A hamstring injury may be a pull, partial tear or complete tear in a hamstring muscle, one of the large muscles in the back of the thigh that allows you to extend your hip and bend and flex your knee. The primary three muscles in this group are the biceps femoris, semimembranosus and semitendinosus.

Hamstring injuries can be graded depending on their severity. Most injuries happen in the thick, central portion of the muscle.

  • 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

In some hamstring injuries, the attachment of the hamstring muscles and tendons at the bone in the in the back part of the pelvis — under the buttock — can completely tear away from the bone, potentially taking away a small fragment of bone with it. This is called an avulsion injury.

What causes a hamstring injury?

Typically, hamstring injuries are caused when the hamstring muscle contracts too strongly at the wrong time and location, overloading the muscle’s ability to stretch.

These injuries most often happen during daily activities, such as slipping and falling on wet or icy surfaces.

What are the symptoms of a hamstring injury?

In hamstring injuries, there’s usually a sudden increase of pain while participating in sports or after a fall. Some patients may experience chronic tendinitis of the proximal hamstring tendon attachment to bone, and those patients may have more chronic pain with activity and with sitting.

Common symptoms 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

How are hamstring injuries diagnosed?

Diagnosing a hamstring injury begins with Ohio State Sports Medicine experts gathering a detailed medical history, physical examination and a list of reported symptoms. We’ll see what types of activities and motions seem to provoke more pain.

X-rays are typically part of the initial evaluation to help solidify diagnosis and rule out other significant problems. Magnetic resonance imaging (MRI) may be used for better visualization of the hip joint, gluteal tendons and hamstring muscles to assess the amount of tearing and to see if there’s been a complete avulsion tear.

How are hamstring injuries treated?

Hamstring injuries typically are treated without surgery. Nonsurgical treatments can include:

  • Rest
  • Ice
  • Compression
  • NSAID medication
  • Formal physical therapy and/or home exercise programs

For proximal hamstring tendon tears, especially full-thickness avulsions, surgery may be recommended to return the tendon back to its proper location.

For tendinitis and partial injuries of the tendon, nonsurgical options include focused physical therapy and injections, such as cortisone or platelet-rich plasma. If nonsurgical options fail to provide pain relief, surgery may be discussed.

Why choose Ohio State for hamstring treatment?

The Ohio State University Wexner Medical Center specializes in the most advanced, personalized treatment options for proximal hamstring injuries.

The Ohio State Wexner Medcial Center’s integrated hip team includes surgeons, sport medicine physicians, physical therapists, clinic staff, administrative staff and a research team who specialize in these types of injuries and treatments. Orthopedic experts at the medical center lead medical research to improve hip treatment and determine more specific causes for injuries.

Patients at the Ohio State Wexner Medical Center also have the unique opportunity to receive new, novel treatments, such as orthobiologic treatments like platelet-rich plasma, and to participate in clinical trials of newly developed therapies.

Learn more about what to expect during your orthopedic procedure


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