What it is

Surgical repair re-attaches a tendon that has pulled away from bone, commonly the proximal hamstring at the sitting bone or the adductor longus near the pubic bone.

Repairs are chosen for complete avulsions or high-grade tears with loss of function. Rehabilitation protects the repair while capacity is rebuilt.

What happens when it occurs

Sutures and anchors re-attach the tendon to bone. Early phases protect against excessive stretch and load until healing gains strength.

Common causes and risk factors

  • Powerful sprinting, water skiing, kicking, or slips into the splits
  • Previous tendon symptoms and deconditioning
  • High eccentric loads without preparation

Who is most affected

Field and court athletes, runners, and water sports participants.

Typical symptoms pre-op

  • Sudden sharp pain with a pop, bruising, weakness, and difficulty sitting (hamstring) or adduction (adductor)

When to seek care

Follow your surgical review schedule. Urgent review is needed for calf pain, fever, or wound concerns.

How we diagnose

MRI defines tear extent. Post-op restrictions are set by the surgeon and guide rehabilitation.

Management

  • Protected range avoiding overstretch of the repair early
  • Progressive heavy slow loading at controlled lengths
  • Running, change-of-direction, and kicking progressions

Rehabilitation milestones

Phase 1 weeks 0 to 4: brace or hip position precautions, isometrics, gait with aids as directed.

Phase 2 weeks 4 to 8: strength at short lengths, bike and pool.

Phase 3 weeks 8 to 16: progressive lengthening strength, plyometric preparation.

Phase 4 months 4 to 6: running, cutting, and sport integration.

Readiness to progress

  • Low next-morning pain and swelling
  • Strength within 90 percent at multiple lengths
  • Sprint, hop, or kicking tests passed without pain

Prevention / long-term care

  • Maintain eccentric strength at long muscle lengths
  • Manage weekly spikes in sprinting and kicking
  • Technique coaching for starts, slips, and tackles

Australia snapshot

  • Repairs performed in public and private centres with sports rehabilitation pathways
  • Field and kicking sports are common sources of avulsions
  • Return-to-sport testing is standard before clearance

Latest insights

Protect early, then load heavy and long. Eccentric strength is your insurance policy.

Criteria-based return reduces re-injury risk.

Frequently Asked Questions

Limit prolonged hip flexion early. Use a wedge or frequent standing breaks until comfort improves.

Usually after 8 to 12 weeks for early drills, progressing to full speed by 4 to 6 months when criteria are met.

Most do with diligent rehabilitation focused on long-length loading.

Some surgeons use braces or hip position limits early. Follow your protocol.

Escalating pain, swelling, or a new pop needs urgent review.

Plan a graded return once gait is normal and sitting is comfortable.

Clearance is based on function and strength, sometimes supported by imaging.