Muscular Tears & Strains — Physiotherapy in London & Henley

Three rough buckets. Grade 1 (mild): localised tenderness, full strength, full range of motion, ability to walk normally. Grade 2 (moderate): visible bruising within 24 to 72 hours, weakness on testing, gait limp. Grade 3 (severe/rupture): immediate sharp pain with a 'pop', visible defect or muscle bunching, severe loss of function, often unable to weight-bear. Grade 3 needs same-week imaging and surgical opinion; Grade 1 and 2 are routine physiotherapy cases.

Only after structured return-to-sport testing — limb-strength symmetry of at least 90 %, full range of motion, sport-specific drills under fatigue, and psychological readiness. Skipping these stages is the strongest predictor of re-injury (more than 50 % of recurrent hamstring injuries happen within the first month post-return when criteria are skipped). We test against measurable benchmarks rather than discharging on "feels OK".

For the first 24 to 48 hours, ice + compression + relative rest helps with pain and swelling. Beyond that the evidence for icing is weak — and for some tissue (tendon-dominant injury) prolonged ice may slow healing. Move to gentle range-of-motion and very early loading work as soon as the acute pain settles, usually within the first week. We will guide the timing at your first appointment.

Three reasons: athletes return to sport before strength has actually rebuilt, eccentric strength is rarely tested before clearance, and underlying movement-pattern drivers (sprint mechanics, hip drop) are not always addressed. Modern rehab — Nordic hamstring exercise variants, eccentric loading throughout range, biomechanical assessment of sprint mechanics — has cut elite recurrence rates substantially. We use the same approach for amateurs.