Hamstring Injury: Symptoms, Recovery Time, Rehab and When to See a Physio

A sudden sharp pain at the back of the thigh during sprinting, football or a fast change of direction may be a hamstring injury. Mild strains can settle quickly, while larger tears may take weeks or months. Early protection followed by graded movement and strengthening can help you recover without rushing the return to sport.

What is a hamstring injury?

The hamstrings are a group of muscles running down the back of the thigh. They help bend the knee, extend the hip and control the leg during running. An injury occurs when muscle fibres or their tendon are overloaded and damaged.

Hamstring injuries are often described as strains or tears. The amount of tissue involved varies considerably, from a mild strain to a complete rupture. A grade alone does not determine your exact recovery time: the location of the injury, previous injuries, sport, strength and day-to-day demands all matter.

Common symptoms of a hamstring strain

The NHS lists the following typical features:

• a sudden sharp pain in the back of the thigh during exercise or sport;
• a snapping sensation or audible pop in a more severe injury;
• tenderness at the back of the thigh;
• swelling or bruising that may appear over the next few hours;
• difficulty standing, walking or using the affected leg.

Not every pain at the back of the thigh comes from the hamstring. Symptoms can also be referred from the lower back or a nerve, and pain near the sitting bone or behind the knee may require a more specific assessment.

What should you do in the first 48 to 72 hours?

For the first two to three days, NHS guidance recommends PRICE:

• Protection: stop the activity and protect the leg from further strain.
• Rest: avoid movements that reproduce sharp pain and reduce weight-bearing if walking is difficult.
• Ice: apply a wrapped ice pack for up to 20 minutes every two to three hours. Never put ice directly on the skin.
• Compression: use a tubular or elastic bandage that feels snug, not tight, and remove it before sleep.
• Elevation: raise the leg on pillows when practical.

The NHS also advises avoiding heat, massage and alcohol during the first three days because they may increase swelling. Ask a pharmacist about suitable pain relief if needed, particularly if you take other medicines or have another health condition.

When should you start moving?

Complete rest for too long can allow the leg to become stiff and weak. When pain no longer stops you, begin gentle movement and short bouts of comfortable walking. The aim is to restore normal movement gradually without repeatedly provoking sharp pain.

Do not aggressively stretch a newly injured hamstring. Early stretching should feel gentle; forcing range can irritate healing tissue. A physiotherapist can help decide when to progress from basic movement to strengthening and faster activity.

Hamstring rehabilitation: a staged approach

The exercises below describe common stages, not a universal prescription. Start at a level that matches your symptoms and progress according to function.

Stage 1: comfortable movement and muscle activation

• gentle knee bending and straightening within a comfortable range;
• short walks without forcing a pronounced limp;
• low-effort heel presses or hamstring isometric holds;
• bridges using both legs if they can be performed comfortably.

A small amount of discomfort may be acceptable, but sharp pain, increasing bruising or a marked next-day flare means the dose was too high.

Stage 2: rebuild strength

• progressive bridge variations;
• controlled hamstring curls;
• hip-hinge exercises with a light load;
• gradual strengthening through a larger range of movement.

Increase one variable at a time: repetitions, resistance, range or frequency. Hamstrings need to regain strength at both shorter and longer muscle lengths before high-speed running.

Stage 3: prepare for running and sport

• single-leg strength and control exercises;
• more demanding hip-hinge and hamstring-loading exercises;
• jog–walk intervals, then continuous running;
• progressive acceleration, deceleration and direction changes;
• sport-specific drills before full training or competition.

Return to sport should be based on function rather than a date alone. Useful milestones include pain-free normal walking, near-full movement, good strength compared with the other leg, comfortable faster running and the ability to complete sport-specific drills without pain or loss of confidence.

How long does a hamstring injury take to heal?

The NHS says mild hamstring injuries may improve within a few days. More severe injuries can take weeks or months, and a complete tear may need specialist treatment or surgery followed by several months of recovery.

Feeling better during everyday walking does not automatically mean the hamstring is ready for sprinting. High-speed running places much greater demand on the tissue. Recovery should therefore include a graded exposure to speed, not an abrupt jump from rest to competition.

Setbacks can happen. If symptoms rise after a new exercise, reduce the next session rather than abandoning rehabilitation completely. The overall pattern should be improving: less pain, easier movement, better strength and greater tolerance of activity.

How can physiotherapy help?

A physiotherapist can review the mechanism of injury, bruising, walking pattern, movement and strength, and screen for other causes of posterior thigh pain. Treatment may include:

• advice on early protection and activity modification;
• a progressive home exercise plan;
• strength testing and load progression;
• a structured return-to-running programme;
• sport-specific rehabilitation and recurrence-risk management;
• referral for medical assessment or imaging when a major tear is suspected.

NICE recommends that rehabilitation after traumatic injury is tailored to individual needs and goals, with exercise dosage based on clinical judgement. This matters because the demands of an office worker, distance runner and footballer are different.

When should you seek medical advice?

Contact NHS 111 if the pain is severe or worsening, bruising or swelling is extensive, it hurts to stand or walk, the leg is very stiff, or the injury is not improving with self-care. A high temperature with hot-and-cold shivering also needs urgent advice because it may indicate infection.

Arrange an assessment if you heard a pop, cannot use the leg normally, feel a gap in the muscle, have rapidly spreading bruising, or have had repeated hamstring injuries. These features do not prove a complete tear, but they justify a closer examination.

Can you prevent another hamstring injury?

No programme removes all risk, but recurrence may be reduced by rebuilding strength fully and returning to speed gradually. The NHS also advises increasing fitness progressively, warming up before exercise, stopping if hamstring pain develops and avoiding hard training when the muscles are very tired.

If running is also provoking knee symptoms, our guide to knee pain after running may help. For an injury caused by rolling the ankle, see our guide to sprained ankle recovery and exercises.

Sources

• NHS: Hamstring injury (accessed 5 October 2026).
• NICE NG211: Rehabilitation after traumatic injury (accessed 5 October 2026).

This article provides general information and does not replace an individual medical assessment.