First 48-72 hours

• Stop the activity that caused pain. Avoid sprinting, kicking, deep stretching, or heavy lifting.
• Protect and compress: use an elastic compression bandage or thigh sleeve if comfortable.
• Ice for pain relief: 15-20 minutes at a time, every 2-3 hours while awake. Do not place ice directly on skin.
• Elevate when resting if there is swelling or bruising.
• Consider simple pain relief such as paracetamol/acetaminophen if safe for you. Anti-inflammatory medicines such as ibuprofen may help some people, but avoid them if you have kidney disease, ulcers, anticoagulant use, or other contraindications. In the first day or two, some clinicians prefer avoiding routine NSAIDs because they may theoretically interfere with early healing.

After acute pain settles

1. Gentle walking, aiming for a normal gait.
2. Pain-free knee bending and hip movement.
3. Isometric hamstring exercises, for example gently pressing the heel into the floor without moving the leg.
4. Progress to bridges, hamstring curls, hip-hinge exercises, then eccentric strengthening such as controlled Nordic hamstring work.
5. Add jogging, faster running, acceleration, and sport-specific drills only when strength and movement have returned.

Return to sport

• No pain during daily activities, jogging, sprinting, or stretching
• Full or near-full range of motion
• Hamstring strength close to the uninjured side
• Ability to sprint, stop, cut, jump, and perform sport-specific movements without pain or apprehension

Seek urgent assessment now if

• You felt a pop and have marked weakness
• You cannot walk normally or bear weight
• Rapid, extensive bruising or swelling develops
• There is a visible/palpable gap in the muscle
• Pain is high near the buttock or at the knee attachment
• Numbness, tingling, cold foot, or severe worsening pain occurs
• Symptoms do not begin improving within about a week