Right Hamstring Partial Tear in Badminton Player

A 37 yrs old male badminton recreational athlete came in last week after injuring his right thigh doing a 'split' while reaching for a net shot from the baseline 2 days earlier. He felt something snap and had pain lifting his thigh. He found it difficult to bend forward to reach for things due to the pain.

He hobbled onto the examination couch in pain. He was only able to flex his hip up to 40 degrees (Straight Leg Raising) and had a defect in the proximal attachment (see photos) of the semitendinosus muscle with a bulge distally. There was tenderness at the distal bulge of the semitendinosus muscle.

I sent him for an X-ray to rule out avulsion fracture and an MRI to assess the extent of the tear and hematoma. He was given Cox-2 Selective NSAIDS for pain and inflammation and advised to undergo RICE treatment regularly. (awaiting MRI films... )

Clinically, he has at least a grade II strain of the Right semitendinosus which would require at least 12 weeks rehabilitation before return to play. He may have difficulty regaining his full agility and power if he is an elite athlete vying for a place to represent the country in international competition.

Hamstring Strain

Raju (not his real name) is an ex-International hockey player who suddenly suffered from a sharp pain in the back of his right thigh while sprinting towards the 'D'. He thought that it was just a muscle cramp and wanted to play. I ran on the pitch and took him off. He tried to stretch himself but he could not due to the pain. He refused to be strapped and wanted to go into play again but he could hardly straighten his leg.

I quickly iced his hamstring and wrapped it with crepe bandage. After 10 minutes, I reviewed the injury and found that he could hardly lift leg against gravity. Upon palpation, I found out that he had a deep tenderness along the sides of the semimembranosus tendon (musculotendinous junction).

He was advised to obtain an Ultrasound scan to determine the extent of damage (partial tear). He was advised to continue RICE treatment and asked to continue treatment of his Sacroiliac Joint Dysfunction. We also advised him to warm-up, stretch and drink-up (rehydrate with sports drinks or water) adequately.

It should take him at least 6 - 8 weeks to recover adequately with rehabilitation exercises. However, he would be reviewed every 2 weekly do assess his progress. He would also require a fitness test before return to sport.

Hamstring Strain

A martial arts elite athlete came with pain in his right thigh after doing rapid high kicks during filming of a movie. He added that his hamstring was extremely tight and he could not execute a high kick. He already went for treatment by an acupunturist who did some acupunture and massage to release the spasm. He told me he had forgotten to do RICE treatment. It was only after 1 week that he came in to see me.

I examined him and found that he still had mild spasm of his semitendinosus muscle (one of the 3 hamstrings) and tenderness at the myofascial junction. He was able to fully flex and extend(a good sign) but had pain with resisted flexion. I gave him some muscle relaxants and NSAIDS for another 5 days as he had some bruising from the massage. He was told to undergo hydrotherapy (aqua-joggin) and focus on core stability rehabilitation. Since it was only a mild muscle strain I would expect him to recover fully within 2 weeks. However, he would need to be careful if he was to do the high-speed high kicks.