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How long does rehab and recovery take for a torn hamstring?

Q: I just found out that I tore my hamstring muscle. How long does it take to rehab and recover from this type of injury? We are mid-basketball season and I hope to finish out as many games as possible.

A: Many athletes involved in running sports (including basketball) with fast starts and sudden stops injure their hamstring muscle. Like you, the first thing they naturally ask is: how long will it take to recover and get back in the game? The answer is not always so easy to provide. It seems recovery time varies significantly from player to play. Not only that, but second injuries to the same muscle can occur, especially if the player goes back to the game too soon.

A recent study of hamstring injuries has some interesting findings that might help you discuss your prognosis with the physician you are working with. Researchers from Australia evaluated the use of MRIs to predict recovery time from hamstring injuries. They particularly focused on hamstring injuries that involved disruption of the central tendon.

The hamstring muscle is the large muscle along the back of the thigh. It is made up of three muscles and their tendons: the biceps femoris, semimembranosus, and semitendinosus. The central tendon runs down the center of the muscle for the full length of the hamstrings.

The reason this tendinous portion of the muscle is important is because injury to this area often means a longer, slower recovery. So it's good to know exactly where your injury is, what portion of the hamstring (muscle or tendon or both) is involved and how severe is the injury.

MRIs showed that central tendon disruption only occurred in injuries involving the biceps femoris. Almost half (45 per cent) of the hamstring muscle injuries of the biceps femoris included central tendon disruption. Comparing recovery times, it was clear that recovery took much longer for injuries involving the central tendon.

In general for all the players combined, recovery time varied from as short as two weeks up to six weeks. Comparing injuries to the three hamstring muscles (semimembranosus, semitendinosus, and biceps femoris), the recovery time was the same. In other words, there was no significant difference in recovery time for the three hamstring muscles.

Recovery time for central tendon injuries of the biceps femoris was much longer (72 to 91 days). Tendons have less blood supply than muscle fibers so this delay in recovery when the central tendon is injured makes sense. The shorter time (72 days) was for players with this type of injury who were treated conservatively (without surgery). The longer recovery time (91 days) was associated with players who had surgery to repair the damage.

Using MRIs to assess hamstring muscle injury might aid your physician in making predictions about expected length of time for recovery. Returning to sports activities too soon is linked with an increased risk of reinjury. Avoiding recurrent damage to the hamstring muscle is an important goal.

Reference: Jules Comin, MBBS, et al. Return to Competitive Play After Hamstring Injuries Involving Disruption of the Central Tendon. In The American Journal of Sports Medicine. January 2013. Vol. 41. No. 1. Pp. 111-115.

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