Hamstring Muscle Injuries

A hamstring injury can be a pull, a partial tear, or a complete tear.

Muscle strains are graded according to their severity. A grade 1 strain is mild and usually heals readily; a grade 3 strain is a complete tear of the muscle that may take months to heal.

Most hamstring injuries occur in the thick part of the muscle or where the muscle fibers join tendon fibers.

In the most severe hamstring injuries, the tendon tears completely away from the bone. It may even pull a piece of bone away with it. This is called an avulsion injury.

Cause

Muscle Overload

Muscle overload is the main cause of hamstring muscle strain. This can happen when the muscle is stretched beyond its capacity or challenged with a sudden load.

Hamstring muscle strains often occur when the muscle lengthens as it contracts, or shortens. Although it sounds contradictory, this happens when you extend a muscle while it is weighted, or loaded. This is called an “eccentric contraction.”

During sprinting, the hamstring muscles contract eccentrically as the back leg is straightened and the toes are used to push off and move forward. The hamstring muscles are not only lengthened at this point in the stride, but they are also loaded — with body weight as well as the force required for forward motion.

Like strains, hamstring tendon avulsions are also caused by large, sudden loads.

Conditions

  • Achilles Tendon Injury
  • Adolescent Anterior Knee Pain
  • Ankle Sprains
  • Anterior Cruciate Ligament Injuries
  • Baseball Injuries
  • Basketball Injuries
  • Burners & Stingers
  • Bursitis of the Hip
  • Compartment Syndrome
  • Elbow Fractures
  • Forearm Fractures in Children
  • Fracture of the Proximal Tibia
  • Golf Injuries
  • Growth Plate Fractures
  • Hamstring Muscle Injuries
  • High School Sports Injuries
  • Hockey Injuries
  • Jumper’s Knee Injuries
  • Meniscus Tear
  • Muscle Contusion (Bruise)
  • Runner’s Knee
  • Shoulder Separation Injury
  • Skiing Injuries
  • Sledding Injuries
  • Soccer Injuries
  • Sprains, Strains & Soft Tissue Injuries
  • Stress Fractures
  • Swimming Injuries
  • Tennis Injuries
  • Throwing Injuries
  • Volleyball Injuries

Treatments

  • Achilles Tendon Repair
  • Acromioplasty
  • Ankle Fracture Repair (Ilizarov/Deformity Correction)
  • Ankle Joint Fusion(Ilizarov/Deformity Correction) Surgery
  • Anterior Cruciate Ligament Repair
  • Arthroscopic Chondroplasty
  • Arthroscopic Meniscus Repair
  • Bankart Repair
  • Biceps Tendon Rupture Surgery
  • Biceps Tenodesis
  • Broken Collarbone Surgery
  • Cartilage Transplant
  • Elbow Epicondylitis Surgery (Tenex Repair)
  • Elbow Fracture Surgery
  • Hand & Wrist Surgery
  • High Tibial Osteotomy
  • Knee Arthroscopy
  • Labrum Surgery
  • Lateral Collateral Ligament Surgery
  • Medial Collateral Ligament (MCL) Repair
  • Meniscus Repair
  • Muscle Strain Treatment
  • MPFL – Reconstruction of the Patella
  • Non-Unions of the Tibia Fractures (Ilizarov Correction Surgery)
  • OCE – Repair of the Osteochondritis
  • Overuse Injury Treatment
  • Partial Menisectomy
  • Posterior Cruciate Ligament (PCL) Repair
  • Revision Shoulder Replacement Surgery
  • Rotator Cuff Repair Surgery
  • Shoulder Arthroscopy
  • Shoulder Arthroplasty
  • Subchondroplasty
  • Shoulder Impingement Syndrome Surgery
  • Shoulder Separation Surgery
  • Taylor Spatial Frame Surgery
  • Throwing Injury Surgery

Conservative Treatments

The Orthopedic physicians at Peninsula Bone & Joint Clinic provide conservative treatment options for Sports Related conditions and injuries.

Symptoms

If you strain your hamstring while sprinting in full stride, you will notice a sudden, sharp pain in the back of your thigh. It will cause you to come to a quick stop, and either hop on your good leg or fall.

Risk Factors

Several factors can make it more likely you will have a muscle strain, including:

Muscle tightness. Tight muscles are vulnerable to strain. Athletes should follow a year-round program of daily stretching exercises.

Muscle imbalance. When one muscle group is much stronger than its opposing muscle group, the imbalance can lead to a strain. This frequently happens with the hamstring muscles. The quadriceps muscles at the front of the thigh are usually more powerful. During high-speed activities, the hamstring may become fatigued faster than the quadriceps. This fatigue can lead to a strain.

Poor conditioning. If your muscles are weak, they are less able to cope with the stress of exercise and are more likely to be injured.

Muscle fatigue. Fatigue reduces the energy-absorbing capabilities of muscle, making them more susceptible to injury.

Choice of activity. Anyone can experience hamstring strain, but those especially at risk are:

  • Athletes who participate in sports like football, soccer, basketball
  • Runners or sprinters
  • Dancers
  • Older athletes whose exercise program is primarily walking
  • Adolescent athletes who are still growing. Hamstring strains occur more often in adolescents because bones and muscles do not grow at the same rate. During a growth spurt, a child’s bones may grow faster than the muscles. The growing bone pulls the muscle tight. A sudden jump, stretch, or impact can tear the muscle away from its connection to the bone

Diagnosis

Physical Examination & Patient History

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

Principles of Sports Medicine

  • Timely Care

  • Minimally Invasive Procedures

  • Advanced Rehabilitation

  • Injury Prevention

One of the main goals of sports medicine is to put off major orthopedic surgery (such as joint replacement) as long as possible or even remove the need altogether with physical therapy, minimally invasive arthroscopic surgery and timely care.

When everything is working well, you hardly give them a thought. But when a problem arises, it’s often impossible to ignore.

Treatment Options

Non-Surgical

Most hamstring strains heal very well with simple, nonsurgical treatment.

RICE. The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.

Rest. Take a break from the activity that caused the strain. Your doctor may recommend that you use crutches to avoid putting weight on your leg.

Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.

Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.

Elevation. To reduce swelling, recline and put your leg up higher than your heart while resting.

Immobilization. Your doctor may recommend you wear a knee splint for a brief time. This will keep your leg in a neutral position to help it heal.

Physical therapy. Once the initial pain and swelling has settled down, physical therapy can begin. Specific exercises can restore range of motion and strength.

A therapy program focuses first on flexibility. Gentle stretches will improve your range of motion. As healing progresses, strengthening exercises will gradually be added to your program. Your doctor will discuss with you when it is safe to return to sports activity.

Surgical

Surgery is most often performed for tendon avulsion injuries, where the tendon has pulled completely away from the bone. Tears from the pelvis (proximal tendon avulsions) are more common than tears from the shinbone (distal tendon avulsions).

Surgery may also be needed to repair a complete tear within the muscle.

Procedure. To repair a tendon avulsion, your surgeon must pull the hamstring muscle back into place and remove any scar tissue. Then the tendon is reattached to the bone using large stitches or staples.

A complete tear within the muscle is sewn back together using stitches.

Conservative Treatment Options

  • Non-Operative Sports Medicine Treatment

Treatment Highlights

FastFix 360 – Meniscus Repair

Peninsula Bone & Joint Clinic

The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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