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    Hamstring injuries are tears to the tendons or large muscles at the back of the thighs. They are common among athletes and usually heal on their own after a period of rest. The hamstrings are tendons (tough fibres) at the back of the thighs that attach the large muscle of the thigh to the bone. The word hamstring may also be used to refer to this muscle. The hamstring muscle spans the thigh, starting just below the buttocks, connecting the pelvis to the leg below the knee. Hamstring muscles are not used much when we stand or walk, but are very active when we run, jump and climb, when we need to bend the knee. Symptoms of a hamstring injury Sudden lunging, running or jumping can cause the hamstring tendons or muscles to tear, which can be felt or heard as a pop and will be immediately painful. The muscle will spasm (seize up) and feel tight and tender. In severe cases, there will also be swelling and bruising. The degree of pain and other symptoms depend on the severity of the tear. Tears range from a grade one tear, which is just a minor strain, to a grade three tear, where the muscle completely ruptures. This causes severe pain and prevents you from doing any activity for several months. Hamstring injuries are often seen in athletes and sportsmen, such as footballers, and recurring injury is common. Rest and recovery You should recover fully from a hamstring injury if you rest until it feels better. Recovery time may be days, weeks or months depending on the severity of the tear. Speak to a sports physiotherapist if you're unsure (see below). Resting means not doing any running or jumping sports during this time, although you can walk, swim and cycle if the pain allows you to. Pain and any swelling can be relieved by raising your leg and holding an ice pack to your affected thigh (try a bag of frozen peas wrapped in a tea towel). Do this for 10 minutes every few hours for the first two days. Over-the-counter painkillers, such as ibuprofen or paracetamol, may also help. Gentle exercises and stretches It's important that you don't stay inactive for too long, as this will cause the hamstring muscles to shrink and scar tissue to form around the tear. As soon as the pain subsides, after resting for several days, you should start to do regular gentle hamstring stretches. Learn how to stretch your hamstrings. This should be followed by a programme of gentle exercise (such as walking and cycling) and hamstring strengthening exercises. You may want to see a sports physiotherapist, who will be able to advise you on a suitable graded exercise programme. Ask your GP for a referral to a physiotherapist on the NHS or arrange an appointment yourself privately with a physiotherapist or doctor specialising in sport and exercise medicine. Search for a sports medicine physiotherapist. You should only return to activity when your hamstring muscles are strong enough, to avoid injuring yourself again. When you want to start running again, reintroduce it into your exercise programme gradually. Your physiotherapist will be able to advise you on this. It is important to warm up and stretch before you start exercising (see Live Well: fitness training tips for more information). If the pain returns, stop immediately.

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