Can a Hamstring Tendon Rupture End an NFL Career?

Surgical Rounds®January 2014

Early repair of complete hamstring tendon rupture offers good-to-excellent recovery of hamstring strength and endurance in professional football players, although the injury may be a marker of elite-level physical deterioration.

Football players are required to rapidly accelerate and decelerate, making the sport a perfect environment for hamstring strains.

In the National Football League (NFL), professional athletes often experience hamstring injuries when their hips are forced into flexion while their knees fully extend as the hamstring contracts. Incomplete tear injuries typically sideline injured players until magnetic resonance imaging (MRI) indicates they are healed. Within a few weeks, these athletes usually return to the field.

However, players sometimes rupture their hamstring tendons completely from the ischial tuberosity, and the nonsurgical interventions that work for incomplete tears are rarely successful in these cases. Unless the injuries heal completely, the NFL will replace these patients with eager and often younger athletes.

Recently, researchers from several sports medicine facilities across the United States retrospectively reviewed the repair of acute proximal hamstring ruptures in NFL athletes to determine how often players return to the game after surgical repair. They identified 10 NFL players who experienced MRI-confirmed proximal hamstring avulsions between 1990 and 2008. Nine of them had palpable defects, though all were surgically fixed within 10 days of injury.

All players reported returning to full strength and wished to play the following NFL season’s opening game. Nine of the patients actually returned to play with no limitations, but only 5 played in more than one game during the first season post-surgery. Overall, the affected athletes played an average of 50 games per season prior to injury, and a mean 39 games after injury.

The authors concluded that early repair offers good-to-excellent recovery of hamstring strength and endurance, although they noted the injury may be a marker of elite-level physical deterioration.

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