If you haven’t injured a hamstring from running, it’s only a matter of time, so at least get ahead of the game and know how to prevent these and how to treat this injury should you fall victim to it.

I injured my hamstring from running; my hamstring injury is healed. So here is my article on treatment options for hamstring injuries as they apply to runners.

A hamstring injury from running is almost always caused by rapid deceleration: quickly transitioning from a fast run to a walk, or stopping the sprint dead in its tracks especially.

“The hamstring muscle-tendon unit crosses both the hip joint and the knee joint, making it especially susceptible to injury,” says John-Paul H. Rue, MD, orthopedic sports medicine surgeon with Orthopedics and Joint Replacement at Mercy Medical Center in Baltimore, MD

“They generally occur during sprinting or jumping. The muscle is injured during the late swing phase when they are firing to slow knee extension.

“The muscle fires at the same time as it is elongating, or lengthening, termed an eccentric contraction, which makes the muscle highly susceptible to injury.”

If you love to run, you’ll have to settle for the elliptical machine, stationary bike, revolving staircase or stepping routines if you’ve suffered a hamstring injury from running.


As aggravating as the hamstring injury’s discomfort may be, even if it’s triggered by just a 6 mph run, you may actually be able to perform other forms of cardio at your highest level, if your hamstring injury is first-degree.

A first-degree hamstring injury involves microscopic muscle tears.

There is no “bruising” visible with a first-degree hamstring injury, and sports participation is possible, though will be accompanied by pain (depending on the sport).

A second-degree strain, though not literally a tear of the muscle-tendon junction, would likely be painful enough to necessitate medical attention.

A second-degree injury will have present some black and blue, caused by local bleeding under the skin.

Pedaling the elliptical trainer or stationary bike, and stepping on the revolving staircase or on stepper platforms, do not require enough hip extension to aggravate a mild or first-degree hamstring injury.

However, running will aggravate it. Figure out which speed starts bringing on that distinct pain. If you have a hamstring injury, never try to “work through” the pain by running!

Toughing out a hamstring injury does not work. Continuing to run with a hamstring injury will prevent healing and may worsen the injury.

There are four phases to treating a hamstring injury for runners.

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First, reduce the pain and inflammation. Second, restore range of motion plus flexibility.

Next, restore muscle function. Finally, engage in exercises, leading up to returning to running.

Most likely, you will need some degree of medical intervention. In my case, it was a massage therapist.

I had tried all sorts of self-treatments: stretching; calisthenics; quitting running altogether; continuing to run but less frequently; continuing to run as frequently but not as fast; and self-massage (which is essentially impossible and impractical, being that within minutes, my fingers and wrists were fatigued).

I always intuitively knew that professional massage treatment would heal my hamstring injury, but kept putting it off because it’s so expensive.

My medical insurance plan deductible, at the time, was $2,000, so seeing a doctor and getting rehab through my medical plan was not an option, as I’d have to pay out of pocket for it anyways; and besides, I continued believing that deep tissue massage for my running-related hamstring injury was the answer.

If your medical plan covers physical rehab by a therapist specializing in hamstring injuries, then this is strongly advisable.

A physical therapist trained in sports injuries can monitor progress with special tests.

Do not stretch the injured muscles right away, as this will aggravate the damaged muscle fibers.

It will probably hurt quite a bit, anyways. A physical therapist can direct you when to resume stretching the muscles.

This stretching is for rehab, not for increasing flexibility.

Tight hamstrings are not associated with increased risk of hamstring injury, but tight quadriceps are.

Ice and heat. An acute (sudden onset) hamstring injury warrants ice application, to manage the inflammatory process. But as healing begins, heat can be applied.

Apply ice as long as there is pain, and especially swelling. As pain diminishes and swelling disappears, apply heat.

This may not work for everyone; it didn’t work for me. Ice application to the hams is impractical, though sitting on a hot water bottle was more doable.

But ice and heat don’t penetrate more than 1 centimeter. A physical rehab therapist may use ultrasound or infrared laser to penetrate deeper.

After more than two years of experiencing pain from my hamstring injury (even though it wasn’t severe enough to prevent me from sprinting; but dang, the pain was a nuisance and made me eventually realize that something was wrong and I needed intervention), I finally decided to invest in a massage therapist  — again.

The first therapist was about 16-18 months after the injury, and she was worthless.

The second therapist was about 26-28 months after the injury, and within three weeks, there was an improvement I had never before experienced.

I was seeing her three times a week for 30-minute sessions.

I insisted that she work ONLY the hamstring glute tie-in plus the hamstring “belly,” with emphasis on the tie-in.

Over several months, the hamstring injury finally began healing beautifully; pain tests came up negative; I was able to run increasingly faster without pain; and was able to do other things without that distinct pain in the hamstring-glute junction.

I reduced the treatment sessions to twice-weekly, and finally to once a week.

Final Thoughts

“Hamstring strains pose a challenge because they are common and typically heal slowly and cause persistent pain and weakness and have a high chance of recurring,” says Dr. Rue.

“Treatment consists of rehabilitation, focused on pain control, stretching and return to sport when pain-free.”

Dr. Rue specializes in prevention and treatment of sports and exercise injuries. His primary focuses are knee, shoulder and elbow injuries including ACL and cartilage injuries, rotator cuff injuries and overuse tendonitis.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
Top image:  Shutterstock/Albina Glisic