A Hamstring Pull & Avulsion

Masseur massaging the leg of a woman while placing it on his thigh

Sports that require a high degree of speed, power and agility place athletes at a higher risk for hamstring injuries, according to the American Academy of Orthopaedic Surgeons. Excessive force can cause the hamstring muscle to stretch beyond its normal range of motion. A pulled hamstring responds well to conservative treatment. If you sustain a hamstring avulsion injury, you are likely to undergo surgery and a longer rehabilitation process. Always consult your doctor if you feel you have sustained a hamstring injury.

Hamstring Anatomy

The hamstrings consist of three muscles. The Biceps Femoris, Semimembranosus and Semitendinosus comprise the hamstring muscle group. A majority of the hamstring muscles form across the femoral muscles -- the muscles in the top half of your leg. The hamstrings run across the hip and knees. They are responsible for flexing the knee and aid in hip extension.

Hamstring Pulls

A pulled hamstring is also referred to as a hamstring strain. This occurs when there is a tear in one or more of your hamstring muscles. Pulled hamstrings are common in individuals who sprint or jump hurdles. Athletes in sports that include a lot of sprinting -- including rugby and football -- are also susceptible to hamstring injuries. If you have sustained a pulled hamstring, you are likely to feel a sharp pain in the back of your leg. Swelling and bruising may also occur. You will feel pain if you try to straighten your knee or contract your muscle. Pulled hamstrings can include minor tears, partial tears or a complete rupture of one of your hamstring muscles.

Avulsion Injuries

Hamstring avulsion injuries are rare but severe. An avulsion occurs when the hamstring muscle is completely torn away from the ischial tuberosity, the portion of your bones you rest your body weight on while seated. It's located near the hip bone and attaches to the hamstring muscles. This injury is usually the result of a sudden contraction of your hamstring muscle during strenuous physical activity. Sprinting, long jumping and hurdling put you at risk for a hamstring avulsion injury. With this injury, you will experience extreme pain and will probably notice a gap where your muscle has detached. It will be difficult to flex your knee or bend your hip. This injury requires immediate medical treatment.


Pulled hamstrings and avulsion injuries should be examined by a physician. The physician will examine you for tenderness and bruising as well as signs of pain, swelling and weakness. Your doctor may order an x-ray or MRI test in order to determine the severity of your injury.


The treatment of a hamstring injury largely depends on its severity and location. Treatment can be surgical or nonsurgical. Hamstring pulls are frequently treated with rest, ice, compression and elevation. For more severe hamstring pulls, a brace to immobilize your knee can help with the healing process. Your doctor may also recommend physical therapy in order to restore strength and range of motion in your hamstrings. For complete ruptures or avulsion injuries, surgery is required. Your surgeon will reattach the muscle to your bones using staples or stitches. He is also likely to clear up any scarred tissue. After surgery, you will spend time with your leg immobilized and on crutches. When it is safe for you to bear weight, your doctor will recommend physical therapy in order to restore normal function in your hamstrings.