Hamstring Injuries Treatment
The hamstrings are a group of three muscles — the semitendinosus, semimembranosus, and biceps femoris — that run along the back of the thigh from the pelvis to the tibia, powering hip extension and knee flexion during every sprint, jump, and kick. Hamstring injuries range from mild muscle strains to partial tears to complete ruptures, and they are among the most common injuries in running and sprinting sports including football, soccer, basketball, and track and field. While most strains heal with rest and rehabilitation, more severe tears — particularly proximal hamstring ruptures where the tendon pulls away from the pelvis — can cause lasting weakness, sciatic nerve irritation, and significant loss of function if not properly diagnosed and treated. Accurate evaluation by a sports medicine specialist is essential for distinguishing between injuries that will heal on their own and those that benefit from surgical intervention.
Dr. Jonathan Glashow is a board-certified orthopedic surgeon, sports medicine specialist, and Clinical Associate Professor of Orthopedic Surgery at NYU Grossman School of Medicine, with over 30 years of experience managing soft tissue injuries in athletes at every level of competition. As Chief Medical Officer for the New Jersey Devils and Philadelphia 76ers — two professional teams where hamstring injuries are among the most common non-contact sidelining events — he has extensive firsthand experience determining when hamstring injuries require conservative management, imaging, or surgical repair. A member of the Arthroscopy Association of North America and the NBA Physician’s Society, Dr. Glashow has performed more than 15,000 orthopedic procedures and has been named a Castle Connolly Top Doctor every year since 2000. He evaluates and treats hamstring injuries at his Upper East Side practice with same-day imaging, on-site MRI, and the full spectrum of treatment options from biologic therapies to surgical repair.
Types of Hamstring Injuries
While hamstring injuries are painful, most can be treated with rest, nonsteroidal anti-inflammatory drugs, compression and elevation, followed by strengthening exercises or physical therapy. However, the treatment required depends on the level of injury. Hamstring tears or ruptures can range from a strain to partial or complete tears of the muscles. Partial and complete hamstring injuries, common in running athletes like football, soccer or basketball players, may require surgical intervention.
When a partial or complete hamstring tear occurs, it can result in loss of strength and function. In some cases, scar tissue can form and cause entrapment of the sciatic nerve. Surgical treatment is usually reserved for those with severe hamstring injuries, especially those who are serious or professional athletes. With the right treatment, athletes can fully recover from severe hamstring injuries and return to the same level of play.
Dr. Glashow is a renowned sports medicine specialist and orthopedic surgeon who works with athletes requiring intricate medical care. Our medical facility on the Upper East Side offers first-class sports medicine treatment for hamstring injuries with same day appointments and treatment available. If you have suffered a severe hamstring or other sports injury, contact us any time of day or night to discuss scheduling an appointment.
Frequently Asked Questions About Hamstring Injuries
How do I know if my hamstring is strained, torn, or ruptured?
Hamstring injuries are graded on a spectrum of severity. A grade 1 strain involves microscopic muscle fiber damage that produces mild pain and minimal strength loss. A grade 2 partial tear causes more significant pain, swelling, bruising, and noticeable weakness. A grade 3 complete tear or rupture produces severe pain at the time of injury, often accompanied by a popping sensation, rapid bruising that extends down the back of the thigh, difficulty walking, and significant loss of strength. Dr. Glashow uses clinical examination and MRI to determine the grade of injury and the most appropriate treatment path.
What is a proximal hamstring rupture?
A proximal hamstring rupture occurs when the tendon tears away from its attachment on the ischial tuberosity — the bony prominence at the base of the pelvis that you can feel when sitting. These injuries typically occur during sudden forceful hip flexion with the knee extended, such as a slip on wet pavement or during water skiing. Proximal ruptures often produce significant bruising that extends down the back of the thigh, persistent weakness during hip extension, and in some cases sciatic nerve irritation caused by retracted tendon tissue pressing on the nerve. Early surgical repair — ideally within the first several weeks — typically produces the best outcomes for complete proximal ruptures.
Do hamstring injuries require surgery?
Most hamstring injuries — including the majority of strains and many partial tears — heal successfully with conservative treatment including rest, ice, compression, elevation, anti-inflammatory medications, and a structured physical therapy program focused on progressive strengthening and flexibility. Surgery is typically reserved for complete tendon ruptures (particularly proximal hamstring avulsions), severe partial tears in competitive athletes, or injuries that have failed to heal with conservative treatment and result in persistent weakness or pain. Dr. Glashow takes a conservative-first approach and exhausts non-operative options before recommending surgical repair in appropriate cases.
What does hamstring surgery involve?
For proximal hamstring ruptures, surgery involves reattaching the torn tendon to the ischial tuberosity using suture anchors — small titanium anchors that are placed directly into the bone and secured with strong sutures. The procedure is typically performed through a small incision at the base of the buttock and is done on an outpatient basis. In some cases, scar tissue that has trapped the sciatic nerve may also need to be released during the procedure. Dr. Glashow uses techniques refined over decades of sports medicine experience to optimize tendon healing and minimize the risk of re-rupture.
How long does recovery take after a hamstring injury?
Recovery timelines vary dramatically based on the severity of the injury. Grade 1 strains typically heal within two to three weeks with proper rest and rehabilitation. Grade 2 partial tears often require four to eight weeks of progressive therapy before a return to sport. Grade 3 complete tears and surgical repairs require a longer, more structured rehabilitation — typically three to six months — with return-to-sport progression based on objective strength testing rather than calendar milestones. Dr. Glashow coordinates rehabilitation closely with physical therapists and athletic trainers to ensure each patient progresses safely and does not return to competition before the hamstring is ready.
How can I prevent hamstring injuries from recurring?
Hamstring injuries have one of the highest recurrence rates in sports medicine, largely because many athletes return to play before the muscle has regained its full strength and flexibility. Effective prevention strategies include a comprehensive strengthening program emphasizing eccentric exercises — particularly Nordic hamstring curls — dynamic warm-up routines before activity, progressive return-to-sport loading rather than sudden increases in training volume, and addressing biomechanical factors like hip mobility, core stability, and running mechanics. Dr. Glashow works with each patient to develop an individualized prevention program based on their sport and injury history.
