Problems After a Hamstring Injury
The history of an acute injury usually involves a traumatic event with forced hip flexion and knee in extension, as is classically observed in waterskiing. However, the injury can result from a wide variety of sporting activities that require rapid acceleration and deceleration (starts and stops).
Proximal hamstring injuries can be categorized as complete tendinous avulsions, partial tendinous avulsions, apophyseal avulsions, and degenerative (tendinosis) avulsions. Degenerative tears of the hamstring origin can occur more slowly and are commonly seen as an overuse injury in middle- and long-distance runners. Repetitive irritation of the inner part of the hamstring tendon (typically along the lateral aspect of the tuberosity, where the bursa resides) can ultimately cause a tear of the tendon as well as chronic pain on sitting.
Commonly, athletes with proximal hamstring tendon tears can describe a popping or tearing sensation with associated pain and bruising over the back of the hip. They may also find themselves to have weakness with bending the knee or giving out in the hip. Some patients may also complain of a pins and needle sensation over the back of the leg and thigh, much like sciatica. This may be due to acute compression of bleeding from the injury in the area of the sciatic nerve or may happen with scar tissue and tethering of the tendon to the nerve.
Symptoms of ischial bursitis include buttock pain or hip pain, and localized tenderness overlying the ischial tuberosity. Additional symptoms of chronic ischial bursitis may include tingling into the buttock that spreads down the leg. This is presumably from local inflammation and swelling in the area of the sciatic nerve. The symptoms usually worsen while sitting. Most of the people affected tend to sit with the painful buttock elevated off their seat.