Hamstring Tendon Tear
The hamstring is a group of muscles and tendons that run along the back of the thigh. There are three hamstring muscles: the semitendinosus, semimembranosus, and biceps femoris. The hamstring starts at your sit bones (the ischial tuberosity), crosses the knee joint, and ends just below your knee.
The hamstring muscles contain thousands of tiny, elastic muscle fibers which help the muscle shorten to generate force. These fibers join with the tough, connective tissue of the hamstring tendons where the tendons attach to bones in your pelvis, knee, and lower leg.
The hamstring muscles help you extend and rotate your hip joint and bend the knee joint. This is necessary for movements such as lunging, running, climbing, and jumping.
A hamstring injury is sometimes called a “pulled hamstring,” and occurs frequently in athletes. In fact, they are the most common sports injury. It can be a strain when the muscle is overstretched or a tear when the muscle fibers break.
This troublesome injury is most typically seen in athletes who participate in sports that require sprinting with sudden stops and starts, such as:
A hamstring injury is classified by grade, according to severity:
- Grade 1 is a mild muscle pull or sprain. You will experience minor pain when you use the leg, and minimal swelling.
- Grade 2 is a partial tear of one or more of the hamstring muscles. This may cause you to experience pain and limp when you walk. You may notice swelling and bruising, and the injury may prevent you from fully extending your leg.
- Grade 3 is a complete tear of one or more of the hamstring muscles. A grade 3 strain is painful, and walking will be very difficult. This grade of strain can take months to heal. With a grade 3 strain, you will notice a tearing or “popping” sensation when the injury happens. Weakness in your hamstring can last a long time after the injury.
When the muscle is challenged with a sudden load during an eccentric contraction, or is stretched beyond its capacity, it can become overloaded. Muscle overload is the main cause of hamstring injury. Hamstring tendon tears often occur in sports like soccer, football, and ice hockey. They can also be seen in skiers, skaters, dancers, and other athletes who often have their knees bent in deep squat positions. In fact, the most common cause of hamstring tendon ruptures or tears is water skiing!
Risk factors include:
- Repetitive stress that overstretches the tendons causing microscopic tears that weaken the tendons
- Poor conditioning
- Tight muscles, muscle imbalances or muscle fatigue
- A sudden sharp pain in the back of the thigh
- A popping sensation
- Bruising, swelling and tenderness
- Difficulty standing or walking
Diagnosis of a hamstring injury is made during a physical exam. Dr. Patel will check for swelling and tenderness along the back of your thigh. He may move your leg in different positions in order to pinpoint which muscle has been injured, and to identify damage to the tendons and ligaments. Imaging tests that help Dr. Patel confirm a diagnosis include x rays and magnetic resonance imaging (MRI).
The best way to prevent a hamstring tendon tear is to stretch and warm up your hamstring muscles before exercising, and to allow your hamstring muscles to rest after periods of exertion. Most hamstring injuries are resolved with self-care measures such as ice, rest, and over-the-counter pain-relieving medication.
Dr. Ronak M. Patel is a double board-certified orthopaedic surgeon and sports medicine physician. He completed his bachelor’s degree, medical degree, and residency training at Northwestern University. He, then completed his fellowship training at the Cleveland Clinic. He specializes in the treatment of complex knee, shoulder and elbow injuries and degenerative conditions. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life worth living. He serves teens and adults in Chicagoland and NW Indiana.
At a Glance
Ronak M. Patel M.D.
- Double Board-Certified, Fellowship-Trained Orthopaedic Surgeon
- Past Team Physician to the Cavaliers (NBA), Browns (NFL) and Guardians (MLB)
- Published over 49 publications and 10 book chapters
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