Proximal Hamstring Tear

Proximal hamstring tears involve injury to one or more of the hamstring tendons where they attach to the ischial tuberosity, a bony area deep in the gluteal fold. These injuries can cause significant pain, weakness, and difficulty with sports and daily activities, especially sitting and bending.

Overview

The hamstrings are a group of muscles located on the back (posterior) of the thigh responsible for hip extension and knee flexion. They include:

• Semitendinosus
• Semimembranosus
• Long head of the biceps femoris
• Short head of the biceps femoris

A proximal hamstring tear occurs when one or more of these tendons partially or completely tear away from their attachment at the ischial tuberosity. These injuries are most common in athletes involved in:

• Soccer
• Baseball
• Gymnastics
• Track and field
• Sports requiring sprinting or explosive movement

Proximal tears may cause deep buttock pain, difficulty sitting, weakness, and limping.

Causes

Proximal hamstring tears typically occur from:

• Sudden acceleration or sprinting
• Overstretching the hamstring
• Forceful kicking or jumping
• Slipping with the leg extended forward
• Repetitive overuse in cutting or running sports

Chronic strain can weaken the tendon and make it vulnerable to tearing.

Signs and Symptoms

Symptoms may vary depending on whether the injury is acute or chronic.

Common signs include:

• Sudden sharp pain in the lower buttock or back of the thigh
• A popping or tearing sensation
• Bruising or swelling
• Persistent pain in the gluteal fold, especially when sitting
• Weakness bending the knee or pushing off
• Difficulty climbing stairs or running
• Limping or altered gait

Non-Surgical Treatment

Less severe or chronic hamstring injuries may respond to conservative care.

Non-surgical treatment options include:

• Rest and reduced activity
• Ice and anti-inflammatory medications
• Physical therapy focused on flexibility and strengthening
• Targeted injections around the ischial tuberosity to reduce inflammation

These options may provide relief but are not always sufficient for significant tears.

Surgical Treatment

Surgery is often recommended for acute or severe proximal hamstring tears, especially when tendons are fully detached or significantly retracted.

Surgical repair may include:

• Endoscopic repair through small incisions
• Reattachment of torn tendons to the ischial tuberosity
• Use of suture anchors to secure the tendon
• Open repair for large or complex tears

These procedures can restore strength, relieve pain, and help patients return to high-level activities.

Recovery

Recovery after proximal hamstring repair is designed to protect the repair and gradually restore mobility and strength.

Typical recovery includes:

• About 6 weeks of limited weight bearing with crutches
• Use of a hip brace for approximately 6 weeks
• Additional bracing depending on the severity of the injury
• Physical therapy to regain range of motion, strengthen the hamstrings, and safely progress back to sports

Full recovery time varies depending on the severity of the injury and the patient’s activity goals.

Benton A. Emblom, MD

Benton A. Emblom, MD, is a board-certified, fellowship-trained orthopaedic sports medicine surgeon who specializes in hip preservation and the treatment of complex soft-tissue injuries around the hip and pelvis, including proximal hamstring tears. He cares for athletes and active individuals seeking to restore strength, reduce pain, and return to high-level performance.

Dr. Emblom serves as a head team orthopaedic physician for Auburn University, the University of Alabama, Hoover High School, and several additional high schools. His expertise in both endoscopic and open hamstring repair allows him to provide advanced, individualized care for patients with these challenging injuries.

If you believe you may have a proximal hamstring tear or another hip or posterior thigh condition and would like to request an appointment with Dr. Emblom, call (205) 939-3699 and ask to speak with his appointment scheduler.

To request an appointment online, CLICK HERE or contact Andrews Sports Medicine & Orthopaedic Center at (205) 939-3699.