Hamstring Strain

Aka: Hamstring Strain, Hamstring Sprain, Hamstring Tendinopathy

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II. Risk Factors

  1. Quadriceps may be overdeveloped compared to Hamstrings
  2. Quadriceps to hamstring strength ratio
    1. Normal: 2 to 1 ratio
    2. Risk for Hamstring Strain: 5 to 1 ratio

III. Symptoms

  1. Cramping pain in posterior thigh or deep buttocks
  2. Pain radiation to popliteal fossa
  3. Insidious onset
  4. Provocative factors
    1. Running
    2. Sitting

IV. Signs

  1. Ecchymosis may be present
  2. Indentation in hamstring muscle at defect or tear
  3. Palpate ischial tuberosity (insertion)
    1. Focal tenderness may be present
  4. Modified bent-knee test (LR+ 10.2, LR- 0.12)
    1. Patient lies supine
    2. Examiner lifts leg to 90 degrees with knee bent
    3. Examiner rapidly straightens leg (extends knee)
    4. Pain at hamstring insertion with maneuver

V. Management

  1. Eccentric Exercise
    1. Single leg squat
      1. Flex and extend knee
    2. Lunges
      1. Lower knee in large step
    3. Nordic curls
      1. Patient kneels with knees held
      2. Lower trunk forward
  2. Other measures
    1. Corticosteroid Injection
      1. Zissen (2010) AJR Am J Roentgenol 195(4): 993-8 [PubMed]

VI. Complications

  1. Myositis Ossificans

VII. References

  1. Arnold (2018) Am Fam Physician 97(8): 510-6 [PubMed]

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Ontology: Hamstring sprain (C0434423)

Concepts Injury or Poisoning (T037)
SnomedCT 209504009, 262992000
Dutch verrekte hamstring, verstuikte hamstring
French Elongation du tendon du jarret, Entorse du jarret
German gezerrter Hamstringmuskel
Italian Distrazione del tendine popliteo, Tendine popliteo stirato
Portuguese Cavado poplíteo com entorse, Cavado poplíteo torcido
Spanish Tirón de los tendones de la corva, Torcedura del tendón de los músculos de la corva, esguince de tendón femoral de la corva (trastorno), esguince de tendón femoral de la corva
Japanese 膝屈曲筋捻挫, 膝屈曲筋肉離れ, ﾋｻﾞｸｯｷｮｸｷﾝﾆｸﾊﾞﾅﾚ, ｼﾂｸｯｷｮｸｷﾝﾈﾝｻﾞ, ｼﾂｸｯｷｮｸｷﾝﾆｸﾊﾞﾅﾚ, ﾋｻﾞｸｯｷｮｸｷﾝﾈﾝｻﾞ
Czech Natažené úpony hamstringů, Natažené flexory lýtka
English hamstring pulls, hamstring pull, pulled hamstring, hamstring sprain, hamstrings pulled, sprained hamstring, hamstring pulled, hamstring pulling, Hamstring sprain, Hamstring sprain (disorder), Pulled hamstring, Sprained hamstring
Hungarian Térdín húzódása, Megrándult térdín
Derived from the NIH UMLS (Unified Medical Language System)

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