Diabetic Hamstring Complications

Each of your knees has three tendons at the back, supported by posterior thigh muscles. These tendons run down the back of your leg from each buttock to just behind each knee. They are called the semi-tendinosus, the semi-membranosus and the biceps femoris tendons. They allow you to bend and flex your knee and straighten or extend your hips. Stress and injury can seriously affect these tendons, as can complications from diabetes.

How Diabetes Affects Hamstring Tendons

• You must keep your blood sugar levels properly controlled and monitored at all times when you have diabetes. If you do not, over a period of time, nerves and blood vessels, particularly in your feet and legs, can deteriorate and lose function. The blood vessels can also narrow and your immune system can become impaired.

  All these factors mean that injuries and conditions that affect your hamstring tendons, such as hamstring tendinitis, tendinopathy or tendinosis, may not receive sufficient blood to heal properly. Also, with diabetes, any injury that you receive tends to heal more slowly, especially if you do not control your blood sugar levels.

What Is Hamstring Tendinitis?

• Hamstring tendinitis is a painful inflammation of the hamstring tendons, often occurring with swelling, heat, redness and impaired function in one or more of these tendons. Contributory factors include diabetes, bursitis and rheumatoid arthritis, as well as injury, stress fractures and problems relating to the spinal disc and back. Diabetes, in particular, complicates and slows the healing process from tendinitis, which, in turn, can lead to hamstring tendinopathy.

What Is Hamstring Tendinopathy?

• Hamstring tendinopathy occurs when your upper leg tendons are continually affected by long-term tendinitis, disease and/or other repetitive injuries. This ongoing stress can cause the tendons to begin to degenerate, particularly at the point where they attach to your shinbone (near the back end of the knee). Diabetes makes this condition worse, because it slows the healing process. Also, because diabetes can affect the nerves, you may feel less pain or even no pain, even though the tendons are still affected. This means you can easily re-injure or more deeply injure your tendons.

Hamstring Tendinosis

• With or without diabetes, hamstring tendinosis is the most serious of the three hamstring tendon complications. Hamstring tendinosis is a hamstring injury at the cellular level, as the collagen fibers that make up each tendon weaken and gradually get thinner, fray and separate. This happens when tendinitis and tendinopathy do not heal properly.

  Scar tissue or calcium deposits can then form around the weakened area, which then further decreases blood flow to the area. And since diabetes can also narrow the blood vessels, the flow of blood can be dangerously decreased and there is a danger of infection.

Diabetic Muscle Infarction

• There is another diabetic complication that can affect the area around the hamstring tendons. Diabetic muscle infarction (DMI), according to the Department of Orthopaedic Surgery, University of Iowa Hospitals, is a rare but serious complication in those with poorly controlled diabetes who are also undergoing dialysis. DMI is characterized by an onset of sudden, very painful swelling, often in the thigh, in the area near the hamstring tendons. This condition is usually diagnosed through an MRI, since symptoms can mimic other disorders. Pain and swelling can continue for weeks and even months, though it usually resolves without the need for surgical intervention. Treatment during DMI's acute phase consists of pain management and rest, followed by mild physical therapy to restore muscle and mobility.