Hip Hamstring Tears: Treatment Options

Hip Hamstring Tears: Treatment Options

Depending on the level of injury, surgical or nonsurgical treatment may be recommended for hamstring tendon tears at the hip. Injuries are generally graded as either grade 1: mild tendon strain; grade 2: partial tendon tear; or grade 3: complete tendon tear. Further classification systems may also be used, taking into consideration how much tendon retraction has occurred and whether there is also associated sciatic nerve injury. Grade 1 injuries, or mild tendon strains, and grade 2 injuries, or partial tendon tears, are often successfully treated with nonsurgical methods. These include rest and activity modification, ice, anti-inflammatory medications, and physical therapy to help the injured tendon heal and get stronger.

Nonsurgical treatment is not as effective in treating grade 3 injuries, or complete tendon tears, as the tendons have limited ability to reattach to the pelvis bone, leading to long-term weakness and loss of function. Surgery is recommended for most cases of complete tendon tears, especially when there are tears in 2 or 3 tendons with more than 2cm of retraction. Surgery may also be needed for partial tears that have not improved after 3-6 months of nonsurgical treatment. Sometimes, nonsurgical treatment for complete tendon tears is used when these injuries occur in people who are not very active and have medical conditions that prevent them from safely undergoing surgery and recovering properly.

When surgery is needed, it is recommended to be performed as early as possible for the best outcomes for the patient. Patients will be lying face down during surgery, which usually involves an open incision made along the back of the thigh, either horizontally or vertically. Vertical incisions are typically needed when there is more tendon retraction and if additional work is needed to remove scar tissue from the sciatic nerve. Sometimes, surgery can be performed endoscopically with a tiny camera through small incisions. Sutures and anchors are used to reattach the torn hamstring tendons back to the pelvis bone.

Rehabilitation after surgery will vary from patient to patient. Sometimes, patients will wear a leg brace that restricts hip or knee movement to protect the hamstrings and limit weight-bearing on the affected leg for several weeks. After an initial healing period, which is about 6 weeks, patients begin physical therapy to gradually improve range of motion, strength, walking, functional movements, and return to sport. This process takes place over several months. Hamstring tendon tear surgery has great outcomes, with over 90% of patients successfully returning to sport after surgery for partial or complete tendon tears.