Hamstring Tears: What They Are, How They Happen, and How Physiotherapy Can Help

A hamstring tear is an injury to one or more of the muscles at the back of the thigh.

The hamstrings help bend the knee, extend the hip, control running stride, decelerate the leg, and absorb force during sprinting, jumping and change of direction.

In simple terms, a hamstring tear happens when the back thigh muscle is stretched or loaded beyond what it can tolerate.

In technical terms, a hamstring tear involves disruption of muscle fibres or the musculotendinous junction, commonly affecting the biceps femoris, semitendinosus or semimembranosus.

What is a hamstring tear?

A hamstring tear can range from a mild strain to a more significant muscle injury.

Hamstring tears are commonly described as:

Grade 1: Mild strain with small fibre disruption

Grade 2: Partial tear with pain, weakness and reduced function

Grade 3: Complete tear or rupture, usually with significant weakness and difficulty walking

The injury may occur higher near the glute, through the middle of the muscle, or closer to the back of the knee.

How do people tear their hamstring?

Hamstring tears commonly occur during high-speed running or sudden stretching under load.

Common causes include:

• Sprinting

• Accelerating quickly

• Sudden deceleration

• Kicking

• Overstriding while running

• Slipping or lunging forward

• Change of direction

• Fatigue during sport

• Returning to sport too quickly after a previous hamstring injury

Hamstring tears are commonly seen in sports such as soccer, rugby, AFL, sprinting, basketball, athletics and field sports involving repeated acceleration.

Common signs and symptoms of a hamstring tear

Symptoms depend on the severity of the injury.

Common signs and symptoms include:

• Sudden pain at the back of the thigh

• A sharp pulling or tearing sensation

• Pain running, sprinting or kicking

• Pain bending forward or stretching the hamstring

• Tenderness over the injured area

• Bruising or swelling

• Weakness when bending the knee

• Difficulty walking normally

• Reduced ability to accelerate or change direction

• A visible dent or gap in more severe injuries

Clinically, a hamstring tear may show pain with resisted knee flexion, pain with hamstring stretch testing, localised tenderness, bruising, reduced strength and altered running mechanics.

Physiotherapy treatment for hamstring tears

Physiotherapy treatment depends on the severity, location of the tear, sport demands and stage of healing.

Treatment usually focuses on:

• Reducing pain and protecting the injury early

• Restoring walking and hip/knee movement

• Gradually rebuilding hamstring strength

• Improving glute, calf and trunk strength

• Progressing running and sprint exposure

• Reintroducing change of direction and sport-specific drills

• Reducing the risk of re-injury

Early rehab usually avoids aggressive stretching and heavy sprinting. As symptoms improve, strengthening is progressed from gentle activation to eccentric loading, running drills, acceleration work and return-to-sport testing.

More severe tears, major bruising, significant weakness, or suspected tendon avulsion may require imaging or specialist review.

Differential diagnosis: what else could it be?

Not all back thigh pain is a hamstring tear. Other conditions can present with similar symptoms, including:

• Hamstring tendinopathy

• Sciatic nerve irritation

• Referred pain from the lumbar spine

• Adductor strain

• Gluteal muscle injury

• Calf injury

• Ischial bursitis

• Posterior hip impingement

• Muscle cramp

• Delayed onset muscle soreness

A proper physiotherapy assessment helps identify whether the hamstring is torn, how severe the injury is, and what rehabilitation is required.

When should you see a physiotherapist?

You should consider seeing a physiotherapist if you develop back thigh pain after sprinting, kicking, lunging, slipping, or changing direction.

Early assessment can help guide recovery, reduce re-injury risk and safely progress your return to running, gym or sport.

At Urban Physiotherapy, we assess the full picture, including injury mechanism, strength, flexibility, running mechanics, sport demands and return-to-performance goals.