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Fracture & Tendon Surgery

Proximal Hamstring Repair After a Tendon Tears Off the Bone

When does a torn hamstring need surgery?

Proximal hamstring repair is a surgery that reattaches hamstring tendons torn off the sitting bone (ischial tuberosity) at the bottom of the buttock. Surgery is usually recommended when all three tendons tear, or two tear and pull back more than about 2 centimeters, and is most reliable when done within a few weeks of injury.

Most hamstring strains heal with time and rehab. A different injury happens when the tendons tear completely off the sitting bone, often during waterskiing, a slip with the leg flying forward, sprinting or a sudden split. People describe a pop high in the back of the thigh, heavy bruising and pain sitting. These avulsions often need a timely repair, so a quick exam and MRI matter.

Written and medically reviewed by Dr. Stride, MD, board-certified orthopedic surgeon
Last reviewed October 2026
Runner on a park trail holding the outside of his hip

At a glance

Also called
hamstring tendon avulsion repair, torn hamstring surgery, hamstring reattachment, high hamstring tear surgery
Typical recovery
Months 6 to 9
Ask about this treatment →(713) 555-0168

Is Proximal Hamstring Repair right for you?

Usually a good fit if

  • All three hamstring tendons torn from the sitting bone
  • Two tendons torn with more than about 2 centimeters of retraction
  • Active adults who want to return to running, sport or heavy work
  • Partial tears that still cause pain and weakness after about 3 months of rehab
  • An injury less than 4 to 6 weeks old, which allows a more direct repair

Another option may be better if

  • Muscle strains in the belly of the hamstring, which heal without surgery
  • Single-tendon tears with little retraction in most less active patients
  • Patients who cannot follow the brace and crutch restrictions

What happens, step by step

  1. Prompt evaluation

    Dr. Stride looks for bruising down the thigh, a palpable gap near the sitting bone and weakness bending the knee. An MRI shows how many tendons are torn and how far they have pulled back. Our team tries to see these injuries within days, since timing affects the repair.

  2. Reattaching the tendons

    Through an incision in the buttock crease, the sciatic nerve is identified and protected, and the tendons are pulled back to the bone and secured with suture anchors. Smaller tears are sometimes repaired endoscopically.

  3. Protecting the repair

    Many patients wear a knee or hip brace that limits stretch on the hamstring. You go home the same day in most cases, with crutches and a rehab plan.

Typical recovery timeline

Weeks 0 to 6

Crutches with touch-down weight bearing and a brace that keeps the knee bent to keep tension off the repair. Sitting on a cushion helps.

Weeks 6 to 12

Weight bearing increases, crutches are weaned and gentle hamstring activation begins in physical therapy.

Months 3 to 4

Strength training, stationary bike and walking for exercise. Desk work has usually resumed earlier.

Months 4 to 6

Jogging, then sport-specific drills, once strength is close to the other leg.

Months 6 to 9

Return to sprinting, waterskiing and competitive sport for many patients, based on testing.

Timelines are typical ranges. Your plan depends on your hip, your health and what was done in surgery.

“A complete hamstring avulsion is one injury where waiting can work against you. The tendons scar down and pull farther away each week, and the sciatic nerve gets caught up in that scar. If you felt a pop and see a big bruise in the back of your thigh, come see me this week.”

Dr. Stride, MD

Frequently asked questions

How do you know if you tore your hamstring off the bone?

A pop at the top of the back of the thigh, heavy bruising spreading down the leg, pain when sitting and weakness bending the knee all point toward a proximal hamstring tear. An MRI confirms how many tendons are torn and how far they have retracted.

How soon should a proximal hamstring tear be repaired?

Repairs are generally easier and more reliable when done within about 4 to 6 weeks of injury. Later repairs are possible but may be more complex, sometimes requiring a graft.

What is recovery like after hamstring repair surgery?

Expect about 6 weeks on crutches, often with a brace, followed by progressive strengthening. Most people return to running and sports in about 4 to 9 months, depending on the tear and the sport.

Can a proximal hamstring tear heal without surgery?

Partial tears and single-tendon tears often improve with rehab. Complete tears of multiple tendons with significant retraction tend to leave lasting weakness and pain sitting when treated without surgery, especially in active people.

Related treatments

Diagnosis

Hip X-ray & MRI

Hip X-rays and MRI answer different questions.

Read more →Non-surgical

Hip Physical Therapy

Physical therapy helps many types of hip pain, including arthritis, gluteal tendinopathy, hip impingement and many labral tears.

Read more →Preservation

Gluteus Medius Tendon Repair

Gluteus medius tendon repair is a surgery that reattaches the torn hip abductor tendons to the outside of the hip bone, done endoscopically or through a small open incision.

Read more →Injections

PRP Hip Injection

A PRP hip injection uses platelets concentrated from your own blood and injected into the hip joint or a damaged tendon.

Read more →

Hip pain this can help with

Hip pain · Back of hip

Pain in the Back of the Hip and Buttock

Pain in the back of the hip and buttock most often comes from the lower back, such as a pinched nerve or sciatica, or from the sacroiliac joint.

Causes & treatment →
SourcesReferences used for this page3

Medically reviewed by Dr. Stride, MD against current guidance from these sources. Last reviewed October 2026. How we write and review content

  1. Management of Proximal Hamstring Injuries: Non-operative and Operative Treatment (opens in a new tab) Current Reviews in Musculoskeletal Medicine (PMC)
  2. Hamstring Muscle Injuries (opens in a new tab) AAOS OrthoInfo
  3. Hamstring Injury: Recovery Time, Treatment & Symptoms (opens in a new tab) Cleveland Clinic
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