Hamstring Injuries

What are the hamstring muscles?

The hamstring group of muscles consists of three muscles that run from the bottom of the pelvis bone (ischium) to the shinbone (tibia). They help you walk, extend the hip, and flex the knee.

What are the risk factors for hamstring injuries?

Possible risk factors for hamstring injuries include:

• Improper warm-up before sports
• Strength imbalances in the leg
• Lack of core muscle strength and stability
• Muscle fatigue
• History of previous injury

People who participate in certain sports, including skiing, dancing, weight lifting, and football, may be at risk of hamstring injuries.

How do hamstring injuries happen?

Hamstring injuries can occur:

• Proximally (where the muscle attaches to the pelvis)
• In the middle (where muscle joins tendon)
• Distally (where the tendons attach to the shinbone)

Most commonly, injuries occur in the middle where the muscle fibers join the tendon. The most severe injuries can occur when the tendon tears away from the pelvic bone.

What are the symptoms of a hamstring injury?

Symptoms of a hamstring injury include:

• A sharp pain or popping sensation in the buttock and upper leg that occurs during physical activity
• Significant bruising down the back of the leg, which can occur within the first 24 to 48 hours after injury
• Discomfort with walking and sitting
• Weakness with knee bending in cases of complete rupture

How are hamstring injuries diagnosed?

To diagnose a hamstring injury, your doctor will check your thigh for bruising and injuries that may occur to the hip or knee as well as assess strength and motion. Your doctor may also order an X-ray of the pelvis to ensure that there are no fractures or tears of the hamstrings.

How are hamstring injuries treated nonsurgically?

The majority of hamstring injuries can be treated without surgery. Nonsurgical treatment options include:

• Activity modification
• Rest
• Ice
• Anti-inflammatory medication

What are the surgical treatment options for hamstring injuries?

For tears from the pelvic bone, treatment depends on the severity of the injury. As a general rule of thumb, if there is injury to two or more of the tendons that pull away from the bone, surgical reattachment may be considered:

• Surgical treatment consists of a small incision below the buttock where small anchors and sutures are used to reattach the tendons to the bone so they can heal.
• The patient wears a protective hip brace after surgery to restrict motion and allow for healing.
• Physical therapy usually begins around five weeks after surgery once healing has occurred.