This guide explains what to expect from your proximal hamstring repair and recovery. Please read all of it before your pre-operative visit. Dr. Jazayeri will go over the details and answer your questions at that visit.

Everyone recovers on a slightly different timeline. Use this guide as your roadmap, and follow the specific instructions from Dr. Jazayeri and your physical therapist.

Note: Every tear and repair is unique. Dr. Jazayeri will give you specific instructions for weight bearing and range of motion after your surgery. If those instructions differ from this guide, follow Dr. Jazayeri’s instructions.

Before your surgery

Sooner is better. Repairing a hamstring tear within the first few weeks after the injury usually gives better strength and function, with a lower chance of the repair tearing again. Try to keep your scheduled surgery date.
Protect the injured leg until surgery. Do not stretch the back of your thigh. Avoid bending forward with your knee straight. You can keep your upper body and core strong.
Start the Xcelerated Recovery (XR) program now. Dr. Jazayeri recommends the XR program for all patients, before and after surgery, to prepare your body for surgery and support your recovery. Visit xrscience.org to get started. XR also provides your carbohydrate-loading drink for the night before and morning of surgery.
Start your XR essential amino acids 1 week before surgery. These come from the Xcelerated Recovery program (xrscience.org). See Your Medications (section 7) for details.
Get your home ready. It helps to have a reacher, a sock aid, a raised toilet seat or toilet safety frame, and a firm cushion for sitting. Practice using crutches before surgery.
Fill your prescriptions in advance so your pain medicine is ready when you get home.
No solid food after midnight the night before surgery. You may have clear fluids up to 2 hours before surgery, such as black coffee with no milk, tea, apple juice, or Gatorade.
Carbohydrate loading with XR (recommended). Instead of fasting overnight, use the XR carbohydrate-loading drink from the Xcelerated Recovery program (xrscience.org). Drink one the evening before surgery and a second the morning of surgery, following the XR instructions for amount. Finish the morning drink at least 2 hours before your scheduled surgery time. This keeps your body in a “fed” state, which lowers surgical stress, limits muscle breakdown, and helps you feel less thirsty, hungry, and anxious. If you have diabetes, ask us before using a carbohydrate drink.
Arrange a ride. You cannot drive after anesthesia or while taking pain medicine.

Questions & Care

Call Monday to Friday, 8 to 5: 1-844-JAZ-0911

Email: [email protected] (for non-urgent questions; do not use email for urgent concerns)

After hours and emergencies: For a medical emergency, call 911. For an urgent concern after office hours, go to the nearest emergency room.

Office: DOCS Health, 8436 W 3rd St #800, Los Angeles, CA 90048

! Call the office right away if you notice:

Signs of a blood clot: severe pain, redness, or swelling and hardness in the calf or behind the knee
Signs of sciatic nerve irritation: new or worsening numbness, tingling, or burning pain down the leg, weakness in the foot or ankle, or trouble lifting your foot
Signs the repair may have torn again: a sudden “pop” with new pain, a new bulge or dent in the back of the thigh, or a sudden loss of strength
Wound problems: drainage or pus that keeps getting worse, spreading redness, or a large, swollen, fluid-filled lump near the incision
Signs of bleeding while on aspirin: black or bloody stools, vomiting blood or material that looks like coffee grounds, or unusual bleeding or bruising
A fever above 100.5 F. A low-grade fever up to 100.5 F for a couple of days is normal.
Any side effects from your medicines

Call us to arrange an evaluation. For chest pain, shortness of breath, or coughing up blood, call 911.

Recovery at a Glance

When	Milestone
Now	Start the Xcelerated Recovery (XR) program (xrscience.org)
1 week before surgery	Start XR essential amino acids
Night before and morning of surgery	XR carbohydrate-loading drinks (finish 2 hours before surgery)
Day 1	Start aspirin (daily for 4 weeks); walking with crutches, ankle pumps, gentle activity; continue the XR program as directed
1 week	First post-op visit and wound check (stitches dissolve on their own, so nothing to remove)
1 to 2 weeks	Formal physical therapy begins after your first post-op visit (gentle, therapist-guided motion)
2 weeks	XR essential amino acids can stop unless told otherwise
4 weeks	Finish aspirin
6 weeks	Brace off; begin moving toward full weight on the leg
6 to 8 weeks	Off crutches; stationary bike and pool exercises
3 to 4 months	Brisk walking, then light jogging
4 to 6 months	Return to most sports
6 to 10 months	Sprinting and high-level sport

1. About Your Surgery

What was repaired. The hamstrings are 3 muscles along the back of the thigh. At the top, their tendons attach to the “sit bone” at the bottom of the pelvis (the ischial tuberosity). In your injury, one or more of these tendons pulled off the bone. During surgery, Dr. Jazayeri brings the tendon back to the bone and holds it there with small suture anchors while it heals.

The incision. You lie face down for the surgery. The incision is usually across the crease of the buttock. For larger or older tears, it may extend down the back of the thigh. The sciatic nerve runs very close to the hamstring tendons. It is identified and protected during surgery. In older (chronic) tears, scar tissue may need to be carefully freed from around the nerve.

Why protection matters. The hamstring is stretched most when you bend at the hip with your knee straight, as when bending forward to touch your toes. For the first 6 weeks, the repair is held together only by the sutures and anchors while the tendon grows back into the bone. Almost every restriction in this guide is there to avoid that position.

What to expect. More than 9 out of 10 patients are satisfied with the results of this surgery, and most return to their usual activities and sports. Strength keeps improving for up to 2 years, so continuing your exercises over the long term matters.

2. Your Surgical Day

Arrive 2 hours before your scheduled start time. You will check in and meet your anesthesiologist, who will talk with you about the anesthesia plan.
You are positioned face down in the operating room. Surgery may take longer for chronic tears or tears involving more than one tendon.
Your leg is set up for recovery. A dressing, cold therapy, compression stockings, and your brace are put on before you wake up.
Dr. Jazayeri will speak with your point of contact and review how the surgery went.
You will spend about 1 hour in recovery before going home.

3. Pain Control

If you receive a nerve block or spinal anesthetic, it wears off over several hours. It is normal to have more pain that night or the next day as it fades.
Take your oral pain medicine before the numbness wears off. Take a pain tablet when you get home and again before bed.
Stay ahead of the pain, especially for the first 3 to 5 days.

4. Your Equipment

Brace

Your brace holds the hamstring in a relaxed, shortened position. Depending on your repair, it may be a hinged knee brace that keeps the knee bent or a hip brace that limits hip bending.
Wear it at all times for about 6 weeks, including while sleeping, unless Dr. Jazayeri tells you otherwise. You may remove it to shower when cleared and during exercises your therapist prescribes.
Do not change the brace settings yourself. Your therapist or our office will adjust them as you progress.

Crutches and weight bearing

Use crutches whenever you walk for the first 6 weeks.
Put only as much weight on the leg as you have been told: ______________________ (for example, toe-touch or 25 percent).
At about 6 weeks, you will gradually move to full weight and then wean off crutches, usually by 6 to 8 weeks.

Cold therapy

Use cold therapy over the buttock and back of the thigh for 15 to 20 minutes at a time, several times a day, to reduce pain and swelling. Keep a cloth or the dressing between the cold pad and your skin.
Do not lie with your full body weight pressing the pad onto the incision for long periods.

Compression stockings

Wear the stockings for 2 weeks after surgery to help prevent swelling and blood clots. Keep wearing them after your 1-week visit until the full 2 weeks are done. You may remove them to wash, but do not put them in the dryer.
Pull them all the way up. Do not leave them bunched halfway down your calf, because that causes swelling.
Pump your ankles often, moving them up and down and in circles, to keep your blood moving.

5. Sitting, Lying Down, and Daily Activities

Sitting

Avoid deep or low sitting for the first 2 weeks, then return to normal sitting gradually as comfort allows.
Sit on a firm cushion. Shift your weight toward the side without surgery. Recline slightly instead of leaning forward.
Use a raised toilet seat. Do not lean forward to stand up from a chair.
Keep sitting time short at first. Get up and walk on crutches regularly.

Lying down and elevation

Do not prop the leg up straight on pillows. Raising a straight leg stretches the hamstring.
Lie on your back with a pillow under your knee so the knee stays bent, or lie on your stomach or on the side without surgery.
Swelling and bruising often spread down the back of the thigh, knee, and calf over the first 1 to 2 weeks. This is normal and is caused by gravity.

Getting dressed

Put the surgical leg into pants, underwear, and socks first, and take it out last.
Use a reacher or sock aid, or ask for help, so you do not have to bend forward.

Avoid for the first 6 weeks

Bending forward at the waist with your knee straight
Stretching the back of your thigh
Taking high steps up with the surgical leg, quick or sudden movements, and lifting

6. Wound Care and Dressings

Some bleeding and fluid leaking is normal for 24 to 36 hours. Change or reinforce the dressing as needed.
Change the gauze every other day, or daily if it gets wet or soiled.
On day 3, you may remove your dressing and cover the incision with a clean, dry dressing or bandage.
Because the incision is in the buttock crease, keep the area clean. Wipe from front to back after using the toilet. Change the dressing right away if it gets soiled.
Do not use ointments, betadine, or peroxide.
Do not touch, remove, or clean any steri-strip tapes covering your incision. They help the wound close.
Your stitches are absorbable. They dissolve on their own, so they do not need to be removed. Your wound is checked at your first post-op visit, about 1 week after surgery.
Numbness around the incision is common and often improves over time.

7. Your Medications

Filled before surgery. Always take them as directed.

Narcotic pain medicine (you will be prescribed one, based on your age):
Adults: Percocet 10/325 mg (oxycodone hydrochloride and acetaminophen). Take 1 to 2 pills every 6 hours as needed, usually for the first 2 weeks. Percocet already contains acetaminophen (Tylenol), so do not take extra Tylenol while taking Percocet unless Dr. Jazayeri tells you to.
Teenagers: Tramadol 50 mg. Take 1 tablet every 6 hours as needed for pain. Do not take more than prescribed. Tell us before surgery if your teen has sleep apnea or snores heavily, has a lung condition such as severe asthma, or takes any other medicine that causes sleepiness. Call 911 if your teen is very hard to wake up, or if their breathing becomes slow, shallow, or noisy.
Use the narcotic medicine for as short a time as possible. As your pain improves, switch to Tylenol and your anti-inflammatory as directed.
Mobic 15 mg (NSAID, anti-inflammatory): Take as directed for the first 2 weeks.
Colace 100 mg (stool softener): Take 1 tablet 2 to 3 times a day while you are taking pain medicine, which often causes constipation.
Zofran 4 mg (anti-nausea): Take 1 tablet every 6 hours as needed for nausea, which can happen after anesthesia.
XR essential amino acids (from the Xcelerated Recovery program, xrscience.org): Take as directed by the XR instructions, between meals, starting 1 week before surgery and continuing for at least 2 weeks after. Most muscle loss happens in the first 2 weeks after surgery, while the leg is protected. In studies of knee and fracture surgery, essential amino acids reduced thigh muscle loss, including in the hamstrings, and helped strength recover. Also try to include protein at every meal.
Aspirin 161 mg (blood clot prevention): Take once a day, starting the day after surgery (day 1) and continuing for 4 weeks. All patients receive aspirin after this surgery to lower the risk of blood clots. Take it with food, and take it for the full 4 weeks even if you feel well. Tell us before surgery if you are allergic to aspirin, have had stomach ulcers or bleeding, or already take a blood thinner.

If you have side effects from your medicines, call the office during clinic hours. For a medical emergency, call 911.

8. Bathing

Keep the wound completely dry for the first 7 to 10 days.
Cover the incision with a waterproof dressing to shower. Showers can be slippery, so use a shower chair or bench and be careful. Keep your brace on unless you have been cleared to remove it.
No baths, hot tubs, pools, or ocean for 4 weeks after surgery, or until your wound is fully healed.

9. Physical Therapy and Rehab

Every tear and repair is unique. Dr. Jazayeri will give you and your physical therapist specific range-of-motion and weight-bearing instructions after your surgery. The phases below are typical, and your plan may differ.

Weeks 0 to 6: Protect the repair

Start ankle pumps, gentle walking with crutches, and light muscle tightening the day after surgery.
Continue your Xcelerated Recovery (XR) program after surgery as directed (xrscience.org). It supports your recovery alongside physical therapy.
Formal physical therapy starts 1 to 2 weeks after surgery, after your first post-op visit. It begins with gentle motion that your therapist does for you. Active hamstring work begins later, usually around 4 to 6 weeks.
No hamstring stretching.

Weeks 6 to 12: Restore walking and motion

Brace off, full weight bearing, and normal walking again
Core and hip strengthening, stationary bike, and pool exercises once cleared
Still no forceful stretching or sudden, explosive hamstring movements

Months 3 to 6: Build strength

Gradual hamstring strengthening (for example, bridges, deadlift-style exercises, and lunges) as your therapist directs
Brisk walking, then light jogging, usually starting around 3 to 4 months
Sport-specific drills once your strength allows

Confirm your physical therapy appointment is scheduled by calling the office at (310) 746-5918.

10. Driving and Return to Work

Driving

It is not safe or legal to drive while taking narcotic pain medicine.
Left leg, automatic transmission: You may drive once you are off narcotic pain medicine and can get in and out of the car and sit comfortably without leaning forward.
Right leg or manual transmission: Wait until the brace is off and you have good muscle control, usually at least 6 weeks.
Dr. Jazayeri will confirm when you are safe to drive.

Rest and work

Rest is part of recovery. Do not overdo it in the first few weeks.
Desk work or school: Return when your pain is controlled, you can walk safely on crutches, and you can tolerate sitting, usually 1 to 2 weeks. A cushion or a sit-stand desk helps.
Heavy or physical jobs (for example, police, fire, construction, or labor): Expect a longer time off. This often lasts until you have regained strength, usually several months. Dr. Jazayeri will guide you based on your job.

11. Return to Sport

Your physical therapist confirms each step.

When	Activity
6 to 8 weeks	Stationary bike (low resistance) and pool exercises
3 to 4 months	Brisk walking, then light jogging
4 to 6 months	Running progression and sport-specific drills
4 to 6 months	Return to most sports
6 to 10 months	Sprinting, cutting, and high-level or contact sport

Clearance depends on how well you are doing, not just on the calendar. To return to play, your hamstring strength needs to be about 80 to 90 percent of your other leg’s, with pain-free motion and no concerns during sport-specific drills. Runners and sprinters often take longer to return to their previous level. Dr. Jazayeri and your physical therapist will confirm when you are safely cleared. Do not rush this. Returning before your strength has recovered puts you at risk of re-injury.

Follow-up visits: about 1 week, 6 weeks, 3 months, and 6 months after surgery, or as scheduled.

Medically reviewed by Reza Jazayeri, M.D. on October 29, 2026

Recovering From Your Proximal Hamstring Repair