Hip
Hamstring Strain
슬굴곡근 좌상 (햄스트링 좌상)
Acute muscle fiber tear of the posterior thigh hamstrings
- How common
- Very common (12–16% of sports injuries)
- Typical age
- Young adult athletes
What is it?
Hamstring muscles (biceps femoris, semitendinosus, semimembranosus) tear at the myotendinous junction during eccentric contraction.
Commonly affected: Biceps femoris long head myotendinous junction most common
How it develops
- Explosive Eccentric LoadSudden load during sprinting or kicking
- MicrotearMicrotears at myotendinous junction
- Hematoma/EdemaAcute hematoma and edema at tear site
- Fibrotic HealingHeals with scar tissue over 3–6 weeks
Symptoms
- Acute Posterior Thigh PainSudden tearing pain during sprint
- Popping Sensation'Pop' felt at moment of injury
- Inability to RunCan walk but cannot run/sprint
- Bruising/SwellingEcchymosis migrates distally in 24–48 h
How it is examined
- Hamstring TendernessFocal tenderness ± palpable defect at tear
- Resisted Knee FlexionPain or weakness with prone resisted knee flexion
- Active SLR LimitReduced active straight leg raise angle
Imaging
X-ray rules out ischial tuberosity avulsion fracture (esp. adolescents).
- Normal or ischial tuberosity avulsion
MRI is standard for grading tears.
- Hyperintense signal at MTJ (edema/hemorrhage)
- Fiber gap (Grade II/III)
- Ischial avulsion (Grade III)
Non-surgical care
- POLICE PrincipleProtection, Optimal Loading, Ice, Compression, Elevation
- Progressive RehabIsometric → dynamic → sprint progression
- Nordic Hamstring CurlGold standard for prevention of recurrence
- PRP (optional)Considered in some elite athletes
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Complete (Grade III) tear or ischial avulsion with >2 cm retraction
Procedures that may be discussed
- Proximal hamstring re-attachment
- Ischial avulsion fixation
Outlook
Grade I: 2–3 weeks; II: 4–8 weeks; III: 3–6 months.