Hamstring Injuries of the Hip

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Anatomic and functional considerations

The hamstrings consist of three muscles that run along the back of the thigh. They include the semitendinosus, the semimembranosus, and the biceps femoris. The hamstring muscles contract to flex the knee and extend the hip. The hamstrings span two joints and are therefore subject to stretching at more than one point. Additional risk factors include composition by fast-contracting type II fibers, eccentric action, and fusiform shape [3], [4], [5]. All the hamstring muscles have a complete or

MR imaging strategies

Although clinical assessment may be sufficient for diagnosis and management of muscle injuries, it is currently accepted that MR imaging may provide accurate information with regard to the site, grade, and prognosis of lesions, particularly in the competitive athlete.

Ultrasound has proved to be sensitive and cost-effective in the early detection and grading of muscle injuries and is widely used in this regard. Conventional radiographs or CT may be useful in specific types of injuries, such as

Avulsion injuries

Avulsion injuries at the origin of the hamstrings results from forceful eccentric muscle contraction or excessive passive lengthening [14]. This occurs with the hip flexed and the knee in extension. Pain is typically referred to the buttock region and may be associated with gait disturbances. Loss of function and severe tenderness are frequently the presenting symptoms in this condition, which may manifest as an avulsion fracture or avulsion injury of the proximal hamstring tendons.

Avulsion

Muscle strain

Myotendinous strains are induced by indirect trauma from excessive stretch or tension. Eccentric exercise, where the contracting muscle is lengthened, produces microscopic damage in muscle fibers and may result in sensations of stiffness and soreness for the next few days (Fig. 9). Because strain injuries are known to occur during eccentric contraction, it is hypothesized that the microscopic damage from eccentric exercise can progress to muscle strain [23]. The athletes most at risk of

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