“Doing a Hammy” is not always the same injury.  Most commonly,  it is a partial tear within the muscle, and anti-inflammatories and physiotherapy are all that is required (and of course more stretching before exercise next time!).  If it’s sore to touch in the buttock, perhaps it’s a tear off the pelvis, but still usually it’s a partial tear, and reasonable to treat the same.  If a partial tear doesn’t settle, it can easily be treated later.

Complete tears off the pelvis is rare, but we see it particularly in water skiers, footballers, and a variety of other injuries.  The bruising is usually dramatic, extending well down the thigh. The problems we see in this group are persistent weakness, pain running, and an inability to return to sport.  And the surgery to fix it is more difficult if performed late, as the hamstring becomes severely scarred to the adjacent sciatic nerve.  For this reason this group tends to have surgery early.

It is possible to operate late on incomplete tears relatively easily.  Late repairs of complete tears are difficult.  The adjacent nerve needs to be dissected free, the tendon brought back up to the pelvis and stitched into place.The further pulled away, the  surgery is more complex, the incision longer, the nerve risk higher, and the recovery more difficult.  The patient has greater risk, and a more difficult recovery, sometimes requiring the foot to be hitched to the back of a belt for some weeks.  To avoid these problems, we have more athletes having surgery early after complete hamstring tears.