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Hamstring strains recur more than almost any other injury, and most repeats happen within two months of returning. Here's why, and what prevents it.
The first one is bad luck. The second one is a pattern.
Hamstring strains have one of the highest recurrence rates of any injury, and most of the repeats happen within the first two months of getting back. That isn't because hamstrings are fragile. It's because of what usually happens between the injury and the return.
A hamstring strain is a muscle asked to produce more force than it could handle at that moment, almost always at speed or during a sudden stretch. Sprinting, a long stride, a slide tackle, a change of direction.
The tissue heals over a few weeks. That part is reliable. What doesn't come back on its own is the strength to control that same force next time, particularly with the muscle lengthened, which is exactly the position it failed in.
Three reasons, and most people have more than one.
Pain settles well before capacity returns. A hamstring can feel completely normal walking around and still be significantly weaker than the other side. Going back at that point puts you into full sprinting with a deficit you can't feel.
Stretching feels productive and does very little for strength. Hamstrings need loading, and specifically eccentric loading, where the muscle is producing force while lengthening.
Most reinjuries happen late in a session or late in a game. A hamstring that copes fine when fresh can fail when tired, so testing on a fresh leg tells you less than you'd like.
Eccentric strength work. Nordic curls and their progressions have better evidence behind them than almost anything else in this area. They're uncomfortable and they work.
Strength at length. Exercises that load the hamstring in a lengthened position, like Romanian deadlifts and single leg variations, because that's the position injuries happen in.
Exposure to speed. You cannot prepare for sprinting without sprinting. Getting back to top speed gradually, under supervision, is part of rehab rather than something that comes after it.
Keeping it in the programme. The protection fades when you stop. Hamstring work needs to stay in through the season, not only in the weeks after an injury.
We work out how bad it is and what you're returning to, then work through the stages. Restore settles symptoms and gets movement back. Rebuild loads the hamstring properly, including eccentric work and strength at length. Resilience brings speed and sport specific demands back in.
There's a test between each stage, comparing sides and checking how you respond the following day. That's the difference between a return that holds and another six weeks out.
Book if you felt a sharp pull and you're limping, if you've strained the same hamstring before, or if it has been more than a fortnight and it's still tight when you try to stride out.
Head to urgent care instead if you heard or felt a pop with immediate severe pain and significant bruising, or if you can't walk on it.
Give us a call and we will talk you through what we think is best for your recovery.
Perhaps you've been here before. A long wait that went nowhere, or a sheet of exercises and no real plan. If you're unsure whether we're the right fit, you don't have to book anything to find out.
Tell us what's going on and we'll come back to you honestly and let you know how we can help.
