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Physiotherapy · Hamstring strain

Hamstring strain physio in Phuket

A pulled hamstring heals. The risky part is the first weeks back at speed. Our physios load it early and rebuild lengthening strength, then your coach takes you back to full-speed sprinting and sport.

For a fresh strain, being back but not yet sprinting, or a hamstring that has gone before.

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Rated 5.0 from 57 Google reviews

What the research says

Repeat strains strike early, same spot

Pain settles before strength and speed fully return. In one small trial, no athlete’s MRI showed complete healing at return to sport, despite near-normal strength.1 That gap is why testing matters.

  • 28days

    back to full training with a lengthening program, against 51 days with a conventional one, in a trial of elite footballers.2

  • 69%

    of same-season repeat hamstring injuries in elite football came within two months of returning to full training.3

  • 79%

    of MRI-confirmed reinjuries in one study struck the same spot as the first injury.4

Feeling fine is not the finish line. Measured strength and pain-free full-speed running are.

How we work

Load early, lengthen, then sprint

Muscle recovers with the right load, not rest alone. Your physio checks a tendon has not torn off the bone, then sets your starting load. Each stage has a test you pass before moving on.5

  • Start loading within days

    In the main trials, lengthening exercises began around day five after injury. One trial found that starting them early was as safe as waiting, with similar reinjury rates.2,6

  • Strength at long lengths

    Exercises that load the hamstring as it lengthens got elite athletes back to training faster than a conventional program in two trials.2,7 We build from gentle holds to heavy, fast lengthening work.

  • Run, then sprint, in steps

    Running starts once walking is pain-free, then speed rises in small steps to a full sprint.8 In elite football, 61% of hamstring injuries happened while running or sprinting, so you rehearse it before you play.3

  • Tests decide, not the calendar

    Return decisions rest on pain-free strength, flexibility and field tests plus your readiness, as agreed by international experts, rather than a set number of days.9

Your recovery

Five phases, moved on by tests

Typical times from the research. Small strains move faster. Strains involving the tendon, or from kicking and splits, took longer in the trials.2,7

  1. 01

    Typically days 0 to 7

    Protect and load

    Your physio confirms it is a muscle strain, not a tendon torn off the bone, and records strength and range on both legs. Walking, gentle hamstring holds, bridges and the bike start within days.5

    Move on whenYou walk normally without a limp, a single-leg squat on the injured side is pain-free, and five minutes of hard cycling is pain-free.6

  2. 02

    Typically weeks 1 to 4

    Lengthening strength

    The core of the physio phase: exercises that load the hamstring while it lengthens, first slowly with bodyweight, then heavier and faster, plus Romanian deadlifts and sliders.2

    Start running whenWalking is pain-free, the lengthening exercises go through full range, and strength and pain-free range are about 75% of the other leg.10

  3. 03

    Typically weeks 1 to 5

    Run and build speed

    Jogging, then speed rising in small steps after each pain-free set. Change of direction, Nordic curls and heavier strength work come in as running passes about 70% of top speed.6,8

    The handover checkPain-free running at 80% of top speed, a pain-free change of direction drill, and strength at least 80% of the other leg. Your physio signs it off.

  4. 04

    Typically weeks 2 to 8

    Sprint and sport

    Your S&C coach takes you to full sprints, accelerations, curved runs and sport drills: kicks, teeps, lunges and cutting. Then a half session, two full sessions and a shortened first game.10

    Return to sport whenFull-speed sprints with no pain or holding back, no pain on strength or flexibility tests, a strength gap under 10 to 15%, and you feel ready.8,9

  5. 05

    From return, ongoing

    Stay strong

    The first two months back carry the highest share of repeat strains.3 Nordic curls at least once a week, weekly sprinting near top speed, and strength retests every 6 to 8 weeks.11

    Signs it is workingStrength holding within 10% of the other leg, weekly sprinting without tightness, and no new pain at the old injury site.

These trials used elite athletes with supervised daily rehab. If you train two or three times a week, expect longer. Your physio estimates your timeline at your first visit.5

Between sessions

Pain, next morning, confidence

Check three things during and after every session. Your physio sets the exact limits for your injury.

Check pain at the injury (low during strength work, none while running), how it feels the next morning, and your confidence when running, kicking or stretching.

  • Green: progress

    Strength work stays at 3 out of 10 or less, running is pain-free, and the next morning is no worse. Progress load or speed one step.

  • Amber: hold

    Pain a little higher during strength work, or the next morning is a little stiffer. Repeat the same session before progressing.

  • Red: step back

    Any pain while running, or worse the next day. Stop running that day, drop back a step and tell your physio.

Get medical help today if

  • A pop, gap or heavy bruising high in your thigh
  • You cannot walk normally on the injured leg
  • Numbness, tingling or weakness spreading down the leg
  • Under 18 with sudden pain at your sitting bone
  • A hot, swollen, painful calf
  • Breathless or chest pain: call 1669 now

A pop, bruising or weakness high in the buttock needs a scan and a surgical opinion within days: early repair did better than late repair.12

Pulled the same one before?

A previous strain is the biggest warning

In one study of 311 professional Australian Football players, a previous hamstring strain nearly tripled the risk of another.13 So the work continues after you are back playing.

In one trial of 942 Danish footballers, a 10-week Nordic program followed by weekly sessions cut repeat hamstring injuries from 45.8 to 7.1 per 100 player-seasons.11 Pooled studies agree that programs including Nordics lower injury rates, but a strict reanalysis called the evidence inconclusive.14,15 We aim to lower your risk, not promise prevention.

2.9x

the risk of a new strain after a previous one13

75%

of sessions completed before programs showed a clear benefit16

Patient reviews

What our patients say

Rated 5.0 from 57 Google reviews

  • “Came to see K. Meaw after a thigh injury due to overuse by playing tennis, I wasn’t able to walk and she helped me recover in 3 sessions plus taught me about strengthening my muscles to do sports.”

    GERARDO TAYGoogle review

  • “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”

    Unfiltered OpinionsGoogle review

  • “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”

    Jamie AllworkGoogle review

  • “Great Physiotherapy. Khun Meaw helped me very professionally with my the post-op rehab of my knee after ACL and Meniscus repair. She is very kind, knowledgeable and helpful. Really recommend her and Optimize!”

    ELIH HectorGoogle review

  • “I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”

    Catlin McCrackenGoogle review

  • “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”

    Michelle LawlorGoogle review

  • “I had an impingement in my shoulder an Karim solved it within three sessions! Really amazing! I can only recommend going there.”

    Julian BarthGoogle review

Read all 57 reviews on Google

Questions

Hamstring strain questions

Should I rest it until it stops hurting?

No. In the main trials, lengthening exercises started around day five. One trial found that starting them early was as safe as waiting, with similar reinjury rates.2,6

Does any pain mean I am making it worse?

Not during strength work. In one trial, rehab that allowed some pain regained more strength than strictly pain-free rehab and did not significantly slow return.17 Running should still be pain-free.

Will Nordics stop it happening again?

Programs including Nordics lowered hamstring injuries across many studies, but a strict reanalysis called the effect inconclusive.14,15 Done consistently, alongside sprinting, they help. No exercise guarantees protection.

Will an injection get me back faster?

In one trial of 90 professional athletes, a platelet-rich plasma injection was no faster than intensive rehab alone.18 Pooled trials hint at a faster return, but results vary and reinjuries were no fewer.19

Do I need a scan?

Mild and moderate strains usually do not.5 Scans matter when a tendon tear is suspected, such as a pop and heavy bruising high in the thigh.

What happens at the free physio assessment?

Your physio checks for a tendon tear and other red flags, measures both legs and estimates your timeline. You leave with a clear plan. It’s free, with no obligation.

Physio team

Your physio team

Karim has a background in return to sport. Meaw leads our clinical standards.

How physiotherapy works here
  • Meaw, Head Physiotherapist at Optimise

    Meaw

    Head Physiotherapist

  • Karim, Physiotherapist at Optimise

    Karim

    Physiotherapist

Also on the team Sukanya, Physiotherapist

Next step

Find out where your hamstring stands

Message us on WhatsApp to book your free physio assessment. Whether you are days in or weeks back, you leave with a clear plan and tests to pass.

Book a free physio assessment

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Questions first? WhatsApp +66 65 914 1604

Low back painSciaticaShoulder painKnee arthritisRunner’s kneeACL rehabAnkle sprainNeck painTendon painMeniscus tearsHeel painHip arthritisFrozen shoulderRotator cuff tearsKnee and hip replacement
Sources (19)
  1. Silder A, et al. Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial. J Orthop Sports Phys Ther. 2013;43(5):284-299.
  2. Askling CM, et al. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2013;47(15):953-959.
  3. Ekstrand J, et al. Hamstring injury rates have increased during recent seasons and now constitute 24% of all injuries in men’s professional football: the UEFA Elite Club Injury Study from 2001/02 to 2021/22. Br J Sports Med. 2023;57(5):292-298.
  4. Wangensteen A, et al. Hamstring reinjuries occur at the same location and early after return to sport: a descriptive study of MRI-confirmed reinjuries. Am J Sports Med. 2016;44(8):2112-2121.
  5. Martin RL, et al. Hamstring strain injury in athletes. J Orthop Sports Phys Ther. 2022;52(3):CPG1-CPG44.
  6. Vermeulen R, et al. Early versus delayed lengthening exercises for acute hamstring injury in male athletes: a randomised controlled clinical trial. Br J Sports Med. 2022;56(14):792-800.
  7. Askling CM, et al. Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2014;48(7):532-539.
  8. Hickey JT, et al. Hamstring strain injury rehabilitation. J Athl Train. 2022;57(2):125-135.
  9. van der Horst N, et al. Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making. Br J Sports Med. 2017;51(22):1583-1591.
  10. Whiteley R, et al. Rehabilitation and return to sport after hamstring injury. Aspetar Sports Med J. 2019;8 (Targeted topic: hamstring injuries).
  11. Petersen J, et al. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011;39(11):2296-2303.
  12. Jokela A, et al. A systematic review of surgical intervention in the treatment of hamstring tendon ruptures: current evidence on the impact on patient outcomes. Ann Med. 2022;54(1):978-988.
  13. Opar DA, et al. Screening hamstring injury risk factors multiple times in a season does not improve the identification of future injury risk. Med Sci Sports Exerc. 2022;54(2):321-329.
  14. Impellizzeri FM, et al. Why methods matter in a meta-analysis: a reappraisal showed inconclusive injury preventive effect of Nordic hamstring exercise. J Clin Epidemiol. 2021;140:111-124.
  15. van Dyk N, et al. Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. Br J Sports Med. 2019;53(21):1362-1370.
  16. Gu J, et al. Intervention components, training dose, and adherence in exercise-based prevention of hamstring strain injury in football: a systematic review and meta-analysis. Ann Med. 2026;58(1):2652116.
  17. Hickey JT, et al. Pain-free versus pain-threshold rehabilitation following acute hamstring strain injury: a randomized controlled trial. J Orthop Sports Phys Ther. 2020;50(2):91-103.
  18. Hamilton B, et al. Platelet-rich plasma does not enhance return to play in hamstring injuries: a randomised controlled trial. Br J Sports Med. 2015;49(14):943-950.
  19. Nakagawa H, et al. Effects of percutaneous platelet-rich plasma injection on return-to-play after acute hamstring muscle injury: a systematic review and meta-analysis. Br J Sports Med. 2026;60(5):370-378.

This page is general information based on the research listed here. It is not a diagnosis. Your physio will tailor the plan to you, and your surgeon’s or doctor’s instructions come first. Clinically reviewed by Meaw, Head Physiotherapist at Optimise, November 2026.