From the Research
A biceps femoris tear with retraction is a severe muscle injury where the hamstring muscle has been torn and the torn ends have pulled away from each other, requiring prompt treatment to minimize morbidity, mortality, and improve quality of life. This type of injury typically causes sudden, sharp pain in the back of the thigh, often accompanied by swelling, bruising, and weakness. The biceps femoris is particularly vulnerable to this type of injury during activities requiring explosive movements or sudden direction changes, such as sprinting or jumping.
Treatment Considerations
When considering treatment for a biceps femoris tear with retraction, it is essential to prioritize evidence-based practices that minimize harm and promote optimal recovery.
- Rest, ice, compression, elevation (RICE protocol) is often recommended as an initial treatment approach to reduce pain and inflammation.
- Physical therapy can help improve strength, flexibility, and range of motion, reducing the risk of further injury and promoting recovery.
- In severe cases with significant retraction, surgical repair may be necessary to restore muscle function and prevent long-term disability.
Medication Management
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of acute skeletal muscle injury, such as a biceps femoris tear with retraction, has been debated.
- A systematic review and meta-analysis published in 2018 found that NSAID use was associated with a small to medium decrease in markers of injury, including strength loss, soreness, and blood creatine kinase level 1.
- However, another study published in 2020 found that NSAIDs may result in a small increase in gastrointestinal adverse events compared with paracetamol, and may make no difference in neurological adverse events 2.
- A study published in 2017 found that ibuprofen treatment had no effect on gene expression in human chronic tendinopathic tendon, suggesting that tendinopathic cells may not be responsive to NSAIDs 3.
Recovery and Prognosis
Recovery time for a biceps femoris tear with retraction can vary from weeks to months, depending on the extent of the tear and retraction.
- It is essential to prioritize a gradual and progressive rehabilitation program to minimize the risk of further injury and promote optimal recovery.
- A study published in 2021 highlighted the importance of considering anatomical and clinical factors when managing a complete tear of the distal rectus femoris myotendinous junction, a rare knee extensor mechanism injury 4.