What is a proximal hamstring tear?
Your hamstrings are the three muscles down the back of the thigh that bend the knee and extend the hip. Their tendons come together at the top and attach to the ischial tuberosity, the “sitting bone” at the base of the pelvis. “Proximal” means the tear is at that upper end. The tendon can tear partially, or pull off the bone completely, sometimes along with a piece of bone. Complete tears often retract down the thigh.
Most happen during a forceful stretch with the knee straight and the hip flexed: a slip into a split, water skiing, a sprint, a heavy lift, or a stumble.
What does it feel like?
People often feel a pop and sudden pain in the buttock or upper thigh, followed by bruising that may track down the back of the leg over several days. Sitting on hard surfaces, climbing stairs, and running hurt. Weakness bending the knee or extending the hip is common with complete tears. Some tears cause numbness or burning down the leg because the sciatic nerve runs close to the tendon.
How is it diagnosed?
An exam shows tenderness at the sitting bone and weakness against resistance. An MRI confirms how many tendons are torn, how far they have pulled back, and whether the sciatic nerve is involved. These details drive the decision between therapy and surgery.
Do I need surgery?
Small partial tears and mild strains usually heal with rest, a structured rehabilitation program and gradual return to activity. Complete tears and tears involving two or more tendons with retraction are different. Delayed repairs can still help, but they are more complex because scar tissue ties the tendon down.
When is surgery recommended?
Dr. Stepanyan is more likely to recommend repair when:
- Two or three tendons are completely torn or retracted
- You are active in running, sport or heavy work and want your strength back
- You have continuing pain with sitting, or weakness, despite therapy
- The sciatic nerve is being irritated by the stump of the tendon
- A fragment of bone has been pulled off
The tendon is reattached to the sitting bone with suture anchors through a small incision. Because the nerve is close, the operation is done carefully and with the right exposure.
Should I get a second opinion?
If you were told you had a “strain” but you still have pain when sitting after several weeks, or if you were told nothing can be done for a complete tear, it is worth a second look. Request a visit and bring your MRI.
Where can I see Dr. Stepanyan?
Dr. Stepanyan sees patients in Glendale, East LA and Santa Fe Springs.
What does recovery look like?
These are typical stages after a proximal hamstring repair. Your own plan may differ.
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Weeks 0–6
Protect the repair
You walk with crutches and a brace that keeps the knee bent to take tension off the tendon. Sitting is limited at first, and you avoid stretching the hamstring.
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Weeks 6–12
Restore motion
The brace is weaned and weight bearing returns to normal. Gentle strengthening and walking progress under the guidance of your therapist.
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Months 3–6
Build strength
Strengthening becomes more demanding, with cycling, swimming and then jogging introduced as the repair matures.
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6–9 months
Return to sport
Sport-specific drills and sprinting come last. Full strength usually returns between six and twelve months after surgery.
Hamstring tendons heal slowly. Pushing speed work early is the most common reason for setbacks, so Dr. Stepanyan will clear each stage in person.