Anatomy
- Hamstrings – three muscles that travel from the pelvis to the knee (semi-tendinosis, semi-membranosis, biceps femoris)
- Iscial tuberosity – the “butt bone” of the pelvis; the place where the hamstrings start.
- Sciatic nerve – a large nerve leaving the pelvis close to the hamstrings
How Do Hamstring Tears Occur?
Most tears happen during athletic activities during quick sprinting episodes, jumping, or quickly changing directions. A “pop” is often felt and immediate pain is noted in the back of the thigh. This occurs when the connection of the hamstring to the pelvis tears away. Alternatively, some patient feels more of a hamstring strain with more of a chronic history of pain in the back of the thigh with no history of injury.
What Are Some Symptoms Of A Hamstring Tear?
Most people who tear their hamstring immediately know when it happened. The pain is centered near the ischial tuberosity and radiates down the back of the thigh. Sometimes bruising on the back of the thigh and knee can be seen one to two days after injury. The pain is often worsened with bending over, attempted running/jumping, and sometimes even sitting in the early period after injury.
I Think I Have A Hamstring Tear. What Should I Do?
Evaluation by a medical specialist to obtain the necessary examination and imaging studies will likely be quite helpful to you. Plain xrays should be obtained to evaluate for fractures, and ultimately an MRI will be required for definitive diagnosis.
How Are Hamstring Tears Treated?
Most hamstring tears are mild and often involve only one of the three tendons. Even with more tendon involvement, most patients with hamstring tears are able to return to their activities without surgery. A combination of rest and supervised rehabilitation and strengthening is often successful. If, however, a complete tear (all three tendons, or a large tear of two tendons) occurs, or you have failed conservative management, surgical repair is recommended. Depending on how acute (how recent the injury occurred), the hamstring can be repaired arthroscopically through three small (1cm) incisions, or through an open incision. The torn tendon edge is identified and is sutured back to the ischial tuberosity through the use of suture anchors.
What Is The Recovery Following Hamstring Repair?
Patients are required to wear a knee brace with the knee in flexion for 3-4 weeks until the hamstring repair has time to mature and the muscle belly can stretch out. Strengthening and athletic activities are postponed until month 3-4, depending on your progress.
