A therapeutic exercise programme for patients with surgical repair after proximal hamstring avulsion: a case report with 3-year follow-up

Abstract

Background: Surgery is commonly recommended for patients with proximal hamstring avulsion. Rehabilitation is important, but there is limited knowledge of optimal rehabilitation post-surgery. The purpose of this case report was to describe and evaluate a therapeutic exercise programme for a patient with acute surgical repair after proximal hamstring avulsion.

Case presentation: A 53-year-old man was injured while waterskiing. Magnetic resonance imaging (MRI) verified a proximal hamstring avulsion, and he had surgical treatment eight days later. Seven weeks after surgery, he started a therapeutic exercise programme. Performance-based tests and self-reported questionnaires were performed 3, 6, 12 and 42 months post-surgery. MRI was performed after 12 and 42 months.

Results: At 6 months, the patient had returned to previous level of activity but reported some fear for re-injury. He scored 92% (74 points) on the Lower Extremity Functional Scale and estimated his recovery to be 100% on the Proximal Hamstring Injury Questionnaire. The isokinetic muscle strength test for knee flexion showed a leg symmetry index of 99%. MRI at 12 months showed an intact tendon with good congruence.

Conclusion: The described therapeutic rehabilitation programme for this patient resulted in normalized physical function and he returned to pre-injury activity level at 6 months.

Keywords:

• Case report
• hamstring injury
• tendon rupture
• rehabilitation
• physiotherapy

Acknowledgements

The authors acknowledge Marte Lund for running the performance-based tests, Felix Skaara for assistance with figure preparation in Figure 1 and in Supplementary Table S2 and Supplementary Figure S1 and ExorLive for providing exercise illustrations in Supplementary Figure S1.

Ethics, consent and permissions

The study was approved by the Regional Ethics Committee of Eastern Norway (2011/171). Written informed consent was obtained from the patient at the time of inclusion and the rights of the included patient were protected.

Consent for publication of identifying material in the case report has been obtained from the patient.

Disclosure statement

None of the authors has received any financial support or other benefits from commercial sources for the work presented in the manuscript, and no conflicts of interest are declared.