title: Evaluation and imaging of an untreated grade III hamstring tear: a case report.
abstract: BACKGROUND
  Muscle strains are one of the most common complaints treated by physicians. High-force lengthening contractions can produce very high forces resulting in pain and tissue damage; such strains are the most common cause of muscle injuries. The hamstring muscles are particularly susceptible as they cross two joints and regularly perform lengthening contractions during running. We describe a patient with return to full function after a large hamstring tear.
  
  
  METHODS
  We report the case of a 26-year-old man who presented 1 year after a noncontact, left-sided proximal hamstring tear incurred while sprinting. He received no medical treatment or formal rehabilitation. He was able to return to all sports and activities 1 to 2 months after injury, but noted a persistent deformity of the proximal thigh, which led him to seek evaluation. Physical examination, MRI functional tests, and specific muscle tests 1 year after his injury documented a major hamstring tear at the musculotendinous junction with muscle retraction, but no avulsion of the proximal tendon attachment.
  
  
  METHODS
  Surgery often is recommended for major proximal hamstring tendon tears, especially when more than one tendon of origin is ruptured from the ischial tuberosity. Myotendinous tears are treated nonoperatively, but may be associated with decreased strength, prolonged recovery, and recurrence.
  
  
  CONCLUSIONS
  We describe the case of a young man who sustained a hamstring tear, with retraction, at the proximal myotendinous junction, where the biceps femoris and semitendinosus arise from the conjoint tendon. He achieved full functional recovery without medical attention, but had a persistent cosmetic deformity and slight hamstring tightness. This case suggests a benign natural history for this injury and the appropriateness of noninvasive treatment.
authors.affiliation: Department of Orthopaedics, University of Maryland School of Medicine, 100 Penn St, AHB, Rm 540, Baltimore, MD 21201, USA.
authors.forename: Brett B
authors.initials: BB
authors.lastname: Clark
authors.forename: David
authors.initials: D
authors.lastname: Jaffe
authors.forename: R Frank
authors.initials: RF
authors.lastname: Henn
authors.forename: Richard M
authors.initials: RM
authors.lastname: Lovering
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries / Q000473:pathology* / Q000503:physiopathology; D011859:Radiography; D016059:Range of Motion, Articular; D013180:Sprains and Strains / Q000175:diagnosis* / Q000503:physiopathology; D013708:Tendon Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology