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Risk Factors for Pulling Your Hamstring

Identifying your risks for pulling your hamstring is important as it can prevent future injuries and guide your treatment, rehabilitation and future training. Make sure you consult a physiotherapist. Your physio will guide your long-term management.

Muscle Strength

Hamstring strength and the balance between the strength of the quadriceps and the hamstrings have been suggested as risk factors but there appears to be no good evidence to support this idea.

Warming Up Before Exercise

There is evidence that warming up before exercise increases the force and the amount of stretch that a muscle can cope with before it suffers a stretch-related injury. However, how exactly this technique should be applied in practice is not clear at all.

Any break from the athletic activity for 20 minutes could return the muscle to its pre-warmup state. An athlete waiting to come on to play or taking a half-time break might therefore be more vulnerable again despite having warmed up initially.

Muscle Tiredness

Muscle fatigue may be important in getting a pulled hamstring. Tiredness may be neural in nature, i.e. the nervous system chemicals become depleted, or the muscle itself may use up its energy stores.

Tired leg muscles leads to an alteration in running technique which may contribute towards risk of injury.

Tired muscle can also produce less force than a fresh muscle and is therefore more likely to be injured in eccentric contractions where considerable outside forces are being applied and the muscle has to control them. If the forces are too high the muscle cannot control them and an injury occurs.

Surveys of sporting events have shown that hamstring injuries show a significant increase at the end of each half. They can also occur early in training or performance. This could be explained by tiredness, repeated small muscle strains, breaks in the play or lack of warm up, but it’s not clear what the importance of each of these elements is.


It’s not clear whether poor flexibility is linked to hamstring injuries.

Body Posture and Mechanics

Altered postures and patterns of using the lumbar and pelvic regions have often been suggested as related to lower body injuries. Excessive increase in the lumbar curve and a tendency to adopt the swayback posture (standing in a banana shape with the hips forward) has been associated with thigh muscle strains in one study.

It may be important for high-level athletes to identify and correct any postural abnormalities or abnormal patterns of movement when they run. As they are putting out unusually high amounts of force when they run, even small problems might lead to injury.

The examination and treatment of hamstring injuries needs to cover the lumbar and pelvic regions and to consider leg posture during activities.

Even if these factors can be connnected to hamstring injury, it is not clear that treating or altering these factors in any way will make hamstring injury less likely.

Running Technique

Evidence that running technique is implicated in hamstring injury is hard to come by. The common view is that poor technique when sprinting, such as leaning forwards and over-striding, is a common fault which can lead to injury.


Hoskins W, Pollard H. The management of hamstring injury - Part 1:Issues in diagnosis. Manual Therapy 10 (2005) 96-107

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