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Updated: Oct 1, 2025

Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations
Published on: May 1, 2018
Distal Hamstring Muscle Injuries
John R Matthews1, John Hayden Sonnier1, John P Prodoehl2
1Division of Sports Medicine, Rothman Orthopaedics, Philadelphia, Pennsylvania.
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Distal hamstring muscle injuries, although relatively uncommon, can potentially lead to substantial morbidity in athletes; prolonged rehabilitation times and high rates of reoccurrence have been documented.
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Overall, magnetic resonance imaging is considered the "gold standard" for evaluation of hamstring injuries because it allows assessment for concomitant pathology and can clarify return-to-sport timelines.
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Complete tears of the distal biceps femoris and semimembranosus muscles respond well to surgical repair, whereas complete tears of the distal semitendinosus can be successfully treated nonoperatively or with surgical resection.
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Future research may be necessary to further optimize treatment of these injuries and to determine the efficacy of biologic adjuvant therapy.
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