Biology lesson: tendons attach muscles to bone. Anytime a tendon attaches a muscle to a bone, that tendon can pull away from the bone. Sometimes it can partially tear from the bone, and sometimes it can fully detach. When it comes to hamstring tears, we are usually talking about the origin in the buttock on the sit bone (or ischial tuberosity).
There are several hamstring tendons: semi membranous, semitendinosus, and biceps femoris (because it has two heads just like the biceps in the arm). There can be a partial tear or a complete tear if one injures the tendon. It can even pull off a piece of bone.
Injuries can occur with sudden pain in the posterior thigh during running, kicking, or jumping activities. I have had people feel a pop in the buttock or upper hamstring region after landing in a split. Bruising results, and the bruise will travel down the leg due to gravity.
MRI can show a partial or a complete tear.
Repair is usually done for active people with complete tears due to pain that people feel when sitting. If not repaired, weakness can occur and cramping as well. The incision is usually placed in the buttock crease, so it is fairly cosmetic appearing. This depicts an incision that is bigger than normal. The incision is the solid black line.
Repair is accomplished with suture anchors into the bone. The sutures are passed through the tissue, which is then tied down to the bone. I describe this as tying a boat down to a dock.
Rehab consists of crutches and avoiding stretching the repair for the first six weeks. So we don’t want the patient to stress the hamstring by flexing the hip with a straight knee. Imagine a hamstring stretch for an athlete with a straight leg and bent hips. This is not allowed. Don’t do this.
Like all tendon repairs, we loosen things up a bit and start strengthening after six weeks and go for 4-5 months of strengthening. People will notice improvements even up to one year.