What is a hamstring muscle tear?
The hamstring muscles (3 muscles: semitendinosus, semimembranosus, and biceps femoris) are large muscles that attach to the pelvis, run down the back of the thigh, cross the knee and attached at the upper end of the lower leg bones. The muscles are attached by tendons to the bones. These muscles allow us to extend the leg and bend the knee. The hamstrings are balanced by the quadriceps muscles on the front of the thighs. The power and stability of the knees is controlled by these muscles.
Hamstring tears are common muscle strain injuries, due to overloading and overuse. A muscle strain or a pulled hamstring stretches and tears the muscle fibers and/or the tendon. The tear can range from mild (stretched not torn), to partial tearing, to complete rupture (tear). On occasions, the tendon can pull off a piece of bone with it when the tendon tears. This is called an avulsion injury. Avulsion injuries occur from a burst of speed seen in ice skating, weightlifting, and skiing.
What causes a hamstring muscle tear?
Muscle overload is the main cause of a hamstring tear. Risk factors include muscle tightness, muscle imbalance (the quadriceps are stronger than the hamstrings), poor conditioning, muscle fatigue and sports that involve lunging, sprinting, running, and jumping such as tennis, track, soccer, football and basketball. The hamstrings are not significantly active with walking and standing, so a sudden jump, stretch, lunge, or impact can tear the muscle. Furthermore, the muscle can be strained or torn simply by running, kicking, or walking down stairs.
What are the symptoms of a hamstring tear?
The most common site for a muscle tear is the middle of the hamstring muscle. Symptoms depend on the grade of the strain. A mild strain may feel like an ache or pulling pain that worsens with activity. Symptoms of a grade 2 or 3 strain can include:
- A sharp pain in the middle back of the thigh
- Difficulty putting weight on the injured leg causing limping
- Bruising and discoloration
- Hamstring weakness
- Muscle spasms
- Some people hear a pop when the muscle is injured
How is a hamstring tear diagnosed?
Dr. Jorge Chahla will review your medical history and ask you about the circumstances surrounding your injury. He will conduct a physical examination checking for bruising, pain, weakness and swelling. If the tendon has pulled away from the bone, the muscle will appear balled up at the back of the thigh. Imaging tests will confirm the diagnosis. X-rays will reveal an avulsion, when the tendon pulls a piece of bone away with it. An MRI will provide detailed images of the muscles and tendons.
How is a hamstring tear treated?
Most hamstring and tendon injuries can heal without surgery. Mild injuries tend to heal well. Severe hamstring injuries tend to be debilitating. The goal is to restore function and prevent scarring of the muscle.
Conservative treatment involves rest, ice, compression, and elevation, anti-inflammatory medications and activity modifications for about one week. Mild and partial tears often require no other treatment. However, physical therapy may be recommended to improve range of motion and strength. Healing typically occurs within 4-6 weeks.
Treatment for a severe tear may include crutches or braces. Surgery may be needed to repair a complete rupture that damages a large amount of muscle and tendon, or when there is a bony avulsion. Stretching and range of motion exercises are important to rehabilitation, followed by strength training. It can take a few months to return to play. Reinjury is common, often caused by a premature return to sport.
Dr. Jorge Chahla, MD, PhD is an orthopedic surgeon in Chicago, Illinois who specializes in the treatment of complex knee hip and shoulder injuries and all sports related injuries. He is an internationally recognized expert in the use of minimally invasive techniques, joint preservation and cartilage restoration. Dr. Chahla is dedicated to compassionate and personalized care. Contact Dr. Chahla to schedule a consultation and receive the correct diagnosis and treatment to get you back to the life you love.