Isolated distal semitendinosus tendon tear in a collegiate athlete

Complete distal semitendinosus tendon tears are rare hamstring injuries. They often present with a “pop” followed by delayed pain and swelling. We describe the case of a collegiate athlete with an isolated distal semitendinosus tendon tear diagnosed by MRI and ultrasound after being treated for a stress fracture of the anterior tibial shaft with an intramedullary nail. The tear progressed from partial to complete after 2 weeks of rehabilitation and return to practice. The patient was ultimately successfully treated with semitendinosus tenodesis.