Hamstring Injuries

Hamstring injuries range from the very minor, to the very serious when the entire hamstring attachment can be avulsed (pulled off) from its attachment to the pelvis. This can occur during explosive muscle action, especially when the hip is flexed and the knee extended. Rugby players are vulnerable to this particular injury when ‘jackling’ for the ball. During this position, the hips are flexed and the knees can be forced into extension, when the attacking team attempt to ‘clear out’ the defensive player attempting to compete for the ball.

Proximal hamstring avulsion can be missed relatively frequently and this can lead to a delay in diagnosis. Patients can also face difficulties in finding a surgeon, with the expertise to operate on this problem, or find themselves only presented with the option of conservative treatment.

    This image from my operating theatre, shows a torn hamstring attachment. Note that the sciatic nerve has been dissected free and has a yellow band placed around it for identification.  

    This image shows multiple sutures, which are attached to the pelvis by 4 metal anchors. They are used to draw the tendon back to its attachment before allowing a firm repair.  

    This image shows the hamstring tendon after re-attachment to the pelvis.

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