Simple Hamstring Injury: 5 Top Tips

1. During the first 5-7 days the body’s natural inflammatory processes are hard at work and it’s important to optimise this, with gentle range of motion up to pain, not through it, we want to avoid NSAIDs as they can impede this process, we can use compression to help encourage the migration of damaged cells and waste products to the lymph nodes and cold therapy to provide relief from pain.

2. When we can walk pain free we can start loading the hamstring with gentle strengthening exercises that are pain free. Once you have a little more confidence in the structure, we can go for a gentle jog, this should be guided by pain - in order for us to complete this it should be around 12-15 minutes around 2 km and should be pain free and usually happens around 7-10 days after the injury.

3. When we can jog pain free, we need to consider running at higher speeds, including acceleration, maintenance and deceleration. This should be done gradually starting off with a long slow acceleration, a moderate maintenance phase and a long slow deceleration phase. These phases can be split over 100m with 20m being used for the maintenance distance (so lots of distance for the acceleration and deceleration) and should be guided by pain and discomfort. Rule of thumb, you can’t increase the rate of acceleration or pace until you’re pain free on your current level of effort.

4. Once you have some good foundations doing the acceleration, maintenance and deceleration running, you should begin to reduce the acceleration and deceleration distances and repeat the process until you’re around 10m acceleration and deceleration. If you feel any pain or tightening of the muscle that’s your limit for the day.

5. Once you’re confidently doing maximal acceleration and deceleration again over 10m distances, you need to consider change of direction drills, conditioning the hamstring to fatigue and taking part in some specific performance related activities to you and your sport/level of performance. 

Generally speaking the acceleration sessions should be no more than 6-10 sets of 6 repetitions at each session, effort levels are subjective to the individual so you’re relying on being honest about the effort you can put in while remaining pain free. Runs can be performed every other day, or if you are in a high level environment everyday if there are no reactions to the previous day's efforts. During the running conditioning you should be performing guided exercises to help strengthen the hamstring muscles and ideally reduce the risk of further injury.

As always this is a general guide and should not be taken above a healthcare practitioner's advice that knows you and your injury. It’s based on a simple mild strain of the hamstring muscle for instance where no bruising appears and is not associated with lower back pain.