II. Risk Factors
- Quadriceps may be overdeveloped compared to Hamstrings
- Quadriceps to hamstring strength ratio
- Normal: 2 to 1 ratio
- Risk for Hamstring Strain: 5 to 1 ratio
III. Symptoms
- Cramping pain in posterior thigh or deep buttocks
- Pain radiation to popliteal fossa
- Insidious onset
- Provocative factors
- Running
- Sitting
IV. Signs
- Ecchymosis may be present
- Indentation in hamstring Muscle at defect or tear
- Palpate ischial tuberosity (insertion)
- Focal tenderness may be present
- Modified bent-knee test (LR+ 10.2, LR- 0.12)
- Patient lies supine
- Examiner lifts leg to 90 degrees with knee bent
- Examiner rapidly straightens leg (extends knee)
- Pain at hamstring insertion with maneuver
V. Management
-
Eccentric Exercise
- Single leg squat
- Flex and extend knee
-
Lunges
- Lower knee in large step
- Nordic curls
- Patient kneels with knees held
- Lower trunk forward
- Single leg squat
- Other measures