Hamstring Injury Treatments and Management in Athletes: A Systematic Review of the Current Literature.

Hamstring injuries are common in athletes and notoriously slow to rehabilitate, with disagreement in the literature about which treatments actually help people return to sport safely. This review pulled together 30 studies, covering just under 1,200 participants, that tested a wide range of approaches, including eccentric strengthening exercises, agility and trunk stabilization work, platelet-rich plasma injections, manual therapy, stretching, cryotherapy, laser therapy, and anti-inflammatory medication. The overall picture is mixed rather than clear-cut.

Some approaches, like eccentric muscle lengthening exercises, progressive agility training, and trunk stabilization, showed benefit, and stretching combined with cryotherapy also looked helpful. Platelet-rich plasma injections gave inconsistent results for return to sport and reinjury. The authors note that basic acute care and a rehabilitation program built around strengthening and flexibility remain central, but the underlying evidence is generally low-level, drawn from a varied set of individual studies rather than strong pooled trials, which limits how confidently any single treatment can be endorsed.

If you've ever dealt with a hamstring strain, you know how frustratingly slow recovery can be and how confusing it is to sort through advice about what actually helps. This review looked at a wide range of studies, testing things like specific stretching and strengthening exercises, injections of a blood-derived treatment called platelet-rich plasma, massage and manual therapy, laser treatment, and anti-inflammatory medication, in athletes recovering from hamstring injuries. The findings were mixed.

Exercises that lengthen the muscle under control, along with agility drills and core stabilization work, appeared to have benefits, and stretching paired with icing also seemed helpful. The injection therapy produced inconsistent results, sometimes helping and sometimes not, when it came to getting people back to sport or preventing reinjury. It's important to understand that this review pulled together many smaller, differently designed studies rather than one large, tightly controlled trial, so the certainty behind any of these findings is limited.

Basic first-aid measures and a program built around strength and flexibility remain the foundation of care described, but no single add-on treatment stood out as clearly superior.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review synthesized 30 studies totaling 1,195 athletes, evaluating heterogeneous interventions for hamstring injury including eccentric strengthening, progressive agility and trunk stabilization protocols, platelet-rich plasma injections, manual therapy, stretching, cryotherapy, high-power laser, and NSAIDs. Study quality was appraised using Joanna Briggs Institute criteria and Risk of Bias 2, and the overall level of evidence was rated IV, reflecting the predominance of lower-quality or heterogeneous primary studies rather than rigorous randomized comparisons. Across this varied evidence base, extensive eccentric muscle lengthening, progressive agility training, and trunk stabilization exercises were associated with reported benefit, as was stretching combined with cryotherapy.

Platelet-rich plasma injections produced mixed findings for return-to-sport timelines and reinjury rates, with no consistent direction of effect across studies, meaning the abstract does not establish clear efficacy for this modality despite frequent clinical interest. Given the level IV evidence rating and considerable heterogeneity in interventions, populations, and outcome measures, pooled conclusions should be interpreted cautiously. The review does not establish comparative superiority between the various rehabilitation and modality-based approaches, and the authors themselves call for more conclusive research, particularly regarding platelet-rich plasma in chronic presentations.