It is important to understand that there are different types of injuries. The first one involves the biceps femoris' long head and occurs during high speed running. The other injury occurs during movements leading to extensive lengthening of the hamstrings and involves the free proximal tendon of the semitendinosus.
The recurrence rate is higher when the biceps femoris is involved. There is increasing evidence that the eccentric hamstring strength remains reduced, even when the patient has returned to sports activities. This may be a factor associated with the high recurrence rate. Moreover, it has been suggested that, if the lesion is closer to the ischial tuberosity, a longer time to return to play is required.