Leg Muscle Strains: Hamstring, Quadriceps and Calf Injuries

Leg muscle strains are familiar injuries and common occurrences. Most people can tell me the exact moment a strained or pulled muscle happened. Chasing a ball, sprinting for the bus or pushing off at the back of a tennis court and something severe was felt in the thigh or calf. A feeling similar to and as sudden as being kicked.

What follows is a time spent limping around and some outdated advice. It used to be advised to rest it, ice it and wait until it stops hurting. The up to date evidence has moved on from that and it is now a fact that people who start moving sensibly within a couple of days tend to get back to normal faster than those who rest and wait.

This page covers strains of the hamstring, quadriceps in the upper leg and the calf muscles, along with information on dead legs and cramp. Pain in the Achilles tendon and heel pain are detailed on my Achilles tendinopathy page and other leg conditions sit on my leg, knee, ankle and foot pain guide page.

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Which muscles in the leg can be affected by strains and pulls

A strain is a tear in the muscle, usually where muscle fibres meet the tendon, caused by the muscle being forced to lengthen while contracting. Strains are graded by severity, from a few fibres with a little loss of strength through to a complete rupture. Most of what I see as a chiropractor sits in the middle of that range.

Three muscles account for the bulk of injuries. The hamstrings at the back of the thigh are the most commonly injured, usually during fast running. The quadriceps at the front can get injured during kicking. The calf, specifically the inner head of the larger calf muscle, tears in what is still called tennis leg, most typically seen in a player over the age forty because of less compliant muscle and tendon tissue.

Two related problems are not tears at all. A dead leg or corked thigh is bruising within the muscle after a direct blow. Cramp is a sudden involuntary contraction of a muscle with no tissue damage, which is why it can be agonising one minute and gone the next.

Groin pain and adductor injuries are another source of leg pain and injuries.

What causes strains, sprains and muscle pulls in the leg

Strains happen when demand outstrips what the muscle can tolerate and the highest-risk moments are predictable and avoidable. These may involve high-speed running, a sudden change of direction, kicking and any movement forcing the muscle to lengthen under load. Fatigue matters, which is why so many of these injuries arrive in the last twenty minutes of sport or exercise.

The single largest risk factor for a hamstring strain is having had one before, particularly in the previous few months. Weak strength, a sudden return to sport after a lay-off and age all add to the risk of a pull. In older recreational football players the calf is the usual casualty rather than the hamstring.

Cramp is different and often has no identifiable cause. The most common contributors are: Muscular fatigue or overload, working the muscle in a shortened position, sudden increase in exercise, heat and heavy sweating, electrolite disturbances, poor recovery and occasionally lumbar nerve irritation. It becomes more common with age and is commonly associated with pregnancy, some medications and occasionally an underlying medical condition, which is why new frequent cramp is worth booking an appointment with your GP for.

Explore our leg, knee, ankle and foot guides

Leg, knee, ankle or foot pain: the main guide

Heel, ankle and foot

Knee, thigh and calf

Knee pain: runner’s knee, bursitis, clicking, locking and giving way
Knee osteoarthritis: wear and tear, bone on bone
Muscle strains of the leg: pulled hamstring, quadriceps, calf and night cramps (you are here)

Related guides

When leg pain starts in the back

When leg pain starts in the hip or pelvis

Staying active

anatomy of the leg muscles shown on a mans leg explaining the location of pain for leg muscle strains

The anatomy of the leg showing the location of the quadriceps muscles and how they can be affected by leg muscle strains

Strains, dead leg, calf tears and cramp symptoms explained

A strain presents with a sudden sharp pain at a specific point, sometimes with a sensation of being struck and an immediate reluctance to put the leg through its full range of movement. Bruising often appears over the next two or three days following the strain and tracks downwards under gravity, which looks alarming and is usually not significant in itself. The area is tender to press and both stretching the muscle and contracting it against resistance reproduce the pain.

A dead leg feels different: a deep ache and progressive stiffness over the hours after impact, with difficulty bending the knee fully, but no sense of something having given way.

A calf tear is easily confused with a ruptured Achilles and the difference between them is important. A muscle tear is felt in the fleshy part of the calf and you can usually still rise onto tiptoe but painfully. A rupture is felt lower in the calf at the cord above the heel and pushing off becomes impossible.

Cramp is a sudden, visible, rock-hard muscle contraction, usually in the calf or foot and usually at night. It lasts seconds or up to a few minutes and leaves the muscle sore for a day.

Separately, hamstrings that feel permanently tight without any injury are usually not short at all and stretching them harder rarely helps.

How chiropractic care may help

Muscle heals well on its own. The factors that change how quickly you get back to normal and how likely you are to experience the injury again, are how soon you start loading it and how well the return to health is graded. That is where I am useful, you need a fully graded recovery to prevent reoccurrence or lingering pain.

Current guidance for muscle strains for the first few days is protection, elevation, compression and education, followed early by load, optimism, circulation and exercise.[1] A trial of fifty amateur athletes with serious thigh and calf injuries found that starting rehabilitation two days after injury rather than nine days returned them to full activity considerably sooner.[2] In hamstring injuries, a protocol built around lengthening exercises got elite footballers back faster than a conventional one.[3] For preventing the next one, programmes including the Nordic hamstring exercise roughly halved injury rates across more than eight thousand athletes, though that work is in sporting populations and is less relevant for a fifty-five-year-old playing football as an amateur.[4]

Cramp is one of the areas where chiropractic care is recognised as helpful and the practical evidence is unglamorous: nightly calf and hamstring stretching before bed reduced the frequency and severity of night cramps in adults over aged fifty-five.[5]

What I do in my chiropractic capacity is assess and grade the injury, treat the surrounding tissue and the joints above and below it, prescribe and progress the loading and set criteria for ultimate goals of recovery. I also examine the lower back and pelvis, because a hamstring that keeps tearing on the same side often has something else causing it.

If leg muscle strains and sprains are getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

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Or call for a chat on 01202 937568

Red flags: when to seek medical attention first

The one most important medical emergency is a clot. Calf pain and swelling that came on without any injury, particularly with warmth, redness or after surgery, after a long flight or a period of immobility, needs same-day assessment and most urgently if you are breathless or have chest pain. Do not stretch or massage a calf in that situation.

Go to A&E if you cannot bear weight at all, if there is an obvious gap where the muscle should be or if you felt a sudden blow at the back of the ankle. After a heavy dead leg, escalating tightness, numbness or pain out of proportion to the injury needs urgent assessment. Frequent cramp alongside new weakness, weight loss or a change of medication belongs with your GP first.

Your first visit to Bournemouth Chiropractic

At your chiropractic first appointment I take a full medical history covering what you were doing at the moment it happened, whether you felt a pop, how quickly it bruised and what you have not been able to do since. Then I examine the muscle, locate the injury precisely, test strength and length against the other leg and check the lower back and pelvis. I will tell you in clearly what grade of injury I think it is, roughly how long it should take to recover and what the loading plan involves.

Frequently Asked Questions

Can a chiropractor help with a pulled muscle?

Hands-on treatment from a chiropractor may help with the pain and restricted movement of a pulled muscle early on and the graded loading programme that gets you back to normal most reliably. My role is as much about pacing the return as treating the muscle, since going back too early is the commonest reason these injuries recur. A suspected complete rupture needs a surgical opinion instead.

Should I ice a leg muscle strain?

Use ice briefly at the very most for a pulled muscle or strained muscle in your leg. Current guidance leans towards protection, elevation and compression in the first day or two, then early loading, rather than prolonged icing and rest.[1] Getting moving sensibly within a couple of days matters more.[2]

How long before I can run again after straining a hamstring muscle in my leg?

Returning to sport or running with a minor strain is often takes a week or two, a moderate leg strain may take one four to eight weeks, a complete tear far longer. It depends on the grade and on how the muscle responds. Going back when the pain stops rather than when the strength returns is why so many people tear the same hamstring twice.

Why do I get cramp at night?

Often there no reason you get cramp at night in your legs. Cramp becomes more frequent with age and can also be associated with pregnancy, certain medications and some medical conditions. A study showed that stretching the calves and hamstrings nightly before bed reduced both frequency and severity in adults over fifty-five.[5] New, frequent cramp warrant a GP appointment.

When should I go to A&E rather than book an appointment?

Go to A&E if you cannot put weight through the leg, if you can feel a gap in the muscle or if you felt a blow at the back of the ankle and cannot push off. Calf pain and swelling that appeared without an injury, especially with breathlessness, needs same-day attention because of the possibility of a clot.

Whatever has caused your leg muscle strains, come and find out how you can avoid them and recover from them

Most people know exactly the moment the strain or sprain injury happened. A sprint, a stretch too far, a sudden catch at the back of the thigh and then the awkward hobble that follows. What is far less obvious is when it is safe to go back to what you were doing and going back too early is the single most common reason a strain turns into a recurring injury. At a first chiropractic appointment I will take a full medical history, examine the leg muscle and the joints above and below it and give you an opinion about what you have done and how long it is likely to take.

Pulled hamstrings, quad muscles, dead legs and torn calves hobble through the door often here at the clinic. Ranging from weekend footballers and runners to people who simply did more in the garden than advisable.

For a minor sports injury or a muscle spasm, hands-on chiropractic care alongside a graded return to loading is a well-tolerated option worth considering and it is a straightforward area for me to help in. The same goes for cramp, which is far more common in the legs than most people realise and often responds to sorting out load and conditioning rather than anything very complicated. Where I suspect a significant tear or where the pain does not behave the way a strain should, I will tell you and help you get the imaging or the referral opinion you may need instead.

Book an appointment online and you can choose what suits you: a first appointment, which is the full thing with a detailed history, examination and treatment where appropriate, or a free 15 minute consultation, which is simply a no-obligation chat about your problem with no examination and no treatment. If you are not sure which you need, call the clinic on 01202 937568 and we will work it out together.

Call, message or email, whatever is easiest and we will take it from there.

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