Ultrasound-Guided Fascial Hydrorelease for Persistent Pain After Hamstring Injury

Area of Science:

• Musculoskeletal Rehabilitation
• Sports Medicine
• Pain Management

Background:

• Persistent pain after hamstring injury can hinder athlete recovery.
• Fascial dysfunction is increasingly implicated in residual pain.
• Ultrasound-guided hydrorelease (HR) is a novel technique to restore fascial mobility.

Purpose of the Study:

• To evaluate the clinical efficacy of HR for residual hamstring pain.
• To identify the underlying pathological mechanisms of this persistent pain.
• To assess the impact of HR on fascial mobility and pain reduction.

Main Methods:

• Seven patients with residual hamstring pain (≥8 weeks) were included.
• Ultrasound (US) guided hydrorelease (HR) using saline-lidocaine injected into peri-aponeurotic fascia (APF).
• Pain assessed via numerical rating scale (NRS); tightness via passive straight leg raise (SLR).

Main Results:

• Mean NRS pain scores significantly decreased from 10 to 0.86 post-HR (p=0.017).
• All patients showed improved tightness after HR.
• US revealed APF fascial thickening, including around the posterior femoral cutaneous nerve (PFCN).

Conclusions:

• HR targeting the peri-PFCN-APF effectively reduced residual hamstring pain.
• Findings support the concept of "Perineural fascial pain" originating from fascial dysfunction.
• HR offers a safe and effective treatment for persistent hamstring-related pain.