How is it diagnosed?
Diagnosis of hamstring injuries starts with a thorough understanding of your health history and the cause of the injury. The questions your therapist may ask include:
- If you have had a similar injury before
- What you were doing when you first felt the pain
- Where you felt the pain, and if you felt a “pop”
- If you noticed any swelling or bruising in the first 24 hours after the injury
- What you were able to do immediately following the injury, and how you have been functioning since the injury (walking, sleeping, lifting your leg, etc.)
Your physical therapist will also perform a clinical evaluation, including some of the following observations and tests to determine the nature of your injury:
- Observation:To note any discoloration or bruising
- Pain: To identify your current pain level, and the activities that make your pain better or worse
- Palpation: To pinpoint the location and size of the tender area through touch, which will help determine the severity of the injury
- Range of motion: To compare the motion of your injured leg with your healthy leg
- Muscle strength: To determine the strength of the hamstring muscles when bending or straightening your knee and hip
- Gait analysis: To note any limping or pain when walking
Typically, hamstring injuries are classified as Grade I – III depending on the severity of the injury.
- Grade I: Mild strain with minimal tearing; usually feels like a pulled or cramping muscle
- Grade II: Moderate strain with partial tearing; may cause a stinging or burning sensation at the back of the thigh
- Grade III: A severe, complete muscle tear; may result in a “lump” on the back of the thigh where the muscle has torn
If your physical therapist suspects a severe injury, you will likely be referred to an orthopedic physician for medical diagnostic imaging, including x-ray and MRI, to evaluate the extent of the injury. In the event of a fracture of the ischial tuberosity (sit-bone) and/or a complete rupture of the muscle, surgery might be recommended.
Do you need an X-ray and MRI imaging for hamstring muscle pain?
For most common orthopedic cases, imaging is not needed and the diagnosis can be made with a simple physical therapy evaluation. No need to waste thousands of dollars on unwarranted diagnostic imaging. We also have clinical tests which we can perform to help rule in and rule out pathologies that correlate to MRI findings (which is WAY cheaper than an MRI!). An expensive MRI may just tell us what we already know. Also, often times the positive findings found on x-rays, MRIs, and EMGs may not actually be the root cause of your pain. What does that mean? Many positive findings on an MRI are also found in asymptomatic (pain-free) individuals, so diagnostic imaging may not be able to tell us what is actually causing your pain. For example: many people have a herniated disc in their low back but do not have any low back pain. So if herniated discs can cause no pain, just because someone with low back pain has a herniated disc does not mean that is what’s causing their pain. The key is to find out if your clinical evaluation findings during your evaluation at Pursuit match the MRI findings. If so, then we can decide what is the best way to treat it.
How can a Physical Therapist treat it?
Your physical therapist will design an individualized treatment program specific to the exact nature of your injury and your goals.
Physical therapy may include:
Range of motion
- Resting the injured area by avoiding aggravating activities, such as walking or working out. If you are having notable difficulty walking, crutches may be recommended.
- Applying ice to the injured area 3-4x/day for 15-20 minutes (with a towel placed between your skin and the ice).
- Applying a compression wrap to the area to aid in decreasing swelling and pain.
- Referral to another health care provider for further diagnostic testing (if needed).
It is common for muscles and joints to become stiff after an injury. As your pain decreases, your physical therapist will begin gentle flexibility exercises, such as stretching your hamstring muscles.
Hamstring strengthening will be an essential part of your rehabilitation program. Your physical therapist will compare the strength of the muscle groups in each leg, and prescribe specific exercises to target areas of weakness.
Many physical therapists are trained in hands-on “manual” therapy to move and manipulate muscles and joints to improve motion, flexibility, and strength. These techniques can target areas that are difficult to treat on your own.
As you regain the flexibility and strength in your hamstrings, it will be important to teach your body how to move so you no longer put excessive stress on the previously injured area. Your physical therapist will develop a functional training program specific to your desired activity.
In the event that the severity of your hamstring injury requires surgical treatment, a physical therapist will guide your postoperative rehabilitation. Your physical therapist will communicate with your surgeon to ensure complete and consistent postoperative care.
“After at least three years of doctor-hopping […] looking for someone to alleviate my constant dizziness and neck pain, I finally found Dr. Miller. I have more energy and less pain, and have halved my dependence on painkillers. He shouldn’t be the last stop on your road to recovery, he should be the first.”
How long does it take for recovery?
Recovery time for hamstring muscle pain depends on multiple factors:
There are many factors that influence your recovery time and every patient’s recovery time is different. If you do nothing and don’t pursue treatment, it could gradually get better on its own, you could continue to have the same pain persist, or it could continue to get worse. As stated earlier, most acute cases may or may not resolve in 4-8 weeks. If you get expert treatment that solves the root cause of your pain, some cases resolve in 1-3 weeks! Then you can get back to sports, exercise, and your favorite activities without flare-ups and recurrences. Some of our patients are pain-free in 1-3 visits and back to 100% in 2 weeks!
If it is a complex case with chronic pain, your recovery may take longer, but you can still get a good outcome. Some chronic cases can resolve as fast as 2 months but can take as long as 4-6 months. It varies with every patient because every case of hamstring muscle pain is different. Every patient’s recovery varies depending on the factors listed above. After a thorough evaluation here at Pursuit Physical Therapy, you will know your exact timeline of recovery, your prognosis, and when you should reach your goals.
- The severity and chronicity of your pain
- Whether your pain is an easy or complex case
- If the root cause of your pain was solved or if it was missed (this is the key to getting a great recovery!)
- How long you have been in pain for and when you need to be pain-free by
- Other therapies and treatments you have tried
- Which medical professional(s) you saw prior to seeing us
- How active you are in trying to resolve your pain
- Which treatment approach is chosen and if it is proven to work for your pain
How much does it cost?
The average cost of care for a case of spine pain in the US is $1800-$6600. This high price is due to many factors: the over-inflated cost of healthcare, the over expensive cost of unwarranted imaging (x-rays, CT scans, and MRIs) that is not needed, over-utilization of care (which increases the number of visits needed to be treated, requiring multiple visits to different doctors and physical therapists for the same diagnosis), and getting billed for unnecessary and unproven treatments that you don’t even need. All of these factors increase cost and this is why healthcare is so expensive. We strive to end that unnecessary, expensive cycle. In fact, we are currently publishing our first-year data with the University of Central Florida that shows the cost-effectiveness of our treatment approach.
This year, the average cost of our care was shown to be $814-$1141. Some of our patients get even as low as $315 for the full treatment! So if you have a deductible of $3,000-$10,000 and you have to pay out of pocket for your treatment, we can save you lots of money.
Remember, every case of pain is different and not all hamstring muscle pain is the same. It is hard to predict exactly how much your treatment is going to cost you. But after a thorough evaluation, we can tell you exactly what is causing your pain, how long it is going to take, what the best way to treat it will be, and exactly how much it is going to cost. We have no hidden fees, no co-pays, and no miscellaneous bills that you will be surprised by 3 months after you receive treatment. Your pain, your diagnosis, your goals, and what is best for you dictate your treatment and how much it will cost, and while it varies for every patient, treatment at Pursuit is still much more affordable than standard healthcare.
How long are sessions?
Our evaluations are always one-on-one with one of our board-certified specialists and 60-90 minutes long. We like to perform thorough evaluations so we can solve the root cause of your pain, identify all risk factors, and make sure that we do it right. After the evaluation, you will know your diagnosis, the root cause of why you have your pain and symptoms, your prognosis, an expected timeline of when you should see results, what the best way to treat your pain is, how much it will cost, and your expected recovery outcome. We want you to fully understand everything about your pain and injury. What is best for you and will get you the best outcome is what will dictate your care and treatment. There will be plenty of time for you to ask questions so we can make sure you fully understand why you have your pain and what the best way to treat it will be. After the evaluation is completed, all treatment sessions are 60 minutes going forward and still one-on-one with your physical therapist. You and your physical therapist will design a customized treatment plan that works for you and that will achieve your goals.
How can it be prevented?
You can decrease your risk of a hamstring injury in the following ways:
- Always warm up before participating in athletic activities.
- Avoid starting a new activity too quickly; gradually increase the frequency and intensity of the activity so that your body may adapt to the new movement patterns.
- Listen to your body after you work out (and stretch, apply ice, rest as needed) prior to engaging in the same routine again.
- Use proper lifting and squatting techniques, particularly when maneuvering heavy objects.
What are the next steps?
Getting started is simple. The first step, and the key to getting you pain-free again is to solve the root cause or your case of pain. Remember, not all pain is the same. Your pain is different than someone else’s pain, even though it may be in the same area. If you’re ready to get pain free, give us a call at (407) 494-8835 or fill out the form below. The next step is to schedule your evaluation so we can solve the root cause for you. We’re happy to answer any questions you may have and we would love the opportunity to help you.