Causes, Relief, and Prevention Tips

Hamstring cramps are very common. They can come on suddenly, causing localized tightness and pain on the back of the thigh.

What’s happening? The hamstring muscle is contracting (tightening) involuntarily. You may even see a hard lump beneath the skin. That’s the contracted muscle.

While the cause of hamstring cramps isn’t always known, there are several things — like dehydration and muscle strain — that may contribute to them.

Here’s what you need to know about why you might experience hamstring cramps, as well as how you can relieve the pain and prevent them from coming back.

Some 3 out of 4 cases of muscle cramps happen at night during sleep. Interestingly, many cases of hamstring cramps are considered idiopathic. This means that doctors can’t always point to a specific cause.

That said, there are several situations that may lead to muscle cramps. Read on to learn what these may be.

Muscle strain

Hamstring cramps may result from improperly warming up for an activity or doing too much activity. Muscle strain is the most common cause of cramps.

When you don’t warm up or stretch before exercise, the muscles may feel stressed, making them vulnerable to cramping and other injury. When people overuse their muscles, lactic acid may build up and cause tight cramps.

Dehydration

Exercising and not drinking enough water may also cause hamstring cramps. The idea here is that when water and electrolytes are lost through sweat and not replaced, the nerves become sensitized and make muscles contract.

In particular, working out in hot or humid weather may speed up the process of dehydration and muscle cramping.

Mineral deficiency

Too little magnesium, potassium, and calcium in the body may produce hamstring cramps. These minerals are also called electrolytes.

While drinking plenty of water is crucial during exercise and everyday activity, including these electrolytes is equally important to replenish mineral stores.

Other risk factors

There are also certain risks factors that may make a person more likely to experience hamstring cramps:

• People who are older generally don’t have as much muscle mass and may stress muscles more easily, leading to cramping.
• Athletes who frequently exercise in warm weather or who otherwise deal with dehydration may have more cramps.
• People living with diabetes, liver disorders, nerve compression, and thyroid disorders may experience muscle cramps.
• Women who are pregnant tend to experience hamstring and other muscle cramps. If these cramps are new, they may go away after delivery of the baby.

Hamstring cramps and other muscle cramps can come on without warning. You may feel a slight tightness at first followed by sharp pain and increasing tightness.

If you look at your muscle, you might even see a lump of tissue under the skin. This is your contracted muscle. The cramp can last from just a couple seconds to 10 minutes.

After the initial cramping has passed, you may experience a feeling of tightness or tenderness for a few hours.

Act fast when you feel a hamstring cramp coming on. While you may not be able to stop it entirely, you may be able to lessen the severity.

Floor stretch

As the cramp takes hold, try gently stretching the muscle in the opposite direction of the tightening. Sit on the floor with the affected leg extended in front of you and your foot flexed. Lean forward gently until you feel a stretch in the hamstring.

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You can also stretch the hamstring from a standing position. Place the heel of the foot on the affected leg on a curb or other slightly raised surface. It helps to steady yourself by holding on to a tree or other stable surface, like a wall. Slowly bend the knee of the standing leg until you feel a slight stretch in the hamstring.

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Massage

As you stretch, you may also consider applying firm pressure and rubbing the muscle to help it release the cramp.

If you have a foam roller, you might try sitting on the floor with the roller under the affected thigh. Slowly use your arms to raise your hips off the floor, keeping your opposite leg slightly bent. Then slowly roll it between your knee and buttocks.

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Hot and cold therapy

The general rule is to apply heat to muscles when they’re tight. So, at the most acute phase of the cramp, heat can help.

You can make a hot compress at home by placing a towel in a bowl of hot (not scalding) water. Wring out the towel, then fold it into a square before applying to the area for 20 minutes.

Alternatively, you can fill a sock with rice, tie it off, and microwave it for 15-second increments until warm. Apply it on the cramp for 20 minutes.

After the contracting has passed, try applying ice packs to ease sore muscles.

You may be able to tweak some things in your everyday routine and kick those hamstring cramps to the curb.

Hydrate

Experts say men should drink 15.5 cups of fluids per day and women should drink 11.5 cups.

These are general guidelines. You may need to consume more fluids depending on your activity level, your age, the weather, or different medications you’re taking.

Women who are pregnant or breastfeeding may need to drink 13 cups of fluids to stay hydrated.

Good fluid choices include plain water, milk, fruit juices, and herbal teas. Sports drinks can help if you’ve been exercising hard for longer than an hour, as they replenish minerals and sugars.

Address deficiencies

Try eating more beans, dried fruits, nuts, and seeds to boost your magnesium stores. Potassium can be found in bananas, prunes, carrots, and potatoes.

If you still think you may be lacking these essential minerals, consider asking your doctor about taking supplements. Pregnant women, for example, often take magnesium supplements to address muscle cramps.

Warm up

Getting your muscles primed and ready for activity can help prevent the strain that leads to cramping. It’s especially important to warm up your hamstrings before exercise if you notice they’re tight.

Instead of starting off with a full run, try walking for several minutes, then:

1. Stand with your feet hip-distance apart. Bring one foot a few inches in front of the other with the heel touching the ground.
2. Hinge your upper body forward by bending the standing leg and bringing your buttocks back.
3. Return to starting position.
4. Repeat this rocking motion several times for both legs.

Stretch

Along with properly warming up for exercise, try gently stretching the hamstring muscles. Perform the stretches while sitting or standing, whatever feels best to you.

Regularly engaging in yoga may also help. There are different poses that specifically target the hamstrings, including Downward-Facing Dog, Extended Triangle Pose, and Staff Pose.

If you often get cramps at night, do these stretches before going to bed.

While muscle cramps aren’t usually the sign of a more serious condition, they may sometimes be related to underlying health issues, such as:

• Blood supply issues due to hardened arteries in your legs. This means the arteries to the legs may be too narrow to supply enough blood, especially during exercise.
• Nerve compression, specifically in the spine due to lumbar stenosis. Pain and cramping with this condition may be worse after long periods of walking.
• Depletion of potassium, magnesium, or calcium. You may develop insufficiencies through poor diet or by using medications that act as diuretics.

Consider seeing your doctor if your muscle cramps happen frequently and cause severe pain. Also see your doctor if you have:

• swelling or redness in the legs
• muscle weakness
• cramping that doesn’t respond to home care measures

What to expect at your appointment

Before performing a physical exam, your doctor will likely ask you to explain your symptoms. They’ll ask you when the cramps occur, how often, and their severity.

Your doctor may also ask you to provide information about your medical history, including any conditions you have or medications you’re taking.

It’s also important to note what activities you participate in or anything else that may be contributing to cramps.

There are a number of reasons why you may be experiencing hamstring cramps. While unpleasant, cramps are common and may respond favorably to a few simple lifestyle changes, like drinking more water.

If not, make an appointment with your doctor to make sure there aren’t other health issues causing them that need to be addressed.

Cramp in the Hamstring Muscles

May 15, 2023

A cramp is a painful involuntary muscle contraction. Although leg cramp goes away naturally, they can damage the muscle and make them sore and tender.

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Medically reviewed by Dr Chaminda Goonetilleke, 21st Feb. 2021

Symptoms of a hamstring cramp

• If you suffer a bout of cramps you will experience a powerful involuntary contraction of the hamstring muscles, at the back of the thigh.
• It can be particularly painful and you will have great difficulty in straightening your knee.
• Once your bout of hamstring cramps has passed, the muscle may be tender, sore or even have suffered a rupture (hamstring strain).

Causes of cramps in the hamstring muscles

What causes cramps? Although the exact cause of cramps has not yet been successfully determined there are thought to be a number of possible causes:

One theory states that muscle cramps are due to altered neuromuscular control, where muscles go into fatigue.  Also, there appears to be a genetic component making some people more prone to cramps.

Over time theories also include:

• Dehydration (not taking on enough water, especially in hot conditions).
• Low potassium or sodium (salt) levels.
• Low carbohydrate levels.
• Very tight hamstring muscles.

However, there isn’t enough evidence to suggest dehydration, and electrolyte depletion result in cramps.

Hamstring muscles

The hamstring muscles consist of the semitendinosus, semimembranosus and biceps femoris muscle at the back of the thigh. When an athlete suffers a bout of cramps these muscles go into involuntary, painful spasms (contraction).

Muscle strains from cramp

A bout of hamstring cramps may cause damage to the muscle. Fibres of the muscle are torn from the shear strength of the muscle contraction. This, therefore, results in a hamstring strain. If this happens the muscle will be painful for some time afterwards, although most muscle strains from cramps are relatively mild.

Treatment for a hamstring cramp

Stretching

If you are suffering from a bout of leg cramps, stretch the muscles involved. Hold the stretch for as long as is necessary. A partner may be very useful in assisting with the stretch.

Sports massage

Gentle massage to the muscles to the back of the leg, in particular, the hamstring muscles may help relieve cramps. Massage encourages blood flow and therefore relaxes the muscles.

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If you have suffered a muscle tear as a result of a hamstring cramp then wait until the initial acute phase has passed. This is usually 24 to 48 hours. Then deep tissue massage can be done to encourage healing.

If you do not have access to massage then a Foam roller is an excellent substitute and should form part of your warm-up routine.

Pain under the knee – how to treat pulling pain when bending and walking

Pain behind the knee is considered a common reason for visiting a doctor in orthopedic practice. Patients in this case also often complain of swelling, impaired mobility of the lower limb and redness. Pain in this area may be associated with damage to various anatomical structures, so instrumental and laboratory diagnostics will be required. An experienced doctor will prescribe an up-to-date examination method for pulling pain under the knee, and prescribe an adequate treatment. Depending on the established etiology, therapeutic measures can be conservative, surgical or complex.

Causes of back pain behind the knee

If an adult or a child has pain and pulling behind the knee, the causes are mainly associated with an inflammatory process or trauma. In this area is located the popliteal cavity, which forms the inner bend of the knee. It hurts because of damage to muscle tissue, nerves, ligaments, tendons, knee and calyx, tibia or fibula.

Pain behind the knee at the back when bending or at rest is also due to the following reasons:

• degenerative disease of the knee joint
• inflammation of the tissues of the knee joint
• contusion of the lower limb
• intra-articular or extra-articular fracture
• pinched nerve

Soft tissues often swell when inflamed. At the same time, the victims say that they have a pulsing under the knee at the back. The causes are associated with the clinical manifestations and symptoms of the disease, so doctors carefully assess the patient’s condition.

Varieties

Usually, during the examination, the doctor asks the patient to describe in detail the discomfort for preliminary diagnosis. For example, the popliteal cavity may burn, swell, twitch, tighten, or shoot. Often, pain radiates to other anatomical regions. For example, in the foot, heel or thigh. It is important to understand which side of the lower limb is affected.

Main varieties of symptom:

• sharp
• chronic

Specifying the type of discomfort helps to quickly diagnose and start treatment.

Acute pain

In men and women, severe pain behind the knee behind the knee when walking or at rest develops due to infection or acute inflammation. In this case, soft tissues swell, and the skin turns red.

Additional features:

• pulsation
• Increased pain when flexing or extending the leg
• skin burning
• increase in body temperature
• weakness

In most cases, pyogenic bacterial cells enter this area as a result of trauma. They can also spread to the popliteal cavity from other anatomical structures through the blood or lymph.

Chronic pain

If the patient has persistent abscesses in the right or left posterior popliteal region, the doctor will first suspect a degenerative lesion of the bone joint. It could be arthritis or arthrosis. Autoimmune reactions, in which the body’s defense system damages healthy cells, are often accompanied by pain.

Which doctor to contact

If it hurts behind the knee, it is recommended to start the examination with a visit to the surgeon. This specialist will exclude the pathological process in his profile and refer the patient to another specialist. You may need to consult a rheumatologist, orthopedist or traumatologist.

Diagnostic methods

Back pain under the knee requires clarification of the cause and timely treatment. The doctor will interview the victim to collect anamnestic information and identify risk factors. The next step is inspection and palpation. In the process, the doctor will pay attention to sharp or moderate pain, swelling of the popliteal fold, the spread of discomfort in the foot or other parts of the body.

Instrumental and laboratory diagnostics:

• ultrasonography
• computed tomography or magnetic resonance imaging
• articular puncture with laboratory examination of the obtained fluid
• endoscopy
• radiography
• general and biochemical blood tests

After studying the results of the examination, the doctor will be able to conclude that the person has pain in the ligaments under the knee or other tissues.

Treatment of soreness behind the knee

Often, conservative treatment is sufficient to eliminate the pathological condition causing such a symptom. The doctor may prescribe anti-inflammatory, antibacterial and pain medications. Sometimes medicines must be given by injection. In an acute infection with pus formation, surgery will be required to remove the exudate, treat the area with an antiseptic solution, and install a drain. Daily dressings will be needed. If the pyogenic flora is inside the joint, it is possible to perform a puncture or an endoscopic procedure.

Additional treatment measures:

• physiotherapeutic procedures to eliminate unpleasant symptoms and relieve inflammation
• immobilization of the leg with a cast or bandage
• therapeutic exercise with a specific training program during the recovery phase

After treatment, rehabilitation should be carried out in order to restore motor function and improve well-being. Many people forget the importance of this event.

Rehabilitation

Restorative procedures are aimed at the complete elimination of the pathological process and the normalization of lower limb mobility. Therapeutic exercise is the main method. The specialist selects individually exercises to improve muscle condition and coordination. On the basis of the CMRT clinics, a rehabilitation center “Laboratory of Movement” was opened in St. Petersburg, where the patient will be helped to go through all the stages of recovery. The rehabilitation course is based on modern clinical guidelines and the experience of evidence-based medicine.

Sequelae

Back knee pain on flexion, caused by infection or degeneration of the joint, leads to the following complications:

• septic infection
• partial or complete immobility of the bony joint
• spread of purulent infection to neighboring areas and remote areas

Prophylaxis

People who often have leg pulls below the knee should follow prophylactic recommendations after treatment to prevent recurrence. Experts recommend:

• to be examined immediately if discomfort occurs
• warm up before training
• avoid excessive stress
• eliminate foci of chronic infection in the body

These prevention methods are aimed at preventing infection, damage to the joint and periarticular components.

Treatment of pulling pain in the knee

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Complaints of pulling pains under the knee are caused by damage to the knee joint, inflammation of the lymphatic and blood vessels, irritation of the nerve trunks, suppuration of soft tissues or tumors located in the popliteal fossa.

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The methods used in our clinic are safe and have no side effects.

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Long-term effect

Treatment minimizes the risk of new hernias in other segments, as well as hernia recurrence.

The knee joint has a complex structure. The articulation is formed by three bones: the femur, tibia and patella. Inside the joint there are cartilaginous pads – menisci, which provide cushioning and even distribution of the load. The constituent elements of the joint also include the joint capsule, joint bags, tendons and ligaments that fix the bones and limit the range of motion.

There are lymph nodes in the popliteal fossa, and the neurovascular bundle also passes here.

The defeat of any structure of the joint or tissues surrounding it, is manifested by the occurrence of pain with a violation of the functional activity of the joint.

Factors causing pain under the knee are conditionally divided into 3 groups:

• Pathologies of the knee joint itself.
• Periarticular diseases that have a negative effect on the knee joint.
• Other reasons.

Pathology of the knee joint

The appearance of pain in the popliteal fossa after intense physical exertion or injury may indicate stretching of the ligamentous apparatus or damage to the joint capsule or joint capsules.

Knee injuries not only affect the skin and subcutaneous tissue, but also intra-articular structures such as menisci. There is pain, swelling at the site of injury. In the joint itself, blood (hemarthrosis) or synovial fluid accumulates, which leads to aseptic inflammation.

In the acute phase, knee injuries are treated in emergency rooms. During the recovery period, to prevent the development of long-term complications, rehabilitation should be carried out in clinics specializing in the treatment of joint pathologies.

Arthrosis

The disease causes the destruction of the synovial cartilage that lines the surface of articulating bones. The cartilage tissue softens, loses its elasticity, the normal sliding of the articular surfaces is disrupted, any movement in the joint causes pain.

Arthritis

In arthritis, pain occurs as a result of damage to the synovial membrane, in which nerve endings, blood and lymphatic vessels are concentrated. Arthritis is most often a manifestation of systemic diseases (rheumatism, psoriasis, gout) or infection.

Diseases of the periarticular tissues

Diseases of the soft tissues around the joints are inflammatory or degenerative. Inflammation is more often secondary against the background of damage to tendons, ligaments during excessive loads or in violation of the trophism of these tissues.

Bursitis – inflammation of the synovial sac of an infectious and non-infectious nature. With an infection, pulling pains under the knee are accompanied by swelling, redness and hyperthermia of the skin in the area of ​​localization of the pathological process.

Tendonitis occurs when a tendon becomes inflamed or severely stretched. Inflammation begins after injury to the tendon. Connective tissue fibers receive microtears, and the formed hematomas serve as an excellent nutrient medium for pathogenic microbes. The initial signs of tendovaginitis are characterized by slight pain, but with the progression of the purulent process, tissue fusion may occur, which threatens to completely rupture the tendon. Tendinitis is common among athletes (football players, tennis players, basketball players).

Bursitis, tendinitis and other inflammatory diseases of the tendon tissues increase the risk of degenerative processes in the cartilage of the knee joints.

The main cause of inflammation of the sciatic nerve or its branches (small and tibial nerves) is their tunnel compression or stretching in the posterior popliteal fossa. Sometimes the nerve sheaths are damaged by their own antibodies in autoimmune diseases.

A Baker’s cyst is a synovial fluid-filled mass that forms behind the knee. May be the result of arthritis or injury. In addition to pain, the patient is concerned about stiffness and problems with knee flexion.

Other causes

There are a number of reasons why pulling pain under the knee appears in diseases that are not directly related to the pathology of the knee joint.

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Vascular pathology

Varicose disease manifests itself in the weakness of the vascular wall of the veins. Along with pulling pains for varicose veins, a characteristic feature is the appearance of swollen blue veins under the knee, appearing under the skin.

Thrombophlebitis – inflammation of the venous wall – can occur as a complication of varicose veins, or develop due to a violation of blood coagulation processes. Starting with a slight pulling pain, the further development of the disease can lead to complete blockage of the vessel, followed by necrosis.

Among the artery embolisms and aneurysms, artery embolisms and aneurysms are also distinguished among vascular pathologies that can be the causes of pain under the knee.

Polyneuropathy is a group of diseases characterized by multiple diffuse lesions of the peripheral nerves. The causes of diseases are different – exposure to toxins, including alcohol, autoimmune processes, complications of diabetes.

Lymphadenitis with localization in the popliteal lymph nodes can also become a factor in the occurrence of discomfort in the knee area. Drawing pains are typical in the early stages of lymphadenitis. Further development of the disease is accompanied by fever and increased pain.

Pain in the popliteal fossa is often caused by pathological processes in other parts of the lower limb, for example, in the hip joint or ankle joint.

Sometimes a pulling pain under the knee is caused by incorrect foot placement or deformity of the big toe. This changes the position of the muscles of the lower leg, which are unevenly reduced during walking, causing a dull aching pain.

Even a far from complete list of pathologies that can provoke the occurrence of pulling pains under the knee shows how important it is to seek qualified medical help in case of minor, at first glance, symptoms.

Diagnosis and treatment

At the initial consultation, the doctor, after taking an anamnesis, conducts an initial functional diagnosis of the joints.

To clarify the diagnosis, the patient is sent for an examination, which includes:

X-ray, ultrasound of the affected joint; if necessary, CT, MRI, arthroscopy.

In the course of differential diagnostics, additional examinations and consultations of specialized specialists are prescribed.

In Dr. Length’s clinic, they carefully study the methods of treatment and diagnosis of diseases of the musculoskeletal system of the leading centers of manual therapy in the USA, Germany, Israel, and the most effective of them are successfully used in their practical work.

The choice of treatment methods depends on the identified disease. The doctor draws up an individual treatment program: a set of procedures, quantity, variability are determined by the stage of the disease, the severity of clinical symptoms, the patient’s age, and concomitant diseases.

The basic set of procedures for the treatment of the knee joint includes a unique Di-Tazin therapy, articular manual therapy, SWT, taping, orthopedic insoles.

The author’s Di-Tazin therapy consists of 3 components: soft manual techniques, electrophoresis and photodynamic treatment. The method has a powerful regenerative effect on the damaged structures of the knee joint.

If athletes and people leading an active lifestyle pull under the knee, then most likely it is a consequence of numerous knee injuries, as a result of which cicatricial changes are formed in the tendon and muscle tissues. In such cases, a set of rehabilitation measures is prescribed to restore the integrity and elasticity of the muscular-ligamentous apparatus. These include kiseology, reflexology, massage, physiotherapy.

Drawing pains under the knee, caused by damage to the structures of the knee joint, respond well to manual therapy methods.

For pain caused by dystrophic processes of cartilage tissue (gonarthrosis), intra-articular blockades, injections of chondroreparants and hyaluronic acid are effective.

Treatment methods used in Dr. Length’s clinic relieve pain and inflammation in several sessions, start the regeneration process, eliminate the cause of the disease, and prevent complications.

We are recommended by 94% of patients.
Thank you for your trust and your choice.

Material verified by an expert

Mikhailov Valeriy Borisovich

Manual therapist, vertebrologist, neurologist

Work experience – 25 years

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Pain in the lower back and leg

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Pain in the spine

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Shoulder shoulder periarthrosis

I came to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Arthrosis of the knee joint, 2nd degree

She came in with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

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Scoliosis

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Pain in the back

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Cervical hernia

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Pain in the neck

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Pain in the thoracic region

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Hernia and protrusion

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