Hamstring Injuries Treatment

The majority of hamstring injuries — including strains and partial tears — can be managed successfully without surgery. Initial conservative care follows the RICE protocol: rest, ice, compression, and elevation, along with anti-inflammatory medications to help control pain and swelling. After the first 48 hours, gentle stretching and progressive strengthening exercises are introduced, with advancement guided by pain levels. Formal physical therapy is frequently recommended to restore strength, flexibility, and neuromuscular control.

For athletes or patients seeking to accelerate recovery, Platelet-Rich Plasma (PRP) injections performed under ultrasound guidance can be a valuable adjunct treatment. PRP is derived from a small sample of the patient’s own blood, which is processed to concentrate growth factors that may support tissue healing. This minimally invasive treatment can help reduce pain and potentially facilitate a faster return to sport in select patients with hamstring strains or partial tears. Most mild to moderate hamstring injuries resolve within 6 to 12 weeks of consistent conservative care. However, some patients may retain a modest reduction in hamstring strength — approximately 10% — even after a full non-surgical recovery.

Surgery is generally indicated for complete proximal hamstring tendon tears, bony avulsion injuries, and cases in which symptoms persist or functional limitations remain significant despite an adequate course of conservative treatment. The goal of surgery is to reattach the hamstring tendon to its native insertion on the ischial tuberosity of the pelvis, helping restore both strength and function. For high-level or professional athletes, early surgical intervention may also be appropriate when the prolonged recovery associated with conservative treatment is not compatible with competitive demands.

Hamstring repair may be performed using either a minimally invasive open technique or an endoscopic (scope-based) approach and is typically completed as an outpatient procedure in approximately one to one and a half hours. For smaller tears without significant tendon retraction, endoscopic repair is performed using a camera and small instruments inserted near the attachment site, minimizing soft tissue disruption. For more complex injuries — including multi-tendon tears, chronic tears, or cases with substantial retraction — a minimally invasive open repair performed through a small incision concealed within the gluteal crease provides the access necessary for a durable reconstruction.

The best outcomes are consistently achieved when hamstring injuries are evaluated and treated promptly. Delays in diagnosis or management can allow partial tears to progress to complete ruptures, increase tendon retraction, and make surgical repair more technically demanding. Early evaluation and treatment provide the best opportunity for a full functional recovery.