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Muscle and tendon behind the thigh
The hamstrings mainly connect the pelvis to the lower leg. They bend the knee, extend the hip and slow the leg during running.
An injury can affect muscle fibres or the muscle–tendon junction. A tendon detached from bone is a different problem.
Chapter sources [1]
Understand the picture
From pelvis to knee
Upper attachment
The tendons attach near the bone you sit on.
Muscles
They generate and control force during running.
Lower attachments
The tendons join the lower leg near the knee.
Chapter sources [1]
How an injury may feel
A sudden sharp pain, sometimes with a popping sensation, may force you to stop. Walking, bending forwards or bending the knee may become difficult.
Bruising may appear later. Its absence does not exclude injury, and its size alone does not establish severity.
Sprinting, stretching and previous injury
Acceleration or combined hip bending and knee straightening can strongly load the tissues. A previous hamstring injury increases recurrence risk.
Fatigue, preparation and sporting demands all matter. A single “tight muscle” does not explain every injury.
Chapter sources [4]
When to seek prompt assessment
High pain under the buttock after an accident, extensive bruising or marked weakness needs prompt assessment. A tendon avulsion may need timely specialist care.
Rapidly worsening severe pain, a cold leg or sensory changes requires urgent help. Do not force a stretch to check.
Examination and imaging
Assessment considers the injury mechanism, walking, movement and strength, including possible tendon injury or pain coming from the back.
Imaging may clarify a significant or uncertain injury. A scan alone cannot provide a reliable date for returning to sport.
The first days
Stop the triggering activity and protect the leg from sudden effort. Walking support may be needed if you limp heavily.
Prolonged complete rest is not the aim. Resume permitted movements without seeking pain and ask about suitable support or pain relief.
Chapter sources [2]
What rehabilitation develops
The programme gradually restores contraction, strength and pelvic control. Eccentric work means controlling a muscle as it lengthens.
The dose follows your response. Demanding exercises such as Nordics are not a universal first test after a tear.
In everyday life
A footballer who can already walk comfortably
Everyday activity
Comfortable walking is an initial step.
Gradual training
Rebuild strength and acceleration.
Match demands
Repeated sprints and direction changes need preparation too.
Adjusting your day
Shorter steps and divided journeys may ease walking. A different seat may reduce pressure under the buttock.
Compare the same task over time. A demanding working day contributes to total load, even without a sports session.
Chapter sources [5]
Returning to speed and sport
Easy running progresses towards acceleration, braking and specific skills. Your physiotherapist helps assess strength, tolerance and confidence.
Do not jump directly from comfortable jogging to a match. The response afterwards and the next morning also matters.
Chapter sources [4]
How long does recovery take?
A small injury may progress over weeks; a substantial injury may take months. Location and return demands affect the timetable.
If function stalls or pain increases, review the plan. A setback is not a reason simply to repeat the same exercises harder.
Chapter sources [5]
Your questions
Can bruising tell me the severity?
No. Symptoms, function and sometimes imaging must be considered together. Bruising alone cannot grade a tear.
Chapter sources [5]
Is pain under the buttock always tendinopathy?
No. After an accident it may involve an acute tendon injury. Gradual pain requires a different assessment.
Chapter sources [1]
Should I stretch immediately?
Avoid strong stretching of a fresh injury. Restore movement according to tolerance and the instructions you receive.
Chapter sources [2]
When can I play again?
After gradually rebuilding and assessing the demands of your sport, including speed and repeated efforts. There is no date that suits everyone.
Chapter sources [4]
Sources and references
- [1] AAOS OrthoInfo: Muscle Strains in the Thigh
- [2] NHS — Hamstring injury
- [3] Assurance Maladie: Comprendre la déchirure musculaire
- [4] JOSPT/APTA: Hamstring Strain Injury in Athletes (2022)
- [5] IQWiG: Muskelzerrung und Muskelfaserriss
- [6] Assurance Maladie: Déchirure musculaire, bons réflexes et consultation
- [7] IQWiG: Übungen nach einer Muskelverletzung am Bein
- [8] NHS: DVT (deep vein thrombosis)
- [9] NHS: Compartment syndrome
- [10] CGDIS: Appeler le 112
Text updated on
Medical review: awaiting Hasib Selimovic.