At The Ohio State University Wexner Medical Center in Columbus, Ohio, our orthopedic hip experts offer individualized treatment for proximal hamstring injuries. We know hip injuries can greatly affect your quality of life, whether you’re an avid marathon runner or just like to play with your children. Our goals are to help you reduce your hip pain and help you return to your favorite activities as quickly as possible.
What is a hamstring injury?
The hamstring is made up of a group of muscles that help you extend your hip and bend your knee. The hamstring runs along the back of your leg in the thigh. These muscles originate at the base of the pelvis (ischial tuberosity) and attach below the knee on the shinbone (tibia).
This area includes the following muscles:
- biceps femoris
- semimembranosus
- semitendinosus
When you hurt your hamstring, it can cause hip pain because these muscles are connected to your pelvis and help control your leg movements. Proximal hamstring injuries occur in the soft tissues that are attached to your pelvis. You’ll typically notice pain in your buttock or right below it.
What causes a hamstring injury?
Typically, hamstring injuries are caused when the hamstring muscle contracts too strongly at the wrong time and wrong position, and this impacts the muscle’s ability to stretch. Typical hamstring injuries are often caused by activities that involve sudden starts and stops, sprinting or heavy lifting. These actions can overload or strain the muscle and tissue fibers, leading to injury. Slips and falls are also a common cause of acute tendon tears.
Proximal hamstring injuries occur when the upper part of the hamstring muscle, near the pelvis, is damaged. While this can happen because of rapid movement, the injury can also be more chronic and progressive with wear and tear over time.
Anyone can be affected by hamstring injuries, but some risk factors may make it more likely for you to develop one. It’s important to remember that a risk factor only increases the likelihood that you may develop an injury.
Risk factors of proximal hamstring injuries may include:
- Previous hamstring injury
- Older age
- Reduced muscle flexibility
- Muscle fatigue
- Dehydration
- Activity involvement, including sports and high-impact exercise
To avoid hamstring injuries, it's important to warm up before exercising and to stay hydrated, especially if you're older or have had previous injuries. You should talk to your doctor if you have any risk factors, and work with them to reduce your risk of injury.
What are the symptoms of a hamstring injury?
Hamstring injuries can present a range of symptoms that affect your ability to move and function normally. By recognizing symptoms early, our experts can help manage the injury effectively and possibly prevent further complications. Symptoms for hamstring injuries can vary based on the cause, especially those that are acute, caused by a fall or vehicle accident, versus those that progress over time.
For those with chronic tendonitis of the proximal hamstring tendon, you may have more pain with activity and sitting. Other common symptoms for a chronic hamstring injury may also include:
- Pain in the back of the thigh
- Pain in the buttock
- Bruising in the back of the thigh, possibly stretching into the back of the knee and leg
- Cramping in the leg
- Restricted mobility
For those who experience a traumatic event that results in a hamstring injury, symptoms can be more pronounced. Symptoms for an acute hamstring injury include:
- Pain that arises suddenly
- Swelling
- A lot of bruising in the back of the leg
- Difficulty walking or an inability to bear any weight on your lower extremity
Can you walk with a proximal hamstring tear?
If you have a hamstring injury, you may have sudden increased pain in your legs while participating in sports or after a fall. You should be able to walk unless you have a complete tear. You may also feel like your leg is “popping” or tearing.
If you’re experiencing any hamstring injury symptoms, you should see your doctor.
How are proximal hamstring injuries diagnosed?
It’s important to diagnose a hamstring injury early to understand how serious the injury might be. By identifying the problem early, experts at the Ohio State Wexner Medical Center can provide the right treatment to help you heal properly and get back to your favorite activities. Our team will evaluate your symptoms and pain levels to figure out what's wrong, and we’ll develop a plan to help you get better.
Your doctors will get a detailed medical history to understand when your hamstring injury started and the events leading up to it. They’ll ask you questions about your activities and lifestyle. They’ll also perform a physical examination and gather a list of any symptoms you may have.
To properly diagnose a hamstring injury, your doctors will most likely order a series of diagnostic imaging tests.
These may include:
- X-rays
- Ultrasounds
- Magnetic resonance imaging (MRI) scan
These injuries can be a pull, a partial tear or a complete tear, and are also graded based on how severe they are. They are generally categorized by how much the muscle is damaged and how much this damage affects your ability to move normally.
- Grade 1 injury – a mild strain that usually heals well with rest and physical therapy
- Grade 2 injury – a partial muscle tear involving some of the hamstring muscle
- Grade 3 injury – a complete tear of the muscle that could take several months to heal
Once a diagnosis is formed, your doctor will create an individualized treatment plan for you.
How are proximal hamstring injury conditions treated?
Hamstring injuries typically are treated without surgery. Doctors usually recommend resting and protecting the injured area to help it heal. They might also suggest different therapies to improve strength and flexibility.
Nonsurgical treatments can include:
- Following the RICE method:
- Rest: When you get hurt, the first thing to do is rest the injured area. Avoid activities that might make the injury worse.
- Ice: Apply ice to the injured area for about 20 minutes at a time. You can use an ice pack, or a bag of frozen peas wrapped in a towel. Ice helps reduce swelling and numb the pain.
- Compression: Wrap the injured area with an elastic bandage or compression wrap. This helps decrease swelling and provides support to the injured muscle.
- Elevation: Keep the injured area raised above the level of your heart as much as possible. This helps reduce swelling by allowing fluids to drain away from the injured area.
- Oral steroids or nonsteroidal anti-inflammatory medications (NSAIDs)
- Injections, such as cortisone, or orthobiologics therapies like platelet-rich plasma
- Formal physical therapy or home-exercise programs
For proximal hamstring tendon tears, especially full-thickness avulsions, hip surgery may be recommended to return the tendon back to its proper location. If nonsurgical options fail to provide pain relief, other surgery types may be discussed.
Why choose Ohio State for proximal hamstring injury treatment?
The Ohio State Wexner Medical Center specializes in the most advanced, personalized treatment options for proximal hamstring injuries.
Our team of surgeons, doctors, physical therapists, sports medicine experts, and researchers works together to provide advanced care for hamstring injuries. Orthopedic experts at the medical center lead medical research to improve hamstring injury treatment and determine more specific causes for injuries.
We use innovative methods, including minimally invasive surgery, specialized physical therapy and other treatments to help you heal.