UMEM Educational Pearls

Treatment of Hamstring Strains in Athletes


28 year old athlete presents to the ED and diagnosed with a hamstring strain

Localized swelling, moderate pain and a small limp. Incomplete tearing of the muscle

He is worried that he will miss the remainder of his season and when he returns will reinjure the same hamstring

Consider referral to sports medicine/orthopedics

A recent study looked at use of ultrasound guided hematoma aspiration followed by platelet-rich plasma (PRP) treatment on recovery in acute hamstring injuries

55 male athletes between ages 18 -32 weighing between 170 and 260lbs

27 with treatment protocol plus rehabilitation and 28 treated conservatively (rehabilitation)

All had Grade 2 hamstring injuries diagnosed on MRI

                Partial muscle tear (<50% cross sectional area)

Note: Grade 2 hamstring injuries are often associated with INTERmuscle hematoma and subsequent scarring. This can lead to persistent pain/discomfort and reinjury

Average return to play time was 32.4 days in the standard of care group

Average return to play time was 23.5 days in the intervention group (P<0.001)

Recurrence rate of hamstring strain was 28.6% in the standard of care group

Recurrence rater of hamstring strain was <4% in the intervention group (P=0.025)


Athletes with grade 2 hamstring injuries treated with hematoma aspiration and PRP injection into the strain had significantly shorter return-to-play and much lower recurrence rate that athletes treated with rehabilitation alone



Trunz LM, et al. Effectiveness of Hematoma Aspiration and Platelet-rich Plasma Muscle Injections for the Treatment of Hamstring Strains in Athletes. Med Sci Sports Exerc. 2022 Jan 1;54(1):12-17.