Marc Darrow, MD, JD

I often get emails about stubborn hamstring injuries, and the story is usually the same. You’ve tried rest, anti-inflammatories, and maybe even cortisone shots. Still, the pain from microtearing lingers, making simple things like sitting a real problem. So, can PRP for a hamstring tear or chronic tendinopathy actually help? After guiding many patients, I’ve seen how these treatments can work where others have failed. The biggest question is always about the prp hamstring recovery time. You want to know how quickly you can get back to your life. Let’s break down what that healing timeline really looks like.

The hamstrings comprise a group of muscles at the back of the thigh. Among the muscle group is the semitendinosus muscle, semimembranosus muscle and the long and short head of the biceps femoris.The semitendinosus muscle, semimembranosus muscle and the long head of the biceps femoris hamstrings attach to the pelvis at the ischial tuberosity, the bony prominences sometimes referred to as “sit bones.” So named because they are the bones we do sit on. They are also often referred to as the Proximal hamstrings (the center hamstrings) because of their attachment or insertion at this “center” point.

Your Guide to Treating Hamstring Injuries

When we get emails into the office about hamstring injuries it is usually from someone who has a full devastating tear or a recent acute partial tear, or someone who has been suffering from a “nagging,” hamstring problem. A confirmed complete rupture  would require surgery to get an athlete back to his/her sport. A partial acute tear, or, wear and tear damage can be treated non-surgically. Let’s get to some research.

What Happens During a PRP Hamstring Injection?

If you’re considering Platelet-Rich Plasma (PRP) therapy for your hamstring, you’re probably wondering what the treatment actually involves. PRP is designed to concentrate the natural growth factors found in your blood and deliver them directly to the site of your injury, encouraging the tissue to repair itself. Let’s walk through exactly what you can expect during a PRP injection session, from the initial blood draw to the final injection.

The Step-by-Step Procedure

First, a small amount of blood, similar to a standard blood test, is drawn from your arm. This blood is then placed into a centrifuge—a machine that spins at high speed to separate the components of your blood. This process isolates and concentrates the platelets, which are rich in healing growth factors. Once separated, this golden-colored liquid platelet concentrate is prepared for injection. Your doctor may apply a local anesthetic to numb the area. Then, using ultrasound guidance to ensure precise placement, the PRP is carefully injected into the damaged part of your hamstring tendon or muscle, delivering a powerful dose of healing right where you need it most.

Understanding Different PRP Formulations

Not all PRP is created equal, and the specific formulation can influence your recovery experience. The main difference comes down to the concentration of red and white blood cells left in the final mixture. “Red PRP,” which contains a higher number of these cells, can sometimes cause a more significant inflammatory response, leading to more initial soreness. In contrast, “Amber PRP” is filtered to contain fewer red and white blood cells. This version typically results in less post-injection soreness and a quicker reduction in that initial flare-up. An experienced physician, like Dr. Marc Darrow, can determine the most appropriate formulation for your specific injury to optimize healing while managing your comfort.

Potential Risks and Side Effects

One of the biggest advantages of PRP therapy is its strong safety profile. Because the injection is created from your own blood, the risk of an allergic reaction or disease transmission is virtually eliminated. The procedure is generally considered very safe and well-tolerated. However, as with any procedure that involves an injection, there are some minimal risks. These can include temporary pain or soreness at the injection site, bleeding, or bruising. More rare complications might include infection, nerve irritation, or tissue damage, but these are highly unlikely when the procedure is performed by a skilled and experienced medical professional in a sterile environment.

Cortisone vs. PRP: Which Is Right for Your Hamstring?

PRP treatments involve collecting a small amount of your blood and spinning it in a centrifuge to separate the platelets from the red cells. The collected platelets are then injected back into the injured area to stimulate healing and regeneration. 

As hamstring injury is usually accompanied by inflammation, cortisone is often suggested as a treatment. There are times cortisone may be called for, we very, very rarely see a patient where we would suggest cortisone. In our office we specialize in regenerative medicine, treatments that rebuild tissue. Cortisone removes inflammation, it does not rebuild tissue.

An April 2019 study (1) compared the effectiveness of pain relief in patients with grade 2 proximal hamstring injury (typically a partial tear that causes you to limp, have some muscle swelling, and soreness to the touch), treated with platelet-rich plasma (PRP) or corticosteroid injection.

In a group of 56 patients:

  • 32 received PRP
  • 24 received steroid injections

At 1 week post-injection follow-up, 23 patients (71.9%) from the PRP group and 11 patients (45.8%) from the steroid group showed positive response, (as measured by VAS pain scale).

At 4 weeks post-injection, 23 patients (71.9%) from the PRP group and 13 patients (54.2%) from the steroid group showed positive response, (as measured by VAS pain scale).

The research concluded: “The PRP group had shown more favorable response compared to steroid group at 1 week post-injection, which suggests that PRP therapy can be considered as a conservative treatment choice for grade 2 proximal hamstring injuries with better short-term pain relief based on limited pilot data.”

Comparing Recovery Paths: PRP vs. Steroid Shots

When you’re dealing with a nagging hamstring injury, a steroid shot is often presented as a quick fix. It’s a powerful anti-inflammatory that can certainly reduce pain, which sounds great on the surface. However, the relief is often temporary because steroids primarily mask the symptoms by suppressing inflammation; they don’t address the root cause of the pain—the damaged tissue. In contrast, PRP therapy works on a fundamentally different principle. It’s a regenerative treatment that uses a concentration of your own blood platelets to deliver powerful growth factors directly to the injury site. This process signals your body to initiate a natural healing cascade, repairing the torn fibers and rebuilding the tendon for a more durable and lasting solution.

PRP as an Alternative to Hamstring Surgery

If you’ve been struggling with a chronic hamstring tear that just won’t heal, surgery can feel like your only remaining option. While a complete rupture may require surgical reattachment, many partial tears and cases of chronic tendinopathy can be treated without going under the knife. PRP therapy offers a compelling, minimally invasive alternative that helps you avoid the significant risks, downtime, and lengthy rehabilitation associated with surgery. By harnessing your body’s own healing capabilities, this procedure helps repair the hamstring from the inside out. For many patients, this means a much faster return to daily activities and the sports they love, making it a powerful option to explore before committing to an operation.

Will One Injection Be Enough?

Many times we will get an email from someone with chronic hamstring problems seeking stem cell therapy for their injury. A main reason for seeking stem cell therapy to the patient is that they already tried PRP and it did not work for them. Why would it not work for them? Many of these people received a single PRP injection. The single PRP injection is a treatment type that we typically see as not effective for many people. We will suggest to patients that, realistically, to achieve the type of healing they are looking for, 2 – 3 treatments may be required. This was confirmed by research in a March 2019 paper in the Journal of science and medicine in sport.(2)

In this study, doctors tested the efficacy of an ultrasound-guided platelet-rich plasma (PRP) injection in the treatment of patients with proximal hamstring tendinopathy.

  • The patient was given “a single PRP injection under ultrasound guidance.” Following the injection, pain, function and sporting activity were measured via the Victorian Institute of Sport Assessment-Proximal Hamstring Tendons (VISA-H) questionnaire, administered before injection and at 8-weeks follow-up.
  • 69% of patients reported no change in their ability to undertake sport or other physical activity at 8-weeks follow-up. Conclusion: “Patients with proximal hamstring tendinopathy receiving a PRP injection did not improve on clinical outcomes at 8-weeks follow-up.”

Does this mean a single PRP treatment will not help? No, not at all. Even in this the above study 69% of the people said that they had no improvement, 31% had a different outcome. In a study, published in the Journal of Ultrasound Medicine, (3) doctors offered these more positive findings: 

The researchers of this study compared the effects of ultrasound-guided platelet-rich plasma (PRP) and whole blood (WB) injections in patients with chronic hamstring tendinopathy. Again this was a single injection. In our office we have seen consistently better results when a second or third treatment was offered.

  • The doctors performed a  prospective double-blind randomized controlled trial, PRP or WB was injected under ultrasound guidance into the proximal hamstring tendon in a group of patients with clinically suspected hamstring tendinosis. Questionnaires were administered before injection and 2, 6, and 12 weeks and 6 months after injection. Pain and function outcomes were measured.

Results: The whole blood (WB) group showed greater improvements in pain and function over the PRP group before 12 weeks, whereas the PRP group showed improved outcomes over whole blood (WB) at 6 months. “Both PRP and WB groups showed improvements in all outcome measures at 6 months. The PRP group showed significant improvements in 6-month pain and function scores.”

### Success Rates for Partial Tendon Tears

Research shows that platelet-rich plasma (PRP) treatments can be a powerful tool for people dealing with partial hamstring tears. A 2019 study put PRP head-to-head with corticosteroid injections for moderate hamstring injuries, and the results were telling. Just one week after treatment, nearly 72% of patients who received PRP reported a positive response, compared to less than 46% in the steroid group. This isn’t just a fluke; the trend continued at the four-week follow-up. This suggests that PRP helps kickstart your body’s own healing processes for more effective and sustained pain relief, rather than just temporarily masking the inflammation like a steroid shot does.

### A Look at the Conflicting Research

While many studies are encouraging, it’s also true that a single PRP injection might not be a magic bullet for every person or injury. For instance, one study found that many patients with chronic hamstring issues didn’t see a major change eight weeks after one injection. However, it’s important to look at the bigger picture. Another study found that while initial results were slower, the group receiving PRP showed significant long-term improvements in both pain and function at the six-month mark. This highlights a key point: PRP is designed to promote genuine, long-term tissue repair, which takes time. This is why receiving a personalized treatment plan from an experienced specialist is so important, as a single injection may not be enough to fully resolve a chronic injury.

How PRP Can Shorten Your Hamstring Recovery Time

Accelerating the rehab process following an acute hamstring injury is one of the main reasons people reach out to us following hamstring injury. These people tells us that they are already in physical therapy and that they were told by their therapist that the should look into PRP therapy to help accelerate the healing process. In agreement with our own clinical observations, a study in the American Journal of Sports Medicine (4) reported these results:

  • Twenty-eight patients diagnosed with an acute hamstring injury were randomly allocated to autologous PRP therapy combined with a rehabilitation program or a rehabilitation program only. The primary outcome of this study was time to return to play. In addition, changes in pain severity and pain interference scores over time were examined.
  • Patients in the PRP group achieved full recovery significantly earlier than controls. The mean time to return to play was up to 15 days sooner for the PRP group vs the control group. Significantly lower pain severity scores were observed in the PRP group throughout the study. A single autologous PRP injection combined with a rehabilitation program was significantly more effective in treating hamstring injuries than a rehabilitation program alone.

We have been offering regenerative medicine injections for more than 30 Years. We have helped many people with hamstring problems. Can PRP or stem cell therapy be an option for you? Use the contact form below so we can assess your candidacy for treatment.

References

1 Park PY, Cai C, Bawa P, Kumaravel M. Platelet-rich plasma vs. steroid injections for hamstring injury—is there really a choice?. Skeletal radiology. 2019 Apr 1;48(4):577-82.
2 Levy GM, Lucas P, Hope N. Efficacy of a platelet-rich plasma injection for the treatment of proximal hamstring tendinopathy: A pilot study. Journal of science and medicine in sport. 2019 Mar 1;22(3):247-52.
3 Davenport KL, Campos JS, Nguyen J, Saboeiro G, Adler RS, Moley PJ. Ultrasound‐Guided Intratendinous Injections With Platelet‐Rich Plasma or Autologous Whole Blood for Treatment of Proximal Hamstring Tendinopathy: A Double‐Blind Randomized Controlled Trial. Journal of Ultrasound in Medicine. 2015 Aug;34(8):1455-63.
4. A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LP. Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. The American journal of sports medicine. 2014 Oct;42(10):2410-8.

Related Articles