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Hamstring muscle and tendon injuries

Authors
Karl B Fields, MD
Spencer T Copland, MD
John S Tipton, MD
Section Editor
Peter Fricker, MBBS, FACSP
Deputy Editor
Jonathan Grayzel, MD, FAAEM

INTRODUCTION

Hamstring muscle injuries occur frequently among recreational and elite athletes. Several terms, including posterior thigh injury, hamstring strain, hamstring tendinopathy, and hamstring tear, are used to describe such injuries, but they are not always synonymous. In most cases, the severity of the injury determines treatment and the amount of time the athlete must take off from sport [1-9].

For the purpose of this review, we will define hamstring injury as any strain or tear, including avulsion, of any of the muscles or tendons within the hamstring group, including the biceps femoris, semitendinosus, and semimembranosus muscles.

The diagnosis, management, risk factors, and prevention of hamstring muscle and tendon injuries are reviewed here. Other musculoskeletal injuries of the lower extremity are discussed separately. (See "Anterior cruciate ligament injury" and "Ankle sprain".)

EPIDEMIOLOGY

The incidence of hamstring injuries among athletes varies based upon the definition used. Nevertheless, most researchers agree that hamstring injuries comprise a substantial percentage of acute, sports-related musculoskeletal injuries [10]. Prevalence ranges from 8 to 25 percent, depending upon the sport. The timing for return to sport ranges from as early as two weeks to never, depending upon injury severity and the sport in question. One observational study reports a single-season prevalence rate greater than 50 percent among elite soccer players [11]. Recurrent hamstring injuries develop in more than 30 percent of athletes, with most occurring during the ensuing sporting season [4,5,7,8].

Data collected from the United States’ National Collegiate Athletic Association indicates that the three highest risk sports are American football and men’s and women’s soccer [12]. The overall rate of hamstring injury was 3.05 per 10,000 sport exposures. The risk was about twice as high during competition and preseason training compared to general practice. In this database, 12.6 percent of injuries were recurrent strains and 6.3 percent were severe enough to cause the athlete to miss three or more weeks of sport.

                                

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Literature review current through: Nov 2016. | This topic last updated: Fri Sep 16 00:00:00 GMT 2016.
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