Patient Review · The Center for Hamstring Injury

Two Visits. One Week. — “Absolute Relief.”

A mother recently left us a Google review about her son’s high hamstring injury — the kind that sits deep under the glute, takes months to settle, and keeps coming back. He was treated twice in one week. We want to explain what that injury actually is, what we did about it, and why relief can come that fast at The Center for Hamstring Injury.

· Proximal hamstring    · Non-surgical    · Ultrasound-guided    · Metairie · New Orleans

By Jacques Courseault, MD, CAQSM, FAAPMR · The Fascia Institute and Treatment Center®

01 · In Her Words

The Review That Started This Post

★★★★★

“BEST KEPT SECRET!!!! EXCELLENT / AMAZING and HIGHLY RECOMMENDED! My son… sustained a significant hamstring injury in his upper thigh (right below the glutes), a more difficult recovery area that requires longer healing time. Because of the injury location, my son had two visits. First visit gave IMMEDIATE relief with some lingering effects. Second visit = ABSOLUTE RELIEF. This all occurred over a ONE WEEK period. AMAZING!”

— Google review, mother of an athlete treated at The Fascia Institute and Treatment Center®
Shared with permission. Edited only to remove identifying initials.

Two details in that review matter more than the exclamation points. The first is where the injury was: high on the back of the thigh, right below the glute. The second is how fast things changed — one week, two visits. Those two facts are related, and they say a lot about how hamstring injuries are usually managed versus how we approach them.

02 · The Anatomy

Why a High Hamstring Injury Is the Hard One

She called it “a more difficult recovery area,” and she was right. Pain that sits just below the glute usually involves the proximal hamstring — where the three hamstring muscles converge into a long, tough tendon that anchors to the sitting bone (ischial tuberosity). That region behaves differently from a mid-thigh muscle strain:

· It’s tendon and fascia, not just muscle. Tendon has less blood supply than muscle, so it remodels slowly — and pain often persists long after the muscle itself looks healed on imaging.
· It’s buried. The proximal hamstring sits deep to the gluteal muscles, which is why it gets missed on exam and why surface treatments never reach it.
· The sciatic nerve is a neighbor. The nerve runs just lateral to the hamstring origin. When the surrounding fascia thickens and stops sliding, the nerve can get tethered, producing burning, sciatica-like symptoms in addition to the pull.
· Recovery is measurably longer. Injuries closer to the ischial tuberosity — and injuries involving the tendon rather than the muscle belly — take longer to resolve and carry a higher risk of reinjury than the classic mid-belly strain.
· Sitting hurts. A hallmark complaint: pain driving, sitting in class, sitting on a bench or a bleacher.

Hamstring injuries are also the most stubborn recurring problem in sport. Clinical practice guidelines put reinjury among the highest of any athletic injury, and standard care — rest, stretch, eccentric strengthening, wait — often leaves an athlete cleared to play but not actually restored. That gap is exactly where we work.

03 · The Approach

Find the Restriction, Then Release It

Every hamstring visit here starts with imaging, not guessing. The sequence is the same one this athlete went through.

Step 1 — Fascial Mapping

We scan the hamstring with high-resolution ultrasound while the tissue moves. A static MRI can look normal and still miss the problem. Fascial Mapping shows us the layers that have stopped gliding, thickened fascia around the tendon, and whether the sciatic nerve is being tethered.

Then we press on what we see and confirm it reproduces the athlete’s exact pain. That’s the target.

Step 2 — Hydrofascia Release™

Under live ultrasound, fluid is placed precisely between the stuck layers to separate them — Hydrofascia Release™, our form of hamstring hydrodissection.

Nothing is cut. The adhesion is hydraulically released, the tissue is free to slide again, and the nerve gets room. This is the technique Dr. Courseault first published for chronic hamstring injury in 2019.

04 · The Mechanism

Why Relief Can Be Immediate

“First visit gave IMMEDIATE relief” sounds too good to be true if you assume the pain is coming from a torn muscle that has to knit back together. Often it isn’t. In a lingering hamstring problem, a large share of the pain is mechanical: fascial layers that should slide over each other have become densified and adherent, so every stride pulls on tissue that can no longer give.

Release the adhesion and you change the mechanics in that moment — which is why patients often stand up off the table and feel a difference immediately, rather than waiting weeks. Fascial hydrorelease has been described in the literature specifically for persistent pain after hamstring injury, and it is the mechanism we target every time.

And why a second visit? Because deep, proximal targets are frequently layered. The first release addresses the dominant restriction; as the athlete moves normally again, whatever remains becomes obvious and easy to localize on the follow-up scan. Her phrase — “immediate relief with some lingering effects,” then “absolute relief” — describes that staged process almost perfectly.

05 · Honest Expectations

What One Week Does and Doesn’t Mean

We are not going to tell you every hamstring resolves in two visits. It happens, and it happens often enough that we no longer find it surprising — but the honest version is this:

· Some athletes need more than two sessions, particularly if the problem has been there for years or the tendon itself is degenerated.
· A degenerated tendon may need biologic stimulus, not just release — ProloBoost™ dual PRP or prolotherapy.
· Release buys a window; loading and mechanics keep it. If an athlete sprints the same way that injured him, the tissue will protest again — which is why we address movement mechanics and reinjury prevention, and hand off the strength and return-to-sprint work to our performance team at FIT Therapeutics — including AlterG anti-gravity treadmill running progressions that let an athlete load the hamstring at reduced body weight.
· Recurring hamstrings sometimes point to something systemic — connective-tissue laxity, or a nutrient/methylation issue affecting tissue quality. We look for that instead of blaming the athlete.

What we can say is that “wait it out and hope” is not the only option, and it should not take a season to find that out.

06 · Where This Happens

“Best Kept Secret” — We’d Rather It Weren’t

The Center for Hamstring Injury is the world’s first and only medical center dedicated entirely to the hamstring — diagnosis, treatment, and prevention. It exists because hamstring injuries are treated everywhere and specialized in nowhere.

· Directed by Dr. Jacques Courseault, who first published fascial hydrodissection for chronic hamstring injury
· The same protocol used for high school and college athletes is used for professionals — we consult for NFL players and teams
· Out-of-town athletes can fly in for a one-day evaluation and treatment visit
· West Coast athletes can be seen at our Beverly Hills location, The Fascia Institute and Treatment Center of LA, where the same Fascial Mapping and Hydrofascia Release™ protocol is performed
· Rehab, strength, and return-to-play continue with FIT Therapeutics in New Orleans, or the Fascia Performance Program in Los Angeles — on the same chart as the physician team
· Active published research program, not anecdote

If your son or daughter has been told to rest a high hamstring for the third time, that’s a reason to get it imaged properly — not a reason to wait another six weeks.

Ready When You Are

Still Dealing With a High Hamstring?

Bring us the hamstring that hasn’t responded — the one that hurts to sit on, keeps re-pulling, or was cleared months ago and still isn’t right. We’ll scan it, find the restriction, and tell you honestly what it will take.

Get started: Request an evaluation or call (504) 704-1254. Metairie · New Orleans, with one-day visits available for traveling athletes.

Los Angeles: The Fascia Institute and Treatment Center of LA — Beverly Hills, (424) 378-3488.   Rehab & performance: FIT Therapeutics — 1600 St. Charles Ave., New Orleans, (504) 386-3488.

References

Courseault, J., Kessler, E., Moran, A., & Labbe, A. (2019). Fascial hydrodissection for chronic hamstring injury. Current Sports Medicine Reports, 18(11), 416–420. PMID: 31702723

Shiwaku, K., Otsubo, H., Nishikawa, D., et al. (2025). Ultrasound-guided fascial hydrorelease for persistent pain after hamstring injury. Journal of Functional Morphology and Kinesiology, 10(3), 318. PMC12371940

Heiderscheit, B. C., Sherry, M. A., Silder, A., Chumanov, E. S., & Thelen, D. G. (2010). Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. Journal of Orthopaedic & Sports Physical Therapy, 40(2), 67–81. PMID: 20118524

Martin, R. L., Cibulka, M. T., Bolgla, L. A., et al. (2022). Hamstring strain injury in athletes: clinical practice guidelines. Journal of Orthopaedic & Sports Physical Therapy, 52(3), CPG1–CPG44. doi:10.2519/jospt.2022.0301

Patient review shared with permission and edited only to remove identifying initials. Individual results vary; a testimonial does not predict or guarantee any specific outcome, diagnosis, or timeline. This article is for general education and is not a substitute for individualized medical advice. Hamstring hydrodissection is performed as Hydrofascia Release™ by the physicians of The Fascia Institute and Treatment Center®.