Hamstring Strains and Hamstring Tendonitis Rehab

About Hamstring Strains

Your hamstring muscles do double duty during physical activity, working as both knee flexors and hip extensors. The hamstrings and their associated tendons can become ruptured or strained during physical activity, and injuries can be acute or chronic. Failure to fully rehabilitate your injured hamstrings can interfere with athletic performance and set you up for more injuries down the road.

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Hamstring injuries are common in athletes and physically active people, and an injured hamstring can be slow to heal, taking you out of the game while you recover. To rehabilitate your hamstring muscles and return to sports and exercise as quickly as possible, you need to do the following:

Hamstring Strains and Hamstring Tendonitis Rehab
  1. Seek treatment as early as possible from a sports physical therapist
  2. Look for a therapist who uses diagnostic ultrasonography to view your injured structures in real time
  3. Ask about advanced treatment methods that incorporate the latest innovative therapies and advanced technologies
  4. Ask how your rehab progress will be measured, and what criteria will be used to assess your readiness to return to play

Old school timelines for return to sport are obsolete because they fail to take into account the individual athlete, the degree and scope of injury, the effectiveness of individual treatment protocols and the need to restore neuromotor pathways that were disrupted by the injury.

At NYDNRehab, we believe that what cannot be measured cannot be effectively treated. We use advanced technologies to objectify and quantify performance parameters immediately after injury, and at regular intervals throughout the rehabilitation journey, to ensure that our athletes are fully healed and ready to return to play with minimal risk of re-injury.

Hamstring Strains and Hamstring Tendonitis Rehab Image

Let’s Discuss Your Treatment Options

The hamstring rehab treatment toolbox at NYDNRehab is packed with cutting edge technologies and advanced interventions. Your treatment protocol may include some or all of the following:

AI assisted eccentric loading for precision and feedback

Blood flow restriction training to build strength and promote rapid healing

Regenerative shock wave and pressure wave technologies to promote cellular neogenesis

Ultrasound guided dry needling to release myofascial trigger points

Advanced balance retraining methodologies to restore symmetry and functional movement

Rehabilitative ultrasonography to restore optimal muscle recruitment patterns

Sonoelastography and superior microvascular imaging to assess and measure progress

Advanced biofeedback retraining to restore disrupted brain-body pathways


Our Regenerative Technologies are Game-
Changers for Hamstring Injuries

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.

Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.

High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.

INDIBA CT9 Radiofrequency Device

INDIBA CT9 Radiofrequency Device

Our INDIBA Tecar therapy machine converts electrical current into a stable radio frequency current of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing. INDIBA can be used to successfully treat joint and muscle disorders, low-back pain, sports injuries, surgical incisions and various pain syndromes. Another therapeutic effect of INDIBA is extreme and prolonged cellular hyperthermia. Due to this effect, INDIBA therapy combined with manual therapy and soft tissue tissue manipulation enables instantaneous release to occur, significantly shortening the number and duration of physical therapy sessions. What is normally accomplished in two months of physical therapy can be accomplished in 3-4 sessions with INDIBA.

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to lower back pain. Dry needling is an outpatient procedure that inserts non-medicated needles into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Regenerative Ultrasound Guided Injection Therapies

Ultrasound Guided Injection

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.

Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Electromagnetic Transduction Therapy (EMTT)

Our unique toolbox of advanced diagnostic and treatment options cannot be found under one roof in any other sports rehab clinic. If your goal is to get back to your favorite sport or activity as quickly and safely as possible, and with minimal injury risk, contact NYDNRehab today.

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    We contact you during the day

    Dr. Lev Kalika
    Dr. Lev Kalika

    Clinical director & DC RMSK

    Our Sports Injury Specialists Know Hamstrings

    NYDNRehab is NYC’s premier clinic for sports injury rehabilitation. Our clinical director, Dr. Lev Kalika, was trained under some of the world’s foremost innovators in the field of human movement science and physical rehabilitation. Dr. Kalika has dedicated his life’s work to revolutionizing the way injuries and movement disorders are treated, seeking out the most advanced and evidence-based approaches for injury rehab and retraining. Our clients include elite world-class athletes, runners and ballet dancers, as well as recreational athletes and physically active youth and adults.

    Accurate Diagnosis Means Fast and Effective Treatment

    Hamstring injury symptoms often mimic other pathologies, and a diagnosis based on symptoms alone can sometimes lead you down the wrong treatment path, wasting your time and prolonging your recovery.

    At NYDNRehab, we believe that what cannot be measured cannot be effectively treated. After a thorough health history review and clinical exam, we pull out all the stops to ensure that we pinpoint the exact location, nature and severity of your injury. We do extensive testing and assessment to establish a pre-rehab baseline and use it to measure your progress throughout your rehab journey.

    Accurate Diagnosis Means Fast and Effective Treatment
    Accurate Diagnosis Means Fast and Effective Treatment Image 2

    Our diagnostic tools for hamstring strain and hamstring tendinopathy assessment and testing include:

    • Diagnostic ultrasonography, to view the damaged tendon in real time, with the patient in motion.
    • Sonoelastography, to test the tendon’s mechanical properties of elasticity and stiffness.
    • Superior microvascular imaging, to detect early vascular activity that indicates the healing process is underway.
    • Full battery of performance and skills testing to compare the injured vs non-injured limb.

    Once we have a clear picture of the location, nature and severity of your hamstring injury, we put together a personalized rehab program designed just for you. We never take a one-size-fits all approach to hamstring injury treatment. Our therapists work with you one-on-one, to make sure your rehabilitation is thorough and effective.

    Hamstring Injury Symptoms, Causes and Types

    The location and severity of hamstring injuries can be easily detectable with high resolution diagnostic ultrasound. Symptoms, inflammation and bruising are also indicators of injury.

    Hamstring Strains

    Hamstring Strains

    A hamstring strain is an injury that involves tearing of the hamstring tendon or muscle tissue. Severity can range from microtears that produce pain and stiffness but heal quickly on their own, to severe ruptures that cause debilitating pain and dysfunction and require medical intervention. Even mild strains should be treated, as their underlying mechanism may lead to more serious injury down the road if not corrected.

    Symptoms of a hamstring strain include:

    • Severe pain while exercising, accompanied by a snapping or popping sensation

    • Pain in the lower buttock and back of the thigh

    • Bruising

    • Tenderness in the muscle and/or tendon

    • Hamstring muscle stiffness


    Tightness, discomfort, spasm, mild swelling; able to walk normally but not run up to speed


    Impaired walking with limping, twinges of pain with activity, swelling and tenderness; painful to bend the knee against resistance


    Severe pain with tearing of half to all of the muscle; immediate swelling, bruising and weakness; crutches may be needed to ambulate

    Hamstring Tendonitis

    Hamstring Tendonitis

    Hamstring tendonitis occurs when the tendon that attaches muscle to bone becomes irritated or inflamed.

    • Lower hamstring tendonitis presents as pain at the back of the knee, where tendons attach at the top of the lower leg.

    • High hamstring tendinopathy occurs near the hip, and presents as deep buttock or upper thigh pain.

    If left untreated, hamstring tendonitis and hamstring tendinopathy can cause progressive degeneration of the tendon tissue, leading to chronic weakness, pain and dysfunction.

    Clinical Case Studies

    Case Study: Resolving Chronic Sit Bone Pain in a Female Runner

    Our patient is a 45 year-old female runner complaining of left sit bone pain when running and sitting. She has a history of proximal hamstring tendinopathy, and had been treated with plasma injections about 5 years prior, along with physical therapy. Her pain was initially resolved by the injections, and she continued to run.

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    Case Study: Hamstring and SI Joint Dysfunction in Female Runner

    Our patient is a 52 year-old female runner who came to us after unsuccessful treatment elsewhere, complaining of mild low back pain shooting down her right leg.

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    Get the Best Physical Therapy in NYC and Get Back Out There!

    Ignoring a hamstring injury won’t make it go away. In fact, neglecting an injured hamstring can lead to long-term disability, taking you out of the game for good. Contact NYDNRehab today, and get cutting edge treatment for your hamstring injury so you can get back to the sports and activities you love.

      Request a Consultation

      We contact you during the day

      Dr. Lev Kalika
      Dr. Lev Kalika

      Clinical director & DC RMSK

      Or call us

      phone 1-212-308-9595

      In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

      Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

      The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

      Dynamic ultrasonography examination demonstrating
      the full thickness tear and already occurring muscle atrophy
      due to misdiagnosis and not referring the patient
      to proper diagnostic workup

      Demonstration of how very small muscle defect is made and revealed
      to be a complete tear with muscle contraction
      under diagnostic sonography (not possible with MRI)


      Complete tear of rectus femoris
      with large hematoma (blood)


      Separation of muscle ends due to tear elicited
      on dynamic sonography examination

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