About Physiatry

Proximal and Mid-Hamstring Strain/Tendon Tear

Condition: The hamstrings are a group of muscles in the back of the thigh that help the knee flex and the hip extend. A proximal or mid-hamstring strain or tendon tear occurs when a patient injures one of these muscles.

Background: Hamstring injuries account for 12-16% of all injuries in athletes, and it is most common for them to occur in the middle of the hamstring.

Risk Factors: Athletes are more at risk, particularly those who participate in sports that require them to run or stop and start frequently, such as soccer or tennis. If a person has injured a hamstring once, there is a 22-34% chance they will reinjure it.

History and Symptoms: Symptoms include pain, a “pop” sound, swelling, tenderness, bruising and sometimes discoloration on the back of the leg.

Physical Exam: The physician will check for swelling and tenderness and determine where the damage occurred. He or she may also reposition the leg to check strength, range of motion and better assess the injury.

Diagnostic Process: If the injury is severe, the hamstring can tear or detach from where it is connected. Sometimes, a small piece of bone is torn away as well. An X-ray can check for these types of fractures. MRIs and ultrasounds may also be helpful in understanding the injury.

Rehab Management: Pain relievers such as ibuprofen can be helpful. Physical therapy can be beneficial too, such as a program that includes progressive stretching. When pain-free range of motion has been restored, patients can also follow a hamstring strengthening program.

Other Resources for Patients and Families: Athletes should talk to their coaches about the injury and returning to the sport, particularly since re-injury is common. The American College of Sports Medicine offers a brochure for patients and families, “Sprains, Strains and Tears” that may be helpful.


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