Evaluation and Imaging of an Untreated Grade III Hamstring Tear: A Case Report

  • Brett B. Clark
  • David Jaffe
  • R. Frank Henn3rd
  • Richard M. LoveringEmail author
Case Report



Muscle strains are one of the most common complaints treated by physicians. High-force lengthening contractions can produce very high forces resulting in pain and tissue damage; such strains are the most common cause of muscle injuries. The hamstring muscles are particularly susceptible as they cross two joints and regularly perform lengthening contractions during running. We describe a patient with return to full function after a large hamstring tear.

Case Description

We report the case of a 26-year-old man who presented 1 year after a noncontact, left-sided proximal hamstring tear incurred while sprinting. He received no medical treatment or formal rehabilitation. He was able to return to all sports and activities 1 to 2 months after injury, but noted a persistent deformity of the proximal thigh, which led him to seek evaluation. Physical examination, MRI functional tests, and specific muscle tests 1 year after his injury documented a major hamstring tear at the musculotendinous junction with muscle retraction, but no avulsion of the proximal tendon attachment.

Literature Review

Surgery often is recommended for major proximal hamstring tendon tears, especially when more than one tendon of origin is ruptured from the ischial tuberosity. Myotendinous tears are treated nonoperatively, but may be associated with decreased strength, prolonged recovery, and recurrence.

Purpose and Clinical Relevance

We describe the case of a young man who sustained a hamstring tear, with retraction, at the proximal myotendinous junction, where the biceps femoris and semitendinosus arise from the conjoint tendon. He achieved full functional recovery without medical attention, but had a persistent cosmetic deformity and slight hamstring tightness. This case suggests a benign natural history for this injury and the appropriateness of noninvasive treatment.


Muscle Injury Hamstring Muscle Ischial Tuberosity Pennation Angle Myositis Ossificans 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by grants to RML from the National Institutes of Health (K01AR053235 and 1R01AR059179).


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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Brett B. Clark
    • 1
  • David Jaffe
    • 1
  • R. Frank Henn3rd
    • 1
  • Richard M. Lovering
    • 1
    • 2
    Email author
  1. 1.Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Departments of Anatomy and NeurobiologyUniversity of Maryland School of MedicineBaltimoreUSA

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