Hamstring Strain: Difference between revisions

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== Differential Diagnosis  ==
== Differential Diagnosis  ==


On examening the patient the physiotherapist possibly has to differentiate between: adductor strains, avulsion injury, lumbosacral reffered pain syndrome, piriformis syndrome, sacroiliac dysfunction, sciatica, Hamstring tendinitis and ischial bursitis.<ref name="Bryan et al.">Bryan C. Heiderscheit, PT, PhD, et al. (2010) Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation, and Injury Prevention. In Journal of Orthopaedic &amp;amp; Sports Physical Therapy. Vol. 40. No. 2. Pp. 67-81.</ref><ref name="Starkey et al.">Starkey C and Johnson G (2006) Athletic training and sport medicine. United States of America: Jones and Barlett publishers.</ref><br>
On examening the patient the physiotherapist possibly has to differentiate between: adductor strains, avulsion injury, lumbosacral reffered pain syndrome, piriformis syndrome, sacroiliac dysfunction, sciatica, Hamstring tendinitis and ischial bursitis.&nbsp;<ref name="Starky et al.">Starkey C and Johnson G (2006) Athletic training and sport medicine. United States of America: Jones and Barlett publishers.</ref><ref name="Bryan et al.">Bryan C. Heiderscheit, PT, PhD, et al. (2010) Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation, and Injury Prevention. In Journal of Orthopaedic &amp; Sports Physical Therapy. Vol. 40. No. 2. Pp. 67-81.</ref><br>


== Diagnostic Procedures  ==
== Diagnostic Procedures  ==

Revision as of 22:38, 2 January 2011

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

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Search Strategy[edit | edit source]

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Definition/Description[edit | edit source]

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Clinically Relevant Anatomy[edit | edit source]

The hamstrings are comprised of three separate muscles located at the back of the thigh. The biceps Femoris, Semitendinosus and the Semimembranosus. These muscles start at the ischial tuberosity, extending down the back of the thigh and along either side of the knee [1]. The Biceps Femoris exists out of 2 parts: The long head and the short head. These two parts are both attached to the head of the fibulae, but only the long head starts at the ischial tuberosity. The other part, the short head, starts at the lateral lip of the linea Aspera on the posterior aspect of the femur[2]. The Semitendinosus starts at the Ischial tuberosity but unlike the Biceps Femoris, it lays at the medial side of the thigh and is attached to the upper medial surface of the tibia. The Semimembranosus is the most medial of the three hamstrings muscles [3]. It also starts at the ischial tuberosity and is attached to the Pes Anserinus profundus.[4]


Because the Hamstrings cross two joints, there functions are varied.The muscles function as movers and stabilizers of the hip and knee. Contractions of the hamstrings causes flexion of the knee and extension of the hip. The hamstrings help to get from a crouched position to an erect position in sprinting ( the front leg in starting position takes the brunt of the start ).[5]

Epidemiology /Etiology[edit | edit source]

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Characteristics/Clinical Presentation[edit | edit source]

At the instant of an injury during sport activities, patients mostly report a sudden sharp pain in the posterior thigh. also a “popping” or tearing impression can be described.[6] The patients may complain of tightness, weakness and impaired range of motion lik knee exteinsion with the hip in a flexed postion. Sometimes swelling and ecchymosis are possible but they may be delayed for several days after the injury occurs[7]. Rarely symptoms are numbness, tingling and distal extremity weakness. These symptoms require a further investigation into a sciatic nerve irritation. Large hematoma or scar tissue can be caused by complete tears and avulsion injuries.[8]

Differential Diagnosis[edit | edit source]

On examening the patient the physiotherapist possibly has to differentiate between: adductor strains, avulsion injury, lumbosacral reffered pain syndrome, piriformis syndrome, sacroiliac dysfunction, sciatica, Hamstring tendinitis and ischial bursitis. [9][6]

Diagnostic Procedures[edit | edit source]

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Outcome Measures[edit | edit source]

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Examination[edit | edit source]

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Medical Management
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Physical Therapy Management
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Key Research[edit | edit source]

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References[edit | edit source]

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  1. ↑ Schunke M., Schulte E., Schumacher (2005). Anatomische atlas Prometheus: Algemene anatomie en bewegingsapparaat. Nederland: Bohn Stafleu Van Loghum
  2. ↑ Coole WG, Gieck JH.(1987) An analysis of hamstring strains and their rehabilitation. J Orthop Sports Phys Ther 9(3):77-85.
  3. ↑ Worrell, T.W., & Perrin, D.H. (1992). Hamstring muscle injury: the role of strength, flexibility, warm-up, and fatigue. Journal of Orthopaedic and Sports Physical Therapy, 16, 12-18.
  4. ↑ Schunke M., Schulte E., Schumacher (2005). Anatomische atlas Prometheus: Algemene anatomie en bewegingsapparaat. Nederland: Bohn Stafleu Van Loghum
  5. ↑ Taylor M.P., Taylor K. D. (1988). Conquering athletic injuries. Illinois: Leisure press.
  6. ↑ 6.0 6.1 Bryan C. Heiderscheit, PT, PhD, et al. (2010) Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation, and Injury Prevention. In Journal of Orthopaedic & Sports Physical Therapy Cite error: Invalid <ref> tag; name "Bryan et al." defined multiple times with different content
  7. ↑ Frontera WR, Silver JK, Rizzo TD Jr (2008) Essentials of physical medicine and rehabilitation. Muskuloskeletal disorders, pain and rehabilitation. Canada: Saunders Elsevier.
  8. ↑ Frontera WR, Silver JK, Rizzo TD Jr (2008) Essentials of physical medicine and rehabilitation. Muskuloskeletal disorders, pain and rehabilitation. Canada: Saunders Elsevier
  9. ↑ Starkey C and Johnson G (2006) Athletic training and sport medicine. United States of America: Jones and Barlett publishers.
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