The four hamstring muscles, the semitendinosus, the semimembranosus and the two heads of the biceps femoris, run down the back of the thigh and help you bend (flex) your knee and extend your leg. The hamstring muscles originate on the pelvis and insert on the upper aspect of the tibia (shinbone); thus, the muscles span both the hip and the knee joint. Hamstring injuries are common in athletes who participate in sports which involve running such as track, soccer, and basketball.
Injuries to the hamstring group of muscles can range from a minor strain to a complete tear. Avulsion injury occurs when the hamstring muscle tendon completely tears away from the bone. Sometimes, a piece of bone may also be pulled away in an avulsion injury.
Hamstring strain is usually caused when the muscle is stretched beyond its optimum ability. Some of the factors that increase the risk of hamstring strain include tight muscles, muscle fatigue, muscle imbalance, athletic activities, poor running technique and insufficient warm-up.
Patients with hamstring injury will experience a sudden sharp pain in the back of the thigh while running. In case of a muscle tear patients experience a popping or snapping sensation in the back of the thigh. Patients may also notice swelling, bruising and muscle weakness.
The initial treatment consists of rest, ice, compression, and elevation (RICE protocol); all assist in alleviating pain and swelling.
Hamstring avulsion is a serious injury that may require surgery. An avulsion repair may be needed to reattach the torn hamstring tendon back to its normal position. During the tendon avulsion repair, an incision is made on the skin over the attachment of the hamstring tendon to the pelvic bone. The torn end of the hamstring tendon is located and grasped with forceps. Then the hamstring muscles are pulled back to their normal attachment. Dr. Patel will cut away any scar tissue surrounding the hamstring tendon. The ischial tuberosity, the point of origin of hamstring muscles, is prepared using an instrument called a burr. Then the tendon is reattached to the bone using anchors.
After surgery, you will need to use crutches and a knee brace to protect your repair and keep it in a relaxed position. Dr. Patel will advise physical therapy, involving gentle stretching exercises, to restore normal function. Rehabilitation period of at least 3 to 6 months may be needed before returning to athletic activities.
Pulled Hamstring Symptoms & Muscle Tear Symptoms
When a person pulls their hamstring, they are likely to experience moderate to severe pain in the back of the leg. This can occur during movement or rest. Muscle tear symptoms will be more severe than those of a pulled hamstring.
People who experience this may hear a popping or snapping noise in the back of their leg, followed my extreme hamstring pain. Swelling, bruising, and muscle weakness are also symptoms of pulled hamstrings and torn hamstrings.
How to Treat a Pulled Hamstring
Initial treatment for hamstring injuries consists of rest, ice, compression, and elevation.
Anti-inflammatory medications will also be helpful, as long as they are consistent with the doctor’s recommendations.
The goal in initial treatment will be to minimize pain and swelling.
Hamstring Repair Surgery
Injuries such as hamstring avulsion, in which the muscle tears away from the bone partially or completely, is a severe injury and may require surgery to properly treat. In this hamstring repair surgery, Dr. Patel will reattach the torn tendon to its original position.
During the procedure, Dr. Patel will make an incision to access the injured area and work on the damaged muscle.
Forceps will be used to find and secure the tendon, and then pull it back to its original position.
Any scar tissue formed as a result of the injury will also be removed at this time. Sutures with anchors will be used to secure the hamstring.
What is a Typical Pulled Hamstring Recovery Time?
Torn hamstring recovery time varies from patient to patient and depends on the severity of injury and complexity of surgical procedure required to repair the muscle. After surgery, Dr. Patel recommends crutches and/or a brace to secure the leg as it recovers.
Physical therapy will also be recommended to slowly return flexion back to the leg.
For many patients, the torn hamstring recovery time after surgery can be anywhere from 3 to 6 months. “Pulled” hamstring recovery times tend to be less significant.
It will be recommended to treat the leg with proper care (RICE) and to begin physical therapy as soon as possible to build back strength in the muscle and flexion in the leg.
Have any more questions about hamstring injuries and what the treatment plan involves? Reach out to Dr. Ronak Patel to learn more about how you can relieve pulled hamstring pain and treat your injury.
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