Running Hamstring Pain: Resolving Tightness and Hamstring Injuries

Tight hamstrings or the start of a running hamstring injury?It’s always a fine line to figure out when were going from normal running discomfort to the edge pushing things farther than we should and especially with our hamstrings, because many runners become quad dominant and this results in tight hamstrings.

Tight hamstrings are uncomfortable, so we start stretching and stretching and….well that doesn’t fix the issue, but it can lead us straight in to an injury!

Hamstring strains are unfortunately one of the most common running injuries. Even a low grade tear can leave a runner sidelined for weeks, even months.

If not dealt with properly, the frustrating injury can linger on and on. With the right care, gradual introduction back to running, and a proper warm up and strength routine, the hamstring can stay healthy for a long time.

Where is Your Hamstring?

Stay with me for a second as we go through the science, so that you know what you’re dealing with. The hamstring is made up of three different muscles located at the back of the thigh:

Semitendinosus
Semimembranosus
Biceps femoris

Unlike most other muscles in the body, the hamstring muscle group crosses two joints, the knee and the hip. This means it plays a crucial role in two key running movements: bending the knee and extending at the hips.

Within these movements, the hamstring has three roles:

Acting as a braking system by gradually slowing down the front leg as it nears the ground, especially during downhill efforts
Extending the hip to propel the body forward
Assisting the calf muscle to help bend the knee

All together, this makes the hamstring an essential component to the running stride.

What Causes Running Hamstring Pain?

Hamstring injuries typically occur after sudden bursts of speed during sports like soccer, sprinting, or football, when the muscle that attaches to the tendons is strained or torn. That’s why you often see a sprinter suddenly grab the back of their leg with a look of horror on their face!Source

Distance runners are more prone to what is called tendinopathy, or inflammation of the hamstring tendon. This results like most inflammation from some kind of weakness or overuse.

a runner introduces speed or hill workouts before they’re ready
when the quads are too tight, they pull the pelvis forward, which then tightens the hamstring
weak glutes means the hamstrings have to work even harder and that leads to overuse

Is it Ok to Run with Hamstring Pain?

Let’s decide if you have a strain, a little tightness or just a bad day! You’ll know you have a hamstring injury because they’re a pain in the ass. (but not the same pain in the ass as Piriformis Syndrome)

Literally.

Pain in the back of the thigh or lower butt is a telltale sign of a hamstring injury.

Other indications of a hamstring injury include:

Sudden and severe pain during exercise
A snapping or popping sound
Pain while walking
Bruising

Is it ok to run with hamstring pain?

Those with a low grade pain can try to continue running, but if the pain increases, then it’s time to stop.

Basically, if you can walk normally, but have pain in certain positions, go ahead and try an easy run to see how you feel afterward. If the injury is bad enough to alter your gait, then rest is in order.

The longer you run with hamstring tendinopathy, the worse it will get. If you can still continue running, put the speed workouts and hill repeats on hold for a bit. Other high intensity workouts are out, as well.

Recovery can take a long time, depending on the severity of the injury.

Don’t return to previous level of physical activity until you can:

Move your injured leg as well as your healthy one
You leg feels as strong as your healthy one
You feel zero pain when you graduate from walking, jogging, sprinting, and finally jumping over time.

If you start training before the injury is fully healed, you run the risk of prolonging the injury.

At Home Tests to See What Level You’re At

The “shoe test.” Take off the shoe of your injured leg using your healthy foot. If you feel pain when you pull up and out of your shoe, that’s a sign.
Extend your injured leg to a surface at hip height. Hinge at the hip to reach for your toes, as though you were stretching. If the pain exceeds beyond your normal stretching pain, then that’s your hamstring.
Press down on a surface with the heel of the injured leg. This could be done during the previous exercise, while sitting on the floor with both legs extended in front of you, or on a Swiss ball while doing hamstring curls. Pain in the back of the leg means hamstring injury.

Resolve Hamstring Tightness

Hamstring strains have a notoriously high re-injury rate due to improper rehabilitation process. Over 60% of runners that strain their hamstring will do so again within the first year.

Yikes.

Let’s make sure that doesn’t happen and more importantly let’s take care of those tight hamstrings right now with some of my favorite things…pre-hab!!

Hamstring Strength Training

The best way to stop injury before it starts is to add strength to your training plan. To mitigate hamstring injuries, focusing on our glutes, core, and hips will go a long way (feels like I say this about 99% of running injuries).

Luckily for you, I have a whole host of resources for you to get those glutes and hips into tip top shape, this will help to keep your pelvis in proper alignment and reduce hamstring tightness:

Dynamic Warm Ups

I know I sound like a broken record at this point. Skipping the warm up is easy, especially when you’re already waking up at the crack of dawn to get your run in before you have to dash off to work.

I get it.

But your warm up matters.

Taking the time to do a proper warm up transitions your body from rest to activity by stimulating blood flow to the muscles that will do the work. A glute activation warm up will keep you injury-free long term.

Which is worse: waking up 10 minutes earlier or being sidelined due to a totally preventable injury?

Treatment for Hamstring Injury

If you’re past the point of running with a tight hamstring and have moved on to a full blow injury, first up checkout these mental tips for recovery because that’s often the hardest part!

Next, it’s good to know many hamstring injuries can be managed at home, however severe cases should seek physical therapy to help with a more structured treatment plan dedicated to correcting the exact problem.

RICE

After digging deep into the research, I no longer recommend the traditional RICE method (rest, ice, compression, elevation). However, there are instances when components of RICE make sense.

If you felt the injury happen, apply ice immediately afterward for up to 72 hours. After that timeframe, switch to heat.

Compression

If you can tolerate easy running with the injury you have, then consider wearing a [compression wrap] on your thigh during or after your run. They work by helping to stabilize the muscle and support the quad and hamstring muscles.

Foam Rolling

Try rolling before and after your run to break down the connective tissue. If you can’t run at all, then daily rolling for 10-15 minutes will help increase oxygen flow to the area. Foam rolling the hamstrings is fairly straightforward. This post explains how to do so safely.

Rest

If running without pain is impossible, then you’ll have to rest. Take the opportunity to start doing [yoga ] like you’ve always wanted or switch to a cross training activity, like swimming or cycling, as long as it doesn’t cause pain.

Hamstring Recovery Exercises

Physical therapists recommend focusing on eccentric rather than concentric strengthening, which will result in hamstrings that are strong and can work in conjunction with the quad.

Eccentric exercises are those in which the muscle is in a lengthened state versus a shortened state. Lengthening the muscles helps realign them and also strengthens the tendons and ligaments, which decrease the risk of injury. Further, eccentric contractions result in increased mobility.

A progressive treatment plan is essential for full recovery from hamstring injuries. What this means is gradually adding targeted hamstring exercises that focus specifically on strengthening the core, hips, and glutes.

Here’s a great video from my friends at The Run Experience with some exercises:

Additionally, small loop resistance bands and a stability ball are great for recovery strength. They allow for resistance without straining the muscle from using too much weight before the hamstring is ready.

The exercise routines below use both tools and will help build the core, glute, hip, and hamstring power you need to get healthy again.