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PROXIMAL HAMSTRING TENDON AVULSION
Hamstrings are a group of muscles situated on the rear of the thigh. The proximal end of the hamstring muscle originated from the ischial tuberosity of the pelvis.
Hamstring muscles are the major flexors of the knee and also helps in hip extension.
Injury to the hamstring muscles primarily occurs proximally and is a common source of chronic pain and injury in athletes.
Proximal hamstring tendon avulsion injuries are most common in actions that required quick acceleration such as running, jumping, water-skiing, hurdling, and kicking sports. The most common mechanism of injury is suddenly forced hip hyperflexion and ipsilateral knee extension.
Proximal hamstring tendon avulsion injury is where the proximal tendon completely tears away from the attachment with ischial tuberosity. Proximal hamstring tendon avulsion injuries typically occur in a patient who is younger, skeletally immature athletes. And are the most severe type of hamstring muscle injury in the field of sports science.
Symptoms of Proximal hamstring tendon avulsion injury include:
Complaint of sharp pain in the back of the thigh, or buttock with popping and tearing of the muscle.
Difficulty in standing or walking.
Weakness during flexion of the knee.
Ecchymosis of the posterior thigh.
Palpable mass in the mid of the thigh.
This injury is usually diagnosed with MRI.
Treatment of Proximal hamstring tendon avulsion injury includes:
Rest, Cryotherapy, Activity modification, Non-steroidal anti-inflammatories, and physiotherapy.
Physiotherapy treatment of proximal hamstring tendon avulsion injury includes:
In the initial days of injury do isometric muscle contraction exercise for pain relief and muscle activation. Then progress to active assisted exercise.
Stretching of hip flexors, it will increase the rate of recovery and minimize long-term loss of ROM by minimizing the scarring formation.
Eccentric strengthening exercises- For example with thera band, on the Swiss ball, hip hinges, hamstring curl, bridge walkout, Nordic drops.
Strengthening of hamstring synergist muscle- strengthening of gluteal muscle, adductor Magnus by one-legged bridging, squats, and split squats.
Soft tissue mobilization of the lumbar spine, sacroiliac joint, and buttock region.
Neuromuscular control- like single leg balance on Bosu ball, single leg windmill touches.
Osteopathic treatment- such as muscle energy technique (MET), kneading massage, Myofascial release of hip adductors.
Kinesio taping- it will improve circulation, support muscle, help to heal and prevent muscle injury.
And Extracorporeal shockwave therapy, etc.

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