From the Guidelines
Hamstring strains should be treated with the RICE protocol, focusing on rest, ice application, compression, and elevation, as this approach has been shown to decrease pain and swelling in the acute phase, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Key Components of Treatment
- Rest the injured area to avoid worsening the injury
- Apply ice for 20 to 30 minutes, 3 to 4 times daily, using a bag filled with ice and water surrounded by a damp cloth to achieve the greatest tissue cooling, as suggested by the 2024 guidelines 1
- Use compression with an elastic bandage and elevate the leg when possible to reduce swelling
Pain Management
- Over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours with food) or acetaminophen (500-1000mg every 6 hours) can be used to manage pain and reduce inflammation, although the optimal duration and dosage may vary depending on the individual case
Rehabilitation and Prevention
- Begin gentle stretching once acute pain subsides, followed by progressive strengthening exercises like hamstring curls and bridges to promote healing and prevent recurrence
- Return to sports activities gradually, starting at about 50% intensity and increasing slowly to avoid reinjury, as hamstrings are particularly vulnerable during the healing process
- Proper warm-up, regular stretching, and strengthening exercises can help prevent recurrence, as emphasized in the context of tendon health and rehabilitation 1
From the Research
Hamstring Strain Overview
- Hamstring injuries are one of the most common types of injuries affecting athletes, particularly those involved in sports that require sprinting and jumping 2.
- The optimal management of hamstring muscle injuries is not yet defined, and the effect of various treatments, such as platelet-rich plasma (PRP) therapy, on recovery is still being researched 3, 4.
Treatment Options
- Nonoperative measures, such as activity modification and physical therapy, can be effective in managing hamstring injuries, with adjuncts like PRP injections being investigated 5.
- Operative treatment, including endoscopic or open approaches, is typically reserved for severe cases, such as 2-tendon injuries with significant retraction or 3-tendon injuries 5.
- PRP injections have shown promise in reducing time to return to play and pain severity, but the evidence is not yet conclusive, with some studies finding no significant difference compared to control groups 3, 4, 6.
Rehabilitation and Prevention
- Rehabilitation programs for hamstring strains often involve a combination of exercises, including lengthening exercises, which have been shown to reduce time to return to play 6.
- Progressive agility and trunk stability training may also help reduce re-injury rates, although the evidence is limited 6.
- Prevention of hamstring strains is an area that requires further research, with few evidence-based studies available 2.