title: Patterns of Hamstring Muscle Tears in the General Population: A Systematic Review.
abstract: Hamstring tears are well recognised in the sporting population. Little is known about these injuries in the general population.
  
  
  
  Evaluating the rates, patterns and risk factors of non-sporting hamstring tears, compared to sporting related hamstring tears.
  
  
  
  MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (1989-2015).
  
  
  
  Studies reporting patients with a grade 2 or 3 hamstring muscle tear, identified clinically, confirmed by MRI imaging or direct visualisation during surgical exploration.
  
  
  
  144 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).
  
  
  
  This 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.
authors.affiliation: Department of General Medicine, NHS Lothian, Edinburgh, United Kingdom.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kuske
authors.affiliation: Department of Trauma and Orthopaedics, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: David F
authors.initials: DF
authors.lastname: Hamilton
authors.affiliation: Department of General Medicine, NHS Lothian, Edinburgh, United Kingdom.
authors.forename: Sam B
authors.initials: SB
authors.lastname: Pattle
authors.affiliation: Department of Trauma and Orthopaedics, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: A Hamish R W
authors.initials: AH
authors.lastname: Simpson
mesh_terms: D000328:Adult; D005260:Female; D000070633:Hamstring Muscles / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male