Hamstring Strain: Recovery and Return to Sport
By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published November 2026
You were sprinting for a ball, running the last stretch of a race, or kicking hard at a soccer game in the park when you felt a sudden sharp pain in the back of your thigh. You pulled up and grabbed your leg. Now it hurts to walk fast, bend forward, or stretch, and you're wondering how long you'll be out.
Hamstring strains are among the most common injuries in running and field sports, and they have a reputation for coming back. This article explains what a hamstring strain is, how to tell how serious it is, what the APTA guideline says about rehab and prevention, how long recovery usually takes, and when to see a physician.
The short answer
A hamstring strain is an injury to the muscles at the back of the thigh, usually from sprinting or fast stretching. Typical signs are sudden pain in the back of the thigh during activity, pain when stretching or using the muscle, tenderness, and loss of function (Martin et al., 2022). The APTA hamstring guideline recommends a progressive program that includes eccentric strengthening, running progression, agility, and trunk stability to speed return to play and lower reinjury risk, and the Nordic hamstring exercise for prevention. A large bruise, a pop near the buttock, or a lot of weakness can mean a more serious tear that needs a physician. In California, you can see a physical therapist without a referral.
What is a hamstring strain?
The hamstrings are three muscles at the back of the thigh. They run from the sit bone at the bottom of the pelvis to just below the knee, and they bend the knee and help extend the hip. They work hardest during sprinting, especially at the end of each stride, when the muscle is lengthening while it's working.
Strains range from mild (grade I) to severe (grade III). Things linked with a higher chance of a hamstring strain include a previous hamstring strain, older age, and a past ACL injury or calf strain (Martin et al., 2022).
How do I know how bad it is?
Your physical therapist will look at several things that help estimate recovery time, including (Martin et al., 2022):
- How much pain you had at the time of injury
- How many days until you can walk without pain
- How large the tender area is, and how close it is to the sit bone
- Hamstring strength and flexibility compared with the other side
Imaging usually isn't needed for mild or moderate strains. When a severe tear is suspected, the guideline recommends referral to a physician, who may order an MRI (Martin et al., 2022).
How long does a hamstring strain take to heal?
It depends on the severity and location. Mild strains may take a few weeks, while more severe strains, especially those close to the sit bone, often take longer. Returning too soon is one of the main reasons hamstring strains come back.
The guideline advises caution about returning to sport if an athlete hasn't completed a progressive program that included eccentric strengthening (Martin et al., 2022). Rather than going by the calendar alone, your therapist will look at:
- Strength compared with the other leg
- Pain-free sprinting at full speed
- Sport-specific movements like cutting and kicking
- Your confidence in the leg
How can physical therapy help?
The APTA guideline recommends (Martin et al., 2022):
- Eccentric strengthening (as tolerated), added to stretching, strengthening, stability work, and progressive running, to shorten return-to-play time
- Progressive agility and trunk stabilization to help lower the chance of reinjury
- Measuring strength and flexibility to track progress
- Tracking walking, running, and sprinting as you return to full speed
A physical therapy evaluation may include:
- How the injury happened and your sport's demands
- Where it's tender and how large the area is
- Hamstring strength and flexibility
- Walking and running, when ready
- Screening for a severe tear, back-related pain, or other signs that need a physician
A typical plan may include:
- Early, gentle loading and walking
- Progressive hamstring strengthening, including eccentric exercises
- Trunk and hip stability work
- A step-by-step running and sprinting progression
- A prevention program to keep doing after you're back
Physical therapy doesn't guarantee a specific result or timeline. At Nova Physical Therapy in North Hollywood, sports injury rehab is one of our core services, and every plan starts with an evaluation so treatment fits what we find. For more, read our post on what to do after a sports injury.
Can hamstring strains be prevented?
Yes, to a degree. The guideline gives its strongest grade to including the Nordic hamstring exercise in prevention programs, together with warm-up, stretching, stability, strengthening, and sport-specific running and agility work (Martin et al., 2022).
Other practical steps:
- Warm up fully before sprinting
- Build sprint speed and volume gradually
- Keep up hamstring strength work during the season
- Be extra careful if you've had a hamstring strain before
When should I see a doctor?
See a physician promptly if you have:
- A pop or tearing feeling near the buttock or sit bone
- Large bruising down the back of the thigh
- Major weakness bending the knee or trouble walking
- A gap or dent you can feel in the muscle
- Numbness or tingling in the leg or foot
- Calf swelling, warmth, or redness
Back-of-thigh pain that came on gradually, without a clear injury, can also come from the lower back, so it's worth a full evaluation.
We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.
Do I need a referral for physical therapy in California?
Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage or see our insurance page.
Frequently asked questions
How long does a pulled hamstring take to heal?
Mild strains may take a few weeks; more severe strains, especially near the sit bone, often take longer. Your therapist will estimate a timeline based on your exam.
Should I stretch a pulled hamstring?
Gentle, pain-free stretching can be part of rehab, but aggressive stretching early on can aggravate it. Strengthening, especially eccentric exercise, is a key part of recovery.
Should I rest or walk with a hamstring strain?
Gentle walking within comfort is usually fine and helps recovery. Avoid sprinting and painful stretching until your rehab progresses.
What is the Nordic hamstring exercise?
It's a strengthening exercise where you kneel, have your ankles held, and slowly lower your body forward. It's one of the best-supported exercises for preventing hamstring strains.
Why do hamstring strains keep coming back?
A previous strain is a major risk factor, often because people return before strength and sprinting are fully restored. A complete rehab program helps lower that risk.
Do I need an MRI for a hamstring strain?
Usually not for mild or moderate strains. A physician may order one if a severe tear is suspected.
Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.
About Nova Physical Therapy
Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from sports injuries, back and neck pain, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.
Schedule an evaluation
If a hamstring strain has you sidelined, an evaluation can help you build a step-by-step plan to get back to full speed and stay there.
Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Thigh pain has several causes, including severe tears and back-related pain, and only an in-person evaluation can determine what is right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.