What is Proximal Hamstring Tendinosis?
The proximal hamstring tendons connect the three hamstring muscles to the ischial tuberosity, a bone located in the buttocks at the bottom of the pelvis.
How is Proximal Hamstring Tendinosis Caused?
Acute rupture of these tendons is a painful condition commonly caused by rapid acceleration and deceleration. This sort of rapid change of speed is often experienced in sporting activity such as soccer, football, skiing, and hockey. Chronic injuries, present with unrelenting pain during both sports and sitting, can be caused by repetitive motion such as running.
Treatments for Proximal Hamstring Tendinosis
For proximal hamstring complete tendon ruptures in active patients, surgery is indicated to reattach the tendon.
For proximal hamstring tendinosis and partial ruptures of the proximal hamstring, conservative treatment consisting of NSAIDS (non-steroidal anti-inflammatory drugs), physical therapy, and rest and ice are usually first options. Other non-surgical treatment options include platelet-rich plasma (PRP). If conservative measures fail and symptoms continue, surgical debridement and surgical hamstring re-attachment may be performed.
Study Outcomes of Research on Proximal Hamstring Tendinosis and Partial Ruptures
In a recent study Dr. Carreira and colleagues published in the Journal of Orthopedics, a search was performed for the relevant clinical literature for the treatment of proximal hamstring tendinosis and partial hamstring ruptures. This review found 21 studies that met the inclusion criteria. Six articles discussed surgical options and outcomes, 2 articles discussed MRI and ultrasound as diagnostic therapeutic modalities, 4 articles discussed PRP, 1 study discussed shockwave therapy, and 8 studies discussed conservative, non-invasive treatments.
The literature review revealed strong evidence that surgical treatment of proximal hamstring injuries is safe and effective. There were a total of 266 patients in all the articles that studied the surgical treatment of proximal hamstring tendon injuries:
- 52% of patients had excellent outcomes
- 44% of patients had a good outcome
- 4% patients had a fair outcome, and
- 7% of patients had a poor outcome.
A total of 82% of patients were satisfied or somewhat satisfied following surgery.
Finally, across all surgical outcome studies 99% of patients reported improvement following surgery and 99% of patients returned to strenuous activity and sports following surgery.