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Hamstring pain/strains are one of the most common injuries caused in sports. Hamstring strains occur frequently in activities that require a high degree of speed, power and agility such as soccer, rugby, tennis and running.

The hamstring consists of three large muscles, which are located on the back of the thigh; the biceps femoris is located laterally and the semimembranosus and semitendinosus are located medially. These muscles start at the lower part of the pelvis on our sitting bone and attach below the knee joint to the tibia and fibula. The hamstring muscle has two actions as it crosses two joints; they help to extend the hip and bend/flex the knee.

What can cause a hamstring strain?

During contraction of the hamstring, tension is placed through the muscle. If this tension is to excessive due to too many repetition or high force, one or more of the hamstring muscles can tear – causing immense hamstring pain. This commonly occurs during the final part of swing phase as the hamstring reaches its maximal length acting eccentrically (lengthen while contracting) to decelerate the hip and knee in preparation for heel strike.

Hamstring Strain Classification

Hamstring strains can be classified into grades 1, 2 or 3 depending on the severity of the injury.

  • Grade 1: is the least severe. It is the result of some minor stretching of the muscles and tendons. It is accompanied by mild pain and some swelling and stiffness. There is usually very little loss of function.
  • Grade 2: is considered a moderate strain and is the result of both stretching and some tearing of the muscles and tendons. There is increased swelling, bruising and pain associated and a moderate loss of function.
  • Grade 3: is the most severe strain. It is the result of a complete tear or rupture of one or more of the muscles and tendons. A grade 3 strain will result in a large amount of swelling and bruising, severe pain and significant loss of function.

Risk factors

The single biggest risk factor for hamstring strain is having a history of a previous injury, other risk factors include:

Modifiable risk factors

  • Shortened hamstring length
  • Lack of hamstring flexibility
  • Strengthen imbalance
  • Insufficient warm-up
  • Fatigue
  • Lower back injury
  • Poor lumbar posture
  • Increased muscle neural tension
  • Pelvic instability

Non-modifiable risk factors

  • Previous injury
  • Age
  • Muscle composition
  • Race


At The Physicaltherapy Centre we use a range of modalities when treating hamstring pain/strains, these include soft tissue work (massage, Active Release Technique etc.), dry needling, mobilisation/manipulation and an individualised rehabilitation program.

Whether you are a weekend warrior or an elite athlete, our team of skilled chiropractors can help to diagnose and treat you hamstring injury and help to get you back on the road to recovery.