Hamstring Muscle Injuries

Introduction

Hamstring muscle injuries create sudden pain at the back of the thigh. Hamstring injuries occur most frequently among athletes and dancers. The hamstring muscles can strain or tear. Most hamstring tears do not require surgery. Physical rehabilitation following hamstring strain or surgery usually enables a full recovery.

Anatomy

The hamstring muscles are located at the back of the thighbone (femur). The hamstrings attach at the pelvis bone (ischial tuberosity) and the top of the leg bones (tibia and fibula). The three muscles that compose the hamstring are the semitendinosus, semimembranosus, and biceps femoris. The hamstring muscles work together to bend the knee and raise the thigh to the back (extend the hip).

Causes

A pulled hamstring most frequently occurs among dancers and athletes during sports that require sprinting, such as basketball, soccer, football, and track. A pulled hamstring or a hamstring tear may occur when the hamstring muscles are stretched too far or receive a sudden load.

Am I at Risk?

Risk factors for hamstring injuries include:

  • Tight muscles
  • Imbalanced muscle groups, for example if the muscle group at the front of the thigh (quadriceps) are stronger than the hamstring muscles
  • Tired muscles
  • Deconditioned muscles
  • Adolescents during growth periods
  • Older athletes
  • Participation in football, soccer, basketball, running, sprinting, dance

Symptoms

A hamstring strain causes a sudden pain in the back of the thigh. You may fall or will be unable to put weight on your leg. Over the next few hours, your leg will swell. You may also experience:

  • Bruising on the thigh and below the knee in the days following an injury
  • Weak hamstring muscles for several weeks

Diagnosis

A doctor diagnoses hamstring injuries by examining the affected limb. You should tell your doctor about the circumstances that lead to your hamstring injury. Imaging tests, such as X-Rays or MRI scans may be used to determine the extent of injury and identify a hamstring tendon avulsion.

Most hamstring injuries occur in the thickest part of a muscle or where the muscle joins a tendon. Tendons connect muscles to bones.

A hamstring injury can be a:

  • Pull or strain
  • Partial tear
  • Complete tear, tears from the pelvis bone are more common than tears from the leg
  • Avulsion, a piece of bone pulls away when the tendon detaches from a bone

Treatment

Doctors treat hamstring tendon injuries on an individualized basis. The type of treatment that you receive depends on the location and degree of your injury. Most hamstring strains are treated with non-surgical methods.

You should rest and elevate your leg. Your doctor will recommend an icing schedule and compression bandage for your thigh. You may temporarily use crutches or a knee splint. Your doctor may refer you to a physical therapist for exercises to regain motion and strength. Your doctor will let you know when you can return to sports safely.

Surgery

Surgery is used for complete tears in the middle of a hamstring or hamstring muscles that have detached from the bone. Orthopedic surgeons use sutures to connect the muscles in mid hamstring tears. Hamstring muscles are reattached to bones with sutures, anchors or staples.

Recovery

Surgery is followed by a period of rest, during which time you may wear a brace and use crutches. Physical therapy rehabilitation exercises are important for regaining flexibility, range of motion, and function. The rehabilitation period may last from three to six months depending on the type and location of injury. Most people recover fully from hamstring injuries

It is also important to avoid injuring your ACL again. Depending on your injury, your surgeon may provide you with temporary or permanent activity or lifting restrictions. In some cases, specialized knee braces may be recommended for specific activities.