Our understanding of the surgical management of adult and adolescent proximal hamstring avulsions has advanced significantly. It is important to recognise that, while these are distinct types of injuries, both can be severely debilitating. Surgical techniques have been developed, supported by outcome evidence demonstrating their success.

It is well understood that chronic adult proximal tears can present surgical challenges and carry a higher risk of complications. However, the optimal timing for surgical intervention has been unclear. This presentation provides evidence on surgical techniques and outcomes for both acute and chronic adult tears, as well as for adolescent apophyseal avulsions.

Validated assessment tools now aid clinicians in managing these conditions and evaluating outcomes. Improved understanding of these injuries will enable more informed decisions regarding surgical management and timing, ultimately helping athletes return to their pre-injury levels of sport.