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  • Writer's pictureLionel Pannunzio PT / SCS

Hamstrings Injuries? this is how it feels... | Weston | Florida

Updated: Apr 3, 2019


Hamstring injuries are one of the most challenging injuries to treat as a Physical Therapy due to the high rate of re-injury. Over the years, the medical field has tried to accelerate the recovery, and even though good progress has been made we are not quite there yet: hamstring injury number remain high in the soccer population.

Learn about the Types of HSI and the common symptoms of this condition.

The most infamous Hamstring Injury

If you ask me, when people talk about hamstring Injuries my mind always goes to this picture above.

I don't know if any of you can remember the 2014 UEFA Champions' Final in Lisbon where Diego Costa was substituted in the 9th minute of such an important game.

On the weeks previous to the final Diego Costa reinjured a previous Hamstring injury and his participation in the Final was questionable. He only had two weeks or so to recover and he relied on a controversial treatment using Horse Placenta to expedite the healing time. It looks like Costa demonstrated in practice he was ok to play and convinced Simeone ( his coach ) of that but We all now know the result.

It took only Nine minutes for a recurrent Hamstring Injury to sideline this exquisite player and bury Athletico's chances to win the final.

Let me elaborate on this, Simeone had to burn a substitution in only 9 minutes of play. Athletico and Real Madrid went to overtime in that final after a draw 1-1 in regular time. Juanfran got injured in overtime (ankle sprain ) as well but Simeone had exhausted all the subs ( he had to use one to replace Costa very early in the game ) and Juanfran had to continue playing injured in his ankle. The 2-1 for Real Madrid came from a long run from Dimaria against an injured Juanfran who could not stop Dimaria.

I know, I'm being very dramatic here but go get the point: Hamstrings injuries are one of the most difficult injuries to recover from and can be lingering if you don't treat them properly

Types of HSI

We have four hamstring muscles: semimembranosus and semitendinosus (medially) and biceps femoris - short and long heads (laterally).

As most of the Muscle Injuries, Hamstrings Strain Injuries (HSI) are graded 1, 2 or 3 depending on severity.

Ultrasound scan and MRI are able to identify the location and extent of your hamstring tear but usually the physical exam can reveal what time of muscle injury you have and accurately determine the best treatment options.

On examination, we as Physical Therapist will look for signs of pain on hamstring contraction, reduced hamstring flexibility, tenderness or a palpable lump or gap within the hamstring muscle bulk.

Grade 1 Hamstring Strain

With a grade 1 , the mildest of the hamstring strain, you may have tightness in the back of the thigh but will be able to walk normally. You will be aware of some hamstring discomfort and unable to run at full speed. There will be mild swelling and spasm. Bending your knee against resistance is unlikely to reproduce much pain but stretching or eccentric contraction most like will reproduce your pain

Grade 2 Hamstring Strain

With a grade 2 hamstring strain, you will have to stop playing because of the pain, and you will have problems walking and you will most likely be limping. Almost any activity will be painful. You may notice some hamstring muscle swelling and your hamstring will be tender to palpate. It will also be painful for you to bend your knee against resistance. Still with these Grade 2 strains a simple Xray is usually enough to rule out an avulsion. Expensive MRIs are not necessary in my experience for this type of Hamstring Strain

Grade 3 Hamstring Strain

A grade 3 hamstring strain is a severe injury involving a tear to half or all of the hamstring muscle. A grade 3 injury is a serious condition and most likely you will not be able to leave the field on you own. You may need crutches to walk and will feel severe pain and weakness in the muscle. Swelling will be noticed immediately and bruising will usually appear within 24 hours.

Diagnostic MRI may also be used to specifically identify the grade of hamstring tear and its exact location.

What are the Symptoms of a Hamstring Strain?


  • Hamstring Injuries (HSI) are the second most common muscular injury in soccer players (quadriceps is #1)

  • Grade I injuries recover quick, while Grade II and III will take long time to recover and have an unfortunate high risk of re-injury and becoming chronic ( Proximal Hamstring Tendinopathy)

  • Most of these injuries does not require expensive MRIs or Test. The clinical examination by a professional specialized in HSI is usually enough to make the diagnosis and treatment

Do you want to find out more about what you can do to get better from your Hamstring Strain?

Click the link below to get access to our PDF E-Book

where you'll find valuable information about Muscle Injuries in general

and Hamstring Injuries in Particular


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