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

Hip Hamstring Tears

  • What is a Hip Hamstring Tear?

    Causes, Symptoms, and Diagnosis

    Movements that cause the hamstring muscles to quickly contract or stretch often lead to injury. While the hamstring muscles are more likely to be injured, tears can also affect the tendons at the hip that attach the muscles to the pelvis.

    Overview Video 

  • Hip Hamstring Tear Treatment

    With and Without Surgery

    Treatment for a hamstring tear at the hip will vary depending on the level of injury. Some partial tears can be rehabilitated with rest and physical therapy. More involved tears, especially if more than one tendon is affected, can benefit from surgery to restore strength and function.

    Treatment Options Video 

  • Hip Hamstring Tear Surgery

    Surgical Animations

    Surgery for a hamstring tear at the hip most often involves using sutures and anchors to reattach the torn tendon back to the pelvis.

    Animation Video 

  • Hip Hamstring Tear Surgery

    Surgical Demonstrations

    During hamstring tear surgery, a surgeon makes an incision along the back of the thigh. This allows the surgeon to access the torn hamstring tendon and reattach it to the pelvis.

    Repair With Anchors Video 

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.

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