A hamstring muscle tear is a common injury among athletes. This injury usually occurs as a result of overstretching or sudden movements. The treatment of a hamstring muscle tear is usually successful with the correct diagnosis and appropriate treatment methods.
Although hamstring injuries are seen in many sports branches such as football and athletics, hamstring injuries are the most common injury in football and the most common injury that causes football players to miss game.
More than half of a professional football team's medical team's time (team doctor, physiotherapist, masseur) is spent treating hamstring injuries. In the 2022-2023 season, the total cost of hamstring injuries in the Premier League was over 75 million pounds.
Despite how common hamstring tears are, the good news is that less than 10% of hamstring tears require surgery.
Contents:
What is Hamstring?
The hamstring muscle has 3 in each leg. It is also called the upper back muscle group. These are the semitendinosus, semimembranosus and biceps femoris muscles. The hamstring muscles are large muscles that attach to the pelvis, run down the back of the thigh, cross the knee and attach to the upper end of the lower leg bones.
The hamstring muscles are large muscles that attach to the pelvis, run down the back of the thigh, cross the knee and attach to the upper end of the lower leg bones.
As these muscles get closer to the hip and knee joint, they turn into tendons and attach to the bones. These muscles allow us to extend the leg and bend the knee. The hamstring muscles are balanced by the quadriceps muscles on the front of the thighs. The strength and stability of the knees are controlled by these Quadriceps - Hamstring muscle groups.
What is Hamstring Injury, Tear?
Hamstring injury tears are tears of one or more of the hamstring tendons. They are common muscle strain injuries due to overload and overuse during training or a match.
At first, the muscle fibers and/or tendon are stretched and injured as a result of muscle stretching or hamstring pulling (1st-2nd degree injury). If the strain continues, a tear occurs in the muscle fibers or tendon.
Hamstring Muscle Tear Grading
Hamstring Muscle Tear Grading is divided into 3, these are as follows
Grade 1 Hamstring Injury: It is a mild injury, there is no tear in the muscle fibers, there is damage due to stretching.
Grade 2 Hamstring Injury: Moderate injury, partial tear of muscle fibers
Grade 3 Hamstring Injury: It is an advanced injury, the muscle fibers are completely severed. Sometimes when the tendon ruptures, a piece of bone may also break off. This is called an avulsion injury. Avulsion injuries are caused by sudden bursts of speed seen in ice skating, weightlifting and skiing.
What Causes Hamstring Muscle Tear?
Overloading the muscle as a result of intense and high-paced training is the main cause of a hamstring tear. Either the capacity of the muscle has decreased or the load is too much for the muscle to handle. The hamstrings can also be injured when just running, kicking or going down stairs without straining them at all. There are many reasons for this:
Conditions that decrease the capacity of the muscle and increase the risk of a hamstring tear:
Age: The risk of muscle tears increases as the athlete ages
Gender: Female athletes are more prone to muscle injuries.
Body Composition: Factors such as body weight, fat percentage.
Diet: Especially protein, calcium-poor diet
Sleep Less than 8 hours of sleep per day
Previous injury of the muscle: Previous injury of the same muscle group independent of time.
Athlete Anatomy: Deformities of the legs, anatomical disorders such as braces leg, X leg.
Skill level of the athlete: Poor technique specific to the sport, poor posture of the athlete.
Psychological Factors: Highly competitive situations, loss of motivation, distortion of risk perception
Conditions that Exceed the Capacity of the Muscle
Training Mistakes: Overloading in training
Inappropriate and poor quality of sports equipment: quality of shoes, etc.
Environmental Factors: Poor ground conditions in training and match fields, snow and icy weather conditions
Risk Factors for Hamstring Tears:
The main risk factors are muscle tension, muscle imbalance (quadriceps are stronger than hamstrings), poor conditioning, muscle fatigue. The hamstring muscles in particular are significantly inactive when walking and standing, so a sudden jump, stretch, lunge can tear the muscle.
Symptoms of Hamstring Tear?
In hamstring tears, the patient has pain in the area between the knee and hip, in the thigh. Sometimes it can be confused with muscle fatigue.
The hamstring muscles are most commonly injured in the middle. Symptoms of hamstring injuries depend on the degree of strain.
Grade 1 tears: It feels like a stinging or pulling pain that worsens with activity.
Grade 2 and Grade 3 tears have the following symptoms: symptoms include
A sharp pain in the middle part of the upper back muscle group in the thigh
Limping when walking, difficulty in giving a load.
Inflation.
Bruising and discoloration.
Hamstring weakness
Muscle spasms
Hearing an explosion at the time of injury.
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How to recognize a hamstring tear?
After a detailed physical examination, hamstring injury is diagnosed with MR imaging.
MR Image of Hamstring Tear
Imaging techniques such as MRI play an important role in diagnosis and evaluation. MRI provides detailed images of the hamstring muscles and tendons, showing the presence and severity of a tear.
How to relieve hamstring pain?
Hamstring pain in particular can be caused by a discomfort in the hamstring muscle group. It is often common among athletes. We also recommend the following steps to relieve hamstring pain and promote healing:
Rest: Providing rest to the muscles speeds up the healing process and reduces pain. It is important to limit activities and rest.
Ice application: Applying an ice compress to the painful area reduces swelling and relieves pain. However, ice should be applied through a cloth, not directly to the skin, and each procedure should not exceed 15-20 minutes.
Painkillers Taking the painkillers we recommend can help manage pain. However, long-term use of these medicines should be supervised.
Hamstring Tear Treatment
Most hamstring injuries in particular heal without surgery. Mild injuries tend to heal well. Severe hamstring injuries make the hamstring muscles weak. The aim is to restore function and prevent injury to the muscle. It is very important to work one-on-one with a physiotherapist during the rehabilitation process. In addition, 1 in 3 hamstring tears recur. The reason for the recurrence of hamstring injury is that the rehabilitation process is not well spent and return to sports without early full recovery.
A break from sport is essential to allow the injury to heal.
Applying ice to relieve pain and reduce swelling: 20 minutes of ice for 1 hour, 6-7 times a day.
Wrap the injured area with a bandage or wear sports tights to minimize swelling.
If possible, rest with your leg raised above the level of the heart to reduce swelling.
Friction massage away from the tear
You can use painkillers in consultation with your doctor. After 48 hours, we do not recommend its use.
Ultrasound guided PRP injections.
When Is Surgery Necessary for Hamstring Tear Treatment?
Rupture of the Hamstring Tendons.
Tendons rupture where they attach to the bone.
Tendons rupture together with the bone to which they are attached (Hamstring avulsion injuries)
The above hamstring ruptures must be treated with surgery.
How is Hamstring Surgery Performed?
An incision is made over the tear, the tear is found and the tendon is sutured. The knee is not allowed to be straight (knee extension) for about 6 weeks after surgery.
Sometimes all 3 hamstring tendons rupture where they attach to the pelvic bone, in such a case all 3 hamstring tendons are sewn to the bone with screws with long threads.
You can watch images about the hamstring surgery performed by Dr. Utku Erdem Özer by clicking this link.
Conclusion
Hamstring muscle tear treatment and rehabilitation are successful in most patients, but it is important to remember that the treatment process is long and requires patience. We want you to contact us during the treatment process and get through this process with our guidance and support.
Nowadays, hamstring tears are quite common, especially in soccer. Compared to 10 years ago, we know that the annual number of hamstring tears in soccer teams has increased. Despite the advances in technology, there is only one explanation for the increase in hamstring tears, not a decrease: the increased number of matches.
The best treatment of a hamstring tear is to take measures to prevent the tear from occurring. The quality of the ground quality of training and stadium fields is also one of the most important factors affecting hamstring injury.
The use of biological products derived from the patient's own blood, such as PRP and PRGF, is increasing day by day in muscle tears.
Very few hamstring tears require surgery. Grade 3 injuries should be evaluated well and if surgery is necessary, there should be no hesitation about surgery. Because if hamstring tears that require surgery are treated without surgery, the tear will not heal completely. As a result, this will increase the risk of re-tear and decrease the performance of the athlete.
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