Return to Play After Non-surgical Treatment of Severe Proximal Hamstring Rupture in Athlete ―A case report―

Abstract

In this study, we report a case of conservative treatment for severe proximal hamstring rupture. A 25-year-old female judo athlete. During a competition, the patient injured herself by being forced to flex the hip joint while maintaining the right knee in the extended position. She was diagnosed with a complete proximal hamstring tendon rupture. In weeks 4 and 6 post-injury, she started low-intensity concentric and eccentric contractions, respectively. She resumed training and participated in an international competition in weeks 8 and 15 postinjury. Muscle strength markedly differed between the injured and non-injured sides. MRI revealed that the muscular part of the hamstring retracted distally, although conjoined tendon continuity was maintained. Recently, proximal hamstring tendon injuries have been indicated for surgery with several reports of good outcomes. However, in this case, we opted for non-surgical treatment. Although sufficient muscle strength recovery could not be achieved, a factor allowing for her return was her ability to perform substitute movements that considered the affected side, such as competition style and technique selection. For safe functional recovery and treatment selection, it will be necessary to summarize and verify the progress of physical functions based on the competitive characteristics.