Small fascial tear present with a gradual onset of symptoms and may resolve in 7-11 days with minimal treatment input.
A more severe grade 1-2 hamstring strain where there is structural damage to the contractile proteins within the muscle usually presents with some degree of bruising and limited range of motion and take on average 21 days to resolve.
A more significant injury – classified as grade 2+ present with a sudden onset such as feeling a bang in the back of the leg and being unable to carry on playing the sport. There will significant bruising and this type of injury will take 40 days or more to resolve. The greater the difference in SLR between injured and non-injured side can predict the length of time in rehab.
If you have sustained hamstring injury use these time lines to manage your injury or seek the help of a physiotherapist in your area.
0 – 5 days inflammatory phase
Rest, Ice, Compression, Elevation (RICE). However there is no consensus from findings on duration and frequency of RICE. Commence active range of movement exercises and isometric hamstring exercises. Some un-weighted eccentrics may be able to be performed if there is minimal pain. Core stability exercises can also start and there may be some benefit to early gentle stretching.
5 – 21/7 Fibroblastic phase
In this stage strengthening can begin such as using prone hamstring curls, unloaded eccentrics, theraband exercises, bridging, progressive core exercises and neural glides exercises such as slumps and straight leg raises. Soft tissue work such as transverse and longitudinal mobilisation can begin.
21/7+ Remodelling phase
Theraband eccentrics, lunges, squats, stretching and dynamic flexibility should all be done in this phase. There is huge variability in reps, sets, TUT, rest periods, intensity and goals of training programme. Running can also be instigated at this stage.