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Hamstring Injury

Hamstring muscles are a cluster of three muscles in the back of the thigh. A hamstring injury is also referred to as a pulled hamstring and occurs due to a tear in the hamstring muscle. The degree of the tear can be a minor tear or total damage of the muscle itself.

Causes of hamstring injury


  • Overstretching or tightening the muscle excessively can lead to the injury.
  • Stretching the muscle without adequate warming up while taking part in any sporting activity.
  • Running in long strides.
  • Muscle exhaustion and taking part in sports even before the previous hamstring injury has healed.
  • Rigid, stiff and weak hamstring muscles.
  • Abrupt intensive physical training.

Symptoms of hamstring injury include swelling of the affected area and excessive pain in the area. There may be bruising and difficulty in moving the leg. Depending on the severity of the injury, treatment has to be given. Initially for the pain and the swelling to reduce RICE technique i.e. R- Rest, I - Ice pack for the swelling, C - Compression of the injured part and E - elevation of the injured part.

Your physician might order for an x-ray, ultrasound or MRI depending on the degree of the injury. Painkillers are prescribed to reduce the pain and the swelling of the muscles. Surgery is suggested in cases of severe injury and for patients in whom the stiffness of the muscle and pain does not reduce even after non-surgical treatment. Ultrasound or massage might be suggested by the physician, along with exercises that stretch and support the muscles. This helps the muscles to recuperate faster and helps induce the lost motion in the knees and hip.

Avulsion fracture

A fracture is called an avulsion fracture when the injury occurs in a place where a tendon or ligament that attaches to the bone pulls off a piece of the bone. It is common to notice avulsion fractures occur around the pelvis area, though they can occur anywhere in the body. More than adults, children are more prone to avulsion fracture, because a child's bone may give away before the ligament or tendon is injured whereas in adults, ligaments get injured more. Children have an area of bone that grows faster. This area in the skeleton is known as a growth plate. When an injury occurs in children near a growth plate, the tendons or ligaments can pull very hard and it will lead to a fracture of the growth plate. Growth plates are necessary for normal skeletal development of a child and so, avulsion fractures must be treated with utmost care. Surgery is the only option, to align the growth plate and stabilize it. If there is no danger of lasting growth problems and if the avulsion fracture is well aligned, then surgery is not necessary.


Normally, avulsion fractures can be treated without surgery since it is treated as a soft-tissue injury. An avulsion fracture of the hamstring attachment on the pelvis can be treated in the same way as a hamstring tear. Surgery is considered only when the bone is pulled too far from its original position. Some ankle sprains where the damaged ankle ligaments pull off a tiny piece of a bone from the joint are treated like an ankle sprain. Avulsion fractures in children are more complicated.


Avulsion fracture of the pelvis

Teenagers and sports persons are susceptible to a type of pelvic fracture. Often some of the pulled muscles may end in an avulsion fracture not detected earlier. The muscle in the pelvic area tears away a small piece of bone from the top of the hip bone and there may be sudden muscle contractions. The entire pelvic ring is not involved and there is no injury to the internal organs. Avulsion fractures experienced by athletes are stable fractures and will heal without surgery. Elderly persons with osteoporosis are also at a risk for pelvic fracture. It can occur during a fall or when descending stairs. Normally the pelvic ring is not damaged but any of the individual bones of this ring may be fractured. Mostly these pelvic fractures involve high-energy forces. Motor vehicle accident, crush accident and fall are the major causes for this type of fracture. Pelvic fractures can be life-threatening depending on the amount of force involved.


Acute pain, swelling and bruises are symptoms of pelvic injuries. To avoid aggravating the pain, a patient may walk with a bent knee. There may be injuries to other parts of the body like head, legs or the chest, if the injury is due to trauma. Heavy bleeding can lead to shock should be arrested immediately. The doctor will request for X-rays from different angles to find out the exact degree of displacement to the bones. A CT scan will reveal the extent of other injuries. It is routine to examine the blood vessels and nerves to the legs for any damage due to the injuries.


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Collection of Pages - Last revised Date: December 13, 2019