Hamstring Ruptures

  • Hamstring Anatomy

    The hamstring group consists of four muscles located at the back of the thigh:

    • Biceps Femoris (long head and short head)
    • Semitendinosus
    • Semimembranosus

    These muscles originate from the pelvis (ischial tuberosity) and insert along the knee and lower leg bones. They play a crucial role in hip extension, knee flexion, and dynamic lower extremity stability.

  • Understanding Hamstring Ruptures

    Hamstring injuries can occur at various sites:

    • Proximal Rupture (near the pelvis)
    • Midsubstance Tear (within the muscle belly)
    • Distal Rupture (near the knee)


    Epidemiology and Injury Types:

    • Hamstring injuries are common in athletes and active individuals, with a higher incidence in sprinting and explosive activities.
    • Approximately 12-25% of hamstring injuries are complete ruptures; the remainder are partial tears.
    • Proximal ruptures (especially avulsions) are more often complete and occur most commonly in middle-aged athletes.

    Midsubstance and distal injuries are more frequently partial tears, but complete distal tendon ruptures can occur in specific high-load injuries.

Treatment Options

  • Non-Operative Treatment

    Recommended for partial tears and some minimally displaced complete ruptures.

    May include:

    • Activity modification and rest
    • Physical therapy emphasizing gradual range of motion and strengthening
    • Platelet-Rich Plasma (PRP) injections can be considered to promote healing in select cases.

    Non-operative care is appropriate for low-demand patients, partial tears, or complete tears with minimal tendon retraction (<2 cm).

  • Surgical Treatment

    Indicated for:

    • Complete proximal avulsions (especially if ≥2 tendons detached or significant tendon retraction >2 cm)
    • High-grade complete midsubstance or distal ruptures with significant functional loss
    • Surgical repair involves reattaching the tendon(s) to the bone using strong anchors or sutures.

    Ideal Candidates for Surgery:

    • Active individuals
    • High-demand athletes
    • Patients with significant weakness, difficulty walking, or loss of lower extremity function
Watch this animation of a Proximal Hamstring Tendon Repair

Post-Operative Rehabilitation

  • First 4–6 weeks: Protected weight-bearing, use of brace or crutches as needed, gentle range of motion exercises.
  • Weeks 6–12: Progressive strengthening begins, focusing on core stability and hamstring activation under guidance.
  • 3–4 months: Return to light jogging and non-contact drills.
  • 4–6 months: Gradual return to full sports participation, depending on strength recovery, functional milestones, and sport-specific demands.

*IF YOU HAVE ANY ADVERSE EFFECTS WITH THE MEDICATIONS or QUESTIONS, PLEASE CALL OUR OFFICE during clinic hours at 855-892-0919 or the After-hours nurse advice at 1-888-576-6225.