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The human leg comprises an intricate system of muscles that facilitate the movement of feet and toes. Within this system, the muscles are categorized into the anterior, lateral, and posterior compartments, each with a unique set of muscles carrying out specific functions.
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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations
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Proximal Hamstring Injuries.

Amanda N Fletcher1, Jonathan W Cheah2, Shane J Nho3

  • 1Department of Orthopaedic Surgery, Duke University Medical Center, 311 Trent Drive, Durham, NC 27710, USA.

Clinics in Sports Medicine
|March 6, 2021
PubMed
Summary
This summary is machine-generated.

Proximal hamstring injuries range from tendinosis to complete rupture. Treatment options include conservative measures, newer therapies, or surgical repair for severe cases.

Keywords:
Chronic insertional tendinosisHamstringInjuryProximal hamstring injuriesRuptureStrainTendinopathyTendinosis

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Musculoskeletal Research

Background:

  • Proximal hamstring injuries encompass a spectrum of conditions, including chronic tendinosis, acute strains, partial avulsions, and complete ruptures.
  • Understanding the varied presentations is crucial for appropriate management strategies.

Purpose of the Study:

  • To outline the diagnostic considerations and treatment paradigms for proximal hamstring injuries.
  • To delineate the indications for operative versus nonoperative management.
  • To describe current surgical techniques for proximal hamstring injury repair.

Main Methods:

  • Review of current literature on proximal hamstring injuries.
  • Analysis of nonoperative management strategies including activity modification, pharmacotherapy, and physical therapy.
  • Evaluation of emerging therapies such as platelet-rich plasma injections, dry needling, and shock wave therapy.
  • Identification of surgical indications based on injury severity, retraction, and patient factors.
  • Description of surgical techniques including open and endoscopic primary repair, augmentation, and reconstruction.

Main Results:

  • Nonoperative management is suitable for chronic insertional tendinosis and low-grade tears.
  • Emerging therapies may offer additional benefits for certain patient groups.
  • Surgical intervention is indicated for complete proximal avulsions, significant partial avulsions (≥2 tendons with >2 cm retraction in active patients), and refractory cases.
  • Surgical options include primary repair (open or endoscopic) or augmentation/reconstruction.

Conclusions:

  • Proximal hamstring injuries require a tailored treatment approach based on injury type and severity.
  • A combination of conservative treatments and advanced therapies can be effective for less severe injuries.
  • Surgical repair provides a viable option for significant injuries and cases unresponsive to nonoperative management.