant effect on reducing mean time to return to play or reinjury rates compared to no treatment or physical therapy alone for hamstring injuries 4
- However, another study published in 2015 found that PRP injections had no effect on acute hamstring injury, while rehabilitation exercises showed a significantly reduced time to return to play 6
Other Treatment Options
- A systematic review published in 2021 evaluated surgical and non-surgical interventions for proximal hamstring tendinopathy and found that shockwave therapy was more effective than a multi-modal intervention in improving symptoms and physical function in the long-term 5
- The same review found that surgery resulted in a large reduction in symptoms and physical function in the long-term, but there was insufficient evidence to recommend any one intervention over another 5