Hamstring injuries in athletes: Diagnosis and treatment

Abstract

» Hamstring injuries are one of the most common sports injuries and are a leading cause of time away from sports. Previous hamstring injury and age are considered the greatest risk factors for these injuries in both elite and recreational athletes. » Making a diagnosis of hamstring injuries should start with an accurate history describing the mechanism of injury and a thorough physical examination. Magnetic resonance imaging and ultrasound are considered the modalities of choice for both the diagnosis and classification of these injuries. Although multiple classification systems have been described, none of them have been validated for management purposes. » Surgical treatment of these injuries is governed by the anatomical location of the injury (proximal versus distal) and the nature of the injury (acute versus chronic). » Operative treatment of both proximal and distal hamstring injuries is indicated when the injury involves all three muscles, when the injury involves two tendons in athletes who participate in sports requiring the maintenance of a seated position under eccentric loads to the hamstrings, and when nonoperative treatment has failed. Gluteal sciatica is another indication for operative treatment of proximal hamstring injuries. » A crucial aspect of both the operative and nonoperative treatment of these injuries is the rehabilitation process. The rehabilitation program should concentrate on both eccentric strengthening and proprioceptive exercises, but there is a lack of well-designed studies to accurately assess other rehabilitation protocols.