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Evaluation and Imaging of an Untreated Grade III Hamstring Tear: A Case Report

  • Case Report
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Muscle strains are one of the most common complaints treated by physicians. High-force lengthening contractions can produce very high forces resulting in pain and tissue damage; such strains are the most common cause of muscle injuries. The hamstring muscles are particularly susceptible as they cross two joints and regularly perform lengthening contractions during running. We describe a patient with return to full function after a large hamstring tear.

Case Description

We report the case of a 26-year-old man who presented 1 year after a noncontact, left-sided proximal hamstring tear incurred while sprinting. He received no medical treatment or formal rehabilitation. He was able to return to all sports and activities 1 to 2 months after injury, but noted a persistent deformity of the proximal thigh, which led him to seek evaluation. Physical examination, MRI functional tests, and specific muscle tests 1 year after his injury documented a major hamstring tear at the musculotendinous junction with muscle retraction, but no avulsion of the proximal tendon attachment.

Literature Review

Surgery often is recommended for major proximal hamstring tendon tears, especially when more than one tendon of origin is ruptured from the ischial tuberosity. Myotendinous tears are treated nonoperatively, but may be associated with decreased strength, prolonged recovery, and recurrence.

Purpose and Clinical Relevance

We describe the case of a young man who sustained a hamstring tear, with retraction, at the proximal myotendinous junction, where the biceps femoris and semitendinosus arise from the conjoint tendon. He achieved full functional recovery without medical attention, but had a persistent cosmetic deformity and slight hamstring tightness. This case suggests a benign natural history for this injury and the appropriateness of noninvasive treatment.

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Acknowledgments

This work was supported by grants to RML from the National Institutes of Health (K01AR053235 and 1R01AR059179).

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Correspondence to Richard M. Lovering PhD, PT.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved or waived approval for the reporting of this case and that all investigations were conducted in conformity with ethical principles of research.

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Clark, B.B., Jaffe, D., Henn, R.F. et al. Evaluation and Imaging of an Untreated Grade III Hamstring Tear: A Case Report . Clin Orthop Relat Res 469, 3248–3252 (2011). https://doi.org/10.1007/s11999-011-2027-3

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  • DOI: https://doi.org/10.1007/s11999-011-2027-3

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