(a) Grade 1 Hamstring Strain
When there is damage to a small number of muscle fibres – usually less than 5% of fibres this is a considered to be a mild hamstring strain.
- pain may be sudden onset pain or just tightness in the hamstring,
- the player might be able to play on,
- the area will become painful and tender later on,
- there will probably be no visible bruising or swelling,
- and the player will be able to walk around without limping.
This could take 2 to 3 weeks rest, however sometimes this is more like a micro-tear with minimal damage, and with good early management the player may return to sport after a week.
(b) Grade 2 Hamstring Strain
When there is more extensive damage, with a large number of muscle fibres involved, but the muscle is still in tact it is known as a grade 2 hamstring strain or hamstring tear.
In this case there will be
- sudden onset of pain while the player is in full stride, decelerating or sometimes twisting.
- The player will be unable to play on,
- a tender mass at the site of injury,
- may be bruising which may not appear until the following day, and may be lower than the area of pain.
- weakness in the muscle
- player may be limping.
- The rest period required is usually between 3 and 6 weeks. Good physiotherapy treatment and early management will reduce the recovery period.
(c) Grade 3 Hamstring Strain
When there is a complete rupture of a muscle it is referred to as a grade 3 hamstring tear. There will be a sudden severe onset of pain, and the player may not be able to walk off the pitch.
There will be
- severe pain in the muscle and severe pain
- Player clutches back of leg / often hops on other leg
- weakness on resistance
- may be a visible deformity in the muscle where the fibres have recoiled back into a lump
- will be swelling in the area and bruising will be extensive when it appears the following day.
In a sports person this may require surgery to repair the muscle if the fibres have severely recoiled. Even with good physiotherapy and management it may take 3 months to fully recover.
All muscle strains should be rested and allowed to heal. If the patient continues to play, the condition will worsen. If ignored, a grade one strain has the potential to become a grade two strain or even a complete rupture.
