Traumatic and overuse injuries of the ischial origin of the hamstrings

Both acute and chronic hamstring injuries are disabling injuries, and occur almost entirely to elite athletes. We report our experience in the management of injuries of this location.

Twenty-seven patients (29 injuries) were included in the present study. They completed a questionnaire detailing their pre-injury activity, injury mechanism, rehabilitation and a subjective assessment of their recovery. At clinical examination, pain and hip motion were evaluated.

Hamstring injuries predominantly affect males on the left side. Most procedures carried out were explorations with limited debridement and suture of the tendon. Thirty percent of patients felt they had returned to 100% of their pre-injury level, and 33% felt they had returned to 80 - 90% of their pre-injury level, the rest varied between less than 20% to 80%. Forty-five percent gave a value of zero on the visual analogue pain scale independent of activity. Those who gave a value above this had pain during active sports but not at rest.

Early repair leads to acceptable recovery of muscle function, especially when dealing with complete avulsions. Lesions to the origin of the hamstring can be successfully managed if a high suspicion for the condition is exerted.