Hamstring Tears Treatment Options

Hamstring tears are common musculoskeletal injuries that can significantly impact an individual’s mobility, function, and quality of life. Treatment for hamstring tears aims to alleviate pain, promote tissue healing, restore muscle strength and flexibility, and prevent recurrent injuries. Depending on the severity of the tear, as well as the patient’s age, activity level, and overall health, treatment options may include nonoperative or operative approaches.

What nonoperative treatment options are available?

Nonoperative management is often the initial approach for treating mild to moderate hamstring tears, particularly those without significant muscle retraction or tendon avulsion. Nonoperative treatment strategies typically include:

Rest and Activity Modification:

• Resting the injured leg and avoiding activities that exacerbate pain or discomfort are essential for promoting healing and preventing further injury to the hamstring muscles.
• Activity modification may involve temporarily reducing or modifying high-impact activities such as running, jumping, or kicking to allow the injured tissues to heal.

Ice Therapy:

• Applying ice packs to the affected area for 15-20 minutes at a time, several times a day, can help reduce pain, swelling, and inflammation associated with hamstring tears. Ice therapy should be applied cautiously to prevent skin damage, and a barrier such as a cloth or towel should be used between the ice pack and the skin.

Compression and Elevation:

• Compression bandages or wraps may be used to support the injured leg and minimize swelling.
• Elevating the leg above heart level when resting can facilitate fluid drainage and reduce swelling in the injured tissues.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

• Over-the-counter NSAIDs such as ibuprofen or naproxen may be recommended to alleviate pain and reduce inflammation associated with hamstring tears. NSAIDs should be used cautiously and under the guidance of a healthcare professional, as they may have potential side effects and interactions with other medications.

Physical Therapy:

• Physical therapy plays a crucial role in the rehabilitation of hamstring tears, focusing on restoring muscle strength, flexibility, and function.
• A structured exercise program supervised by a physical therapist may include stretching exercises to improve flexibility, strengthening exercises targeting the hamstring and surrounding muscles, and neuromuscular re-education to improve movement patterns and proprioception.
• Modalities such as heat therapy, ultrasound, or electrical stimulation may be used to facilitate tissue healing and reduce pain.

Gradual Return to Activity:

• As symptoms improve and tissue healing progresses, a gradual return to activity and sport-specific training is initiated under the guidance of Dr. Shane J. Nho’s team. Progressive loading and functional exercises are incorporated to rebuild strength, endurance, and coordination in the hamstring muscles while minimizing the risk of reinjury.

What operative treatment options are available?

In cases of severe hamstring tears, particularly those involving complete tendon avulsion, surgical intervention may be necessary to reattach the torn tendon. Operative treatment options for hamstring tears include open and endoscopic approaches.

1. Open hamstring repair involves making an incision along the back of the thigh to access the torn hamstring tendons directly. Dr. Shane J. Nho carefully exposes the injured tissues, reattaches the torn tendon(s) to their anatomical insertion site on the bone using sutures or anchors, and repairs or reinforces damaged muscle tissue if necessary. While open repair offers direct visualization and is suitable for complex tears; although, open repair requires use of a larger incision.
2. Endoscopic hamstring repair is a minimally invasive technique performed through small incisions, typically less than 1 cm in size. A specialized camera called an endoscope is inserted into the incision, providing a magnified view of the internal structures. Using specialized instruments, Dr. Shane J. Nho repairs the torn hamstring tendons by reattaching them to their insertion site on the bone through use of anchors placed directly into the bone. Endoscopic repair offers advantages such as smaller incisions and reduced tissue trauma.

The choice between open and endoscopic repair depends on various factors, including the severity of the tear, number of tendons involved, degree of tendon retraction, and the chronicity of the tear. Both techniques have their advantages and limitations, and the decision should be made in consultation with Dr. Shane J. Nho to determine the most appropriate approach for each individual case. Overall, both open and endoscopic hamstring repairs are effective in restoring function and mobility for patients with hamstring tears.

What does rehabilitation after surgery entail?

Following surgical intervention, a structured rehabilitation protocol is initiated to promote tissue healing, restore muscle strength and flexibility, and optimize functional outcomes. Physical therapy is an integral part of postoperative rehabilitation, focusing on early mobilization, pain management, and gradual progression of exercises and activities. The rehabilitation protocol typically follows a phased approach, starting with gentle range of motion exercises and gradually advancing to strengthening, functional training, and sport-specific activities.

What does return to activity look like?

The timing and criteria for return to activity after surgical treatment of hamstring tears vary depending on the specific procedure performed, as well as the patient’s individual progress and functional recovery. Clearance for return to sports or high-intensity activities is typically based on objective measures of strength, flexibility, and functional performance, as well as the absence of pain or instability in the affected leg. Close communication and collaboration between Dr. Shane J. Nho and his team is essential to ensure a safe and successful return to activity following surgical treatment.

In conclusion, both nonoperative and operative treatment options are available for managing hamstring tears, depending on the severity and location of the injury, as well as the patient’s individual circumstances and treatment goals. Nonoperative management may be appropriate for mild to moderate tears, focusing on rest, ice, compression, physical therapy, and gradual return to activity. In cases of severe or complex hamstring tears, surgical intervention may be necessary to repair or reconstruct the damaged tissue and optimize outcomes. Regardless of the treatment approach, a comprehensive rehabilitation program supervised by Dr. Shane J. Nho is essential for promoting tissue healing, restoring function, and preventing recurrent injuries in individuals with hamstring tears.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of hamstring tears. If you believe you are affected by a hamstring tear, schedule a consultation today with our experienced orthopaedic care team.