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.

All about hamstring strain

What should be done to diagnose and treat hamstring sprains and ruptures? To solve this problem, the first step for the patient is to make an appointment with an orthopedist. After the initial examination, the doctor may prescribe additional tests:

• MRI of the knee joint and MRI of the hip joint
• hip x-ray
• Hip ultrasound
• CT scan of the femur.

A hamstring injury is a tear or strain of a group of muscles and tendons at the back of the thigh. This is one of the most common and unpleasant injuries, occurring mainly in athletes. The hamstring connects the largest muscle of the thigh to the bone. The main job of the hamstring is to allow the leg to flex and extend at the knee. Most of all, the hamstring is involved in: lunge, running, climbing, sprinting, jumping, stretching too much.

Grades of hamstring strain

Grade of hamstring strain describes the severity of the hamstring injury:

• grade 1: mild hamstring strain
• grade 2: partial hamstring rupture
• grade 3: complete rupture of the hamstring.

Causes and risk factors

Athletes, especially those who jump, climb and lunge, are at greater risk. Also, the likelihood of a hamstring injury is higher if there has already been such an injury.

Hamstring strains occur in a variety of ways, the most common being overuse. Other causes include:

• weakness from intense training
• direct blow to the thigh
• inadequate warm-up
• inadequate pre-workout program
• previous hamstring injury

Symptoms of hamstring strain and tear

When the hamstring is injured, the symptoms of the injury vary depending on the severity of the injury:

• Grade 1: Hamstring strain. Sudden radiating pain in the back of the thigh. Muscle strength will not be affected, but it will be difficult to move the leg.
• Grade 2: Partial hamstring tear. The pain is stronger than with the 1st degree. Possible swelling, bruising and loss of strength in the leg
• grade 3: severe hamstring tear. Increased pain, tenderness, swelling, and bruising. When injured, tingling is felt. The pain of a hamstring tear can come on suddenly. The injury may be accompanied by a pop.

Additional symptoms include:

• thigh knot
• spasms
• muscle stiffness, especially after a period of stiffness.

How a Doctor Diagnoses Hamstring Sprains and Tears

Often mild hamstring sprains can be treated at home. However, you should contact an orthopedic traumatologist if:

• the injury is serious
• symptoms get worse
• the injury does not heal
• sudden tingling or numbness in the leg
• edema suddenly increases.

An orthopedic traumatologist diagnoses a hamstring injury based on symptoms. They will check for tenderness and look for swelling and bruising around the hamstring. Sometimes magnetic resonance imaging of the knee joint or ultrasound is prescribed.

How a doctor treats hamstring sprains and tears

Hamstring strains and tears can be treated at home, but some patients require physiotherapy. Your doctor will likely recommend:

• rest, ice, compression and elevation
• Stop physical activity but do light exercise to maintain flexibility
• apply ice to the injury within 24-48 hours of injury use a compression bandage or elastic hip brace
• take over-the-counter pain relievers
• Use crutches if walking is too painful.

Hamstring tear surgery is rare and only required if the hamstring is disconnected from the bone.

Can a hamstring injury heal without treatment?

No. You must follow a recovery plan. If you abstain from exercise for too long, your hamstrings can contract. Scar tissue may also form.

Can the hamstring be injured again?

Mild hamstring strain that is not properly treated will re-stretch the hamstring.

Can you live a normal life with a hamstring injury?

Yes, but options will be limited. You may need crutches to walk, but you can continue to engage in other activities and maintain quality of life.

Prophylaxis

If you’re running or climbing, there’s always a chance you could injure your hamstring. This is less likely to happen if:

• warm up your body for at least 10 minutes before exercising
• doing light gymnastics
• do stretching and flexion exercises for 3-5 minutes before and after a sporting event
• maintain a good strength and conditioning program
• Eat a balanced diet.

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Scientific sources:

1. Bryukhanov A.V. Magnetic resonance imaging in the diagnosis of joint diseases: Abstract of the thesis. diss. . Dr. med. Sciences. Obninsk, 1998.-46 p.
2. Morozov S.P. Multislice computed tomography / S.P. Morozov N.Yu. Nasnikova, V.E. Sinicin; ed. S.K. Ternovoy. -M.: GEOTAR-Media, 2009. 112s.
3. Benevolenskaya L.I., Brzhezovsky M.M. Epidemiology of rheumatic diseases. // M. Medicine 1988, pp. 27-45.
4. Burulev A.L., Medvedev D.V., Trachuk A.P., Dokolin S.Yu. Magnetic resonance imaging in the diagnosis of knee joint injuries. // Traumatology and Orthopedics of Russia, 2005 (35) p.33
5. Drozdovsky B.Ya. Krylov V.V., Belichenko L.V. Pneumoarthrography in the diagnosis of rheumatoid lesions of the knee joints // Bulletin of radiology and radiology. 1993. – No. 2. – P.31-34.
6. White K.P. Pathological characteristics of deforming arthrosis of the knee joint: Dis. cand. honey. nauk.- L., 1980.- 329 S.

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