Patterns of Hamstring Muscle Tears in the General Population: A Systematic Review

Abstract

BackgroundHamstring tears are well recognised in the sporting population. Little is known about these injuries in the general population.PurposeEvaluating the rates, patterns and risk factors of non-sporting hamstring tears, compared to sporting related hamstring tears.Data SourcesMEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (1989–2015).Study SelectionStudies reporting patients with a grade 2 or 3 hamstring muscle tear, identified clinically, confirmed by MRI imaging or direct visualisation during surgical exploration.Data Synthesis144 sets of linked data were extracted for analysis. Most injuries were in males (81.3%), where mean age at injury was lower (30.2, 95% CI 29.1–31.3) than in females (35.4, 95% CI 32.4–38.4) p = 0.06. Key differences were found in the proportion of non-sporting injuries in patients under and over the age 40 (p = 0.001). The proportion of non-sporting injuries was significantly higher in females compared to males (25.9% female non-sporting injuries, versus 8.5% male; p = 0.02). Avulsions were more frequently reported in non-sporting activities (70.5%). The proportion of such injuries was notably higher in females, though this failed to meet significance (p = 0.124). Grouped by age category a bimodal distribution was noted, with the proportion of avulsions greater in younger (age <15) and older patients (age > 40) (p = 0.008). 86.8% of patients returned to pre-injury activity levels with a similar frequency across all study variables; age, activity (sporting vs non-sporting) and injury type (avulsion vs tear).ConclusionThis review highlights a proportion of adults suffering grade 2 or 3 hamstring injuries from activities other than the classic sports trauma. The majority of these non-sporting injuries were avulsion injuries that clustered in older female and skeletally immature patients suggesting a potential link to bone mineral density.

Relationship between Muscle Flexibility and Characteristics of Muscle Contraction in Healthy Women during Different Menstrual Phases

“…Furthermore, it has been reported that the risk of ACL injury in women changes with the menstrual cycle 18,47,48) . Additionally, musculoskeletal injuries, such as ACL injuries and hamstring injuries, have been reported, regardless of the level of competition 49,50) . To conclude, we found that there were no significant differences in muscle flexibility and the maximum muscle strength between the menstrual and ovulatory phases in females.…”

Outcomes of Open and Endoscopic Repairs of Chronic Partial- and Full-Thickness Proximal Hamstring Tendon Tears: A Multicenter Study With Minimum 2-Year Follow-up

“…It found that the majority of patients undergoing hamstring repair for chronic tears were female. In a recent systematic review, Kuske et al 23 showed that although most injuries of the proximal hamstring are seen in males, recreational sport and nonsport injuries in patients younger and older than 40 years revealed a significantly higher prevalence of females acquiring proximal hamstring injuries as compared with males. This is reflected in the current study, as many of the injuries seen in this patient population were nonsport and recreational sport injuries.…”

Influence of Lumbar Mobilizations During the Nordic Hamstring Exercise on Hamstring Measures of Knee Flexor Strength, Failure Point, and Muscle Activity: A Randomized Crossover Trial

“…Hamstring strain injuries (HSI) are common across several sports affecting athletes of all ages, genders, and levels of competition. [1][2][3][4][5] Considerable time can be lost from sport related activity, resulting in diminished performance and financial loss. 6 Despite significant emphasis on injury preventive measures, HSI prevalence continues to rise and recurrence rates remain high.…”