What is happening in your hamstring when new pain arrives and what helps
Nicola Tik
Pain at the back of the thigh that has come on recently can feel uncomfortable and, depending on where it sits, a little uncertain. The hamstring is a muscle group that is involved in so much of everyday movement that even walking to another room can make you aware of it. Most new hamstring pain is the body responding to irritation or increased demand in the area rather than anything serious, and it tends to settle well with the right approach in the first few days. This article explains what is likely going on and what you can do to help things ease.
The hamstrings are a group of three muscles running along the back of the thigh, from the sitting bone at the base of the pelvis down to just below the knee. These muscles work together to bend the knee, extend the hip, and control the leg as it swings forward during walking and running. They are also responsible for decelerating the leg, absorbing force as the foot comes back down to the ground, which is part of why they are susceptible to becoming painful when demand increases or changes.
Pain can show up in different parts of the hamstring depending on which area is most irritated. Some people feel it high up near the sitting bone, which is where the tendon attaches to the pelvis. Others notice it in the middle of the back of the thigh, which is more typical of irritation in the muscle belly itself. Some feel it lower down towards the back of the knee, where the tendons attach again. All of these are common patterns and each tends to respond well to the same early principles of relative rest and gentle movement.
Reducing activities that place the most demand through the hamstring is a sensible first step. This means avoiding anything that requires the muscle to work forcefully or stretch significantly, such as running, lunging, or any activity that causes a sharp increase in pain. Short, gentle walks at a comfortable pace are generally fine and more helpful than staying completely still.
Applying something cool to the area, such as a cold pack wrapped in a cloth, for 10 to 15 minutes at a time can help ease discomfort and reduce any localised swelling in the early days. Once the initial sensitivity begins to settle, warmth can be equally helpful for easing muscle tension.
Avoiding positions that place a sustained stretch on the hamstring is worth paying attention to in the early days. Sitting with the leg fully extended, reaching down to touch the toes, or sitting on a low surface that tips the pelvis forward and stretches the muscle can all keep the area irritated while it is trying to settle.
If over-the-counter pain relief is appropriate for you, taking it as directed for the first day or two can help keep discomfort manageable. A pharmacist can advise on the best option.
Lying on your back with both knees bent and feet flat on the floor, slowly slide one heel away from you until the leg is roughly half straightened, hold for three to five seconds, then slide it back. Repeat eight to ten times on each side, keeping the movement slow and within a comfortable range. This keeps the hamstring gently moving without placing significant load or stretch through it.
If you would like a guided stretch to support you through this, VIDA has a short video you can follow at your own pace.
How you sit can make a meaningful difference when the hamstring is sore. A firm seat at roughly knee height tends to feel more comfortable than a low seat, which tips the pelvis forward and places more stretch on the back of the thigh. Sitting with a small roll or cushion under the thigh rather than directly on the sitting bone can also help reduce pressure on the upper hamstring attachment, which is particularly useful if pain is concentrated high up near the sitting bone.
Avoid sitting for long, unbroken periods. Getting up and moving gently every 30 to 45 minutes prevents the hamstring from stiffening in a sustained position and tends to make the first steps afterwards feel considerably easier.
Most new hamstring pain begins to ease within a week or two with some simple adjustments. If pain is concentrated very high up near the sitting bone and came on during a forceful movement such as sprinting or a sudden lunge, it is worth speaking to a physiotherapist to make sure the tendon attachment has not been more significantly affected.