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E-Young Khoo

Managing a Grade 3 Hamstring Tear with Physiotherapy

A Grade 3 hamstring tear, characterised by a complete rupture of the muscle fibres, presents a significant challenge in terms of rehabilitation and recovery. Whether incurred during sports activities, exercise, or daily movements, effective management is essential to optimise healing, restore function, and prevent long-term complications. In this comprehensive guide, we'll explore the principles of physiotherapy for managing a Grade 3 hamstring tear, empowering individuals to navigate their recovery journey with resilience and determination.


Understanding Grade 3 Hamstring Tears: Grade 3 hamstring tears involve a complete rupture of the muscle fibres, typically resulting in severe pain, swelling, bruising, and significant loss of function. Common causes include sudden acceleration, deceleration, or overstretching of the hamstring muscles, often during explosive movements such as sprinting or jumping. While Grade 3 tears may require surgical intervention in some cases, comprehensive physiotherapy plays a crucial role in optimising outcomes, restoring strength, and facilitating functional recovery.


Effective Physiotherapy Management Strategies:

  1. Early Intervention and Assessment: Immediate evaluation by a physiotherapist or healthcare professional is critical for accurately diagnosing a Grade 3 hamstring tear and determining the most appropriate course of treatment. A thorough assessment may include clinical examination, diagnostic imaging (such as MRI), and functional testing to assess the extent of muscle damage, identify associated injuries, and establish baseline measures for monitoring progress.

  2. Protection and Immobilization: In the acute phase of injury, immobilisation and protection of the injured leg are essential to prevent further damage and facilitate tissue healing. Use crutches or a knee immobiliser to offload weight from the injured leg and minimise stress on the healing tissues. Avoid activities that exacerbate pain or strain on the hamstring muscles, such as weight-bearing or active movement, until cleared by a healthcare professional.

  3. Pain Management and Inflammation Control: Employ a combination of pain-relieving modalities, such as ice therapy, compression, and elevation, to alleviate pain, reduce swelling, and promote tissue healing. Apply ice packs to the affected area for 15-20 minutes every 2-3 hours, use compression bandages or wraps to minimise swelling, and elevate the injured leg above heart level whenever possible to facilitate drainage of excess fluid.

  4. Gradual Rehabilitation and Progressive Loading: As pain and swelling subside, initiate a structured rehabilitation program focused on restoring strength, flexibility, and functional movement patterns. Begin with a gentle range of motion exercises, such as passive stretching and active-assisted movements, to improve flexibility and prevent stiffness in the hamstring muscles. Progress to progressive loading exercises, such as eccentric and concentric strengthening, to rebuild muscle strength and endurance gradually.

  5. Strengthening Exercises: Incorporate targeted strengthening exercises to rebuild muscle strength and stability in the hamstring muscles. Focus on eccentric exercises, such as Nordic hamstring curls and single-leg deadlifts, to eccentrically load the muscle fibres and promote tissue remodelling. Gradually introduce concentric exercises, such as hamstring curls and bridging variations, to improve dynamic strength and functional capacity.

  6. Stretching and Flexibility: Implement regular stretching exercises to improve flexibility, reduce muscle tightness, and prevent scar tissue formation in the hamstring muscles. Perform static stretches targeting the hamstrings, quadriceps, and hip flexors, holding each stretch for 20-30 seconds and repeating several times. Incorporate dynamic stretching and mobility drills to enhance range of motion and prepare the muscles for functional activities and sports-specific movements.

  7. Core and Hip Stability Training: Address any underlying muscle imbalances or weaknesses that may predispose to hamstring injury by incorporating core and hip stability exercises into the rehabilitation program. Strengthening the core muscles, glutes, and hip abductors can improve pelvic stability, reduce excessive strain on the hamstrings, and enhance overall lower limb biomechanics. Examples include plank variations, side-lying leg lifts, and clamshell exercises.

  8. Functional Rehabilitation and Return to Activity: Progressively integrate functional rehabilitation exercises that mimic real-life movements and activities to prepare for a safe return to sport or activity. Emphasise exercises that challenge balance, coordination, and proprioception, such as single-leg squats, lateral lunges, and agility drills. Gradually increase the intensity, duration, and complexity of activities while monitoring for any signs of pain or instability.


Managing a Grade 3 hamstring tear with physiotherapy requires a comprehensive and individualised approach tailored to the specific needs and circumstances of each individual. By following these principles and incorporating targeted rehabilitation strategies, individuals can optimise healing, restore function, and reduce the risk of recurrent injury. However, it's essential to work closely with a qualified physiotherapist or healthcare professional throughout the recovery process to ensure safe and effective progression. With dedication, patience, and perseverance, individuals can overcome a Grade 3 hamstring tear and return to their desired level of activity with confidence and resilience.


At Urban Physiotherapy, our dedicated team is experienced in managing severe injuries like Grade 3 hamstring tears. Contact us today to discover how our personalised treatment plans can support your journey back to full health.

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