How To Diagnose & Treat Hamstring Strains - A Physio's Guide
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In today's video we go over, How To Diagnose & Treat Hamstring Strains - A Physio's Guide - FPF Show Episode 183:
- 0:00 Introduction
- 1:03 How is a hamstring strain patient likely to present in the clinic?
- 4:26 How do we grade the severity of hamstring strain injuries?
- 8:12 What should absolutely be included in the clinical evaluation of hamstring strain injuries?
- 12:13 What should a good subjective examination contain during your examination?
- 12:28 What objective tests should be performed during the examination?
- 15:28 Should physical therapy exercises be pain free during rehabilitation?
- 24:16 If physical therapy exercises are painful will that cause a re-injury during rehabilitation?
- 27:41 What are the exact exercises I should include in my rehabilitation program for patients?
- 31:32 What should be included in phase 1 of rehabilitation? (Exercises, manual therapies)
- 38:11 How do you know when to progress to the next phase and what does phase 2 consist of?
- 47:24 When can patients start running again after a hamstring strain injury?
- 54:26 What does phase 3 of treatment look like?
- 57:33 Example return to running program for a patient after a hamstring strain injury
- 1:01:44 What should athletes pass in order to return back to sport safely after a hamstring strain injury?
- 1:06:08 Is Your Athlete Really Ready to Progress? Learn How Force Plates Can Tell You
Hamstring master...
- Dan Pope DPT,OCS,CSCS
Show Notes / Relevant Articles:
- FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
- What Physical Therapists NEED to Know About Hamstring Strain Injuries
- Patellofemoral Pain MASTER Class
- What Physical Therapists Need to Know About Adult Hip Dysplasia
- What Physical Therapists Need to Know About Femoral Acetabular Impingement Syndrome
- Femoral Acetabular Impingement Treatment WITHOUT Surgery! [Physical Therapist's Guide]
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Thank you!
Dan Pope DPT, OCS, CSCS
References:
Martin RL, Cibulka MT, Bolgla LA, Koc TA Jr, Loudon JK, Manske RC, Weiss L, Christoforetti JJ, Heiderscheit BC. Hamstring Strain Injury in Athletes. J Orthop Sports Phys Ther. 2022 Mar;52(3):CPG1-CPG44. doi: 10.2519/jospt.2022.0301. Epub 2022 Feb 14. PMID: 35164536.
Whiteley R, van Dyk N, Wangensteen A, Hansen C. Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries and their association with running speed and rehabilitation progression. Br J Sports Med. 2018 Mar;52(5):303-310. doi: 10.1136/bjsports-2017-097616. Epub 2017 Oct 30. PMID: 29084725.
Hickey JT, Rio E, Best TM, Timmins RG, Maniar N, Hickey PF, Williams MD, Pitcher CA, Opar DA. Early introduction of high-intensity eccentric loading into hamstring strain injury rehabilitation. J Sci Med Sport. 2022 Sep;25(9):732-736. doi: 10.1016/j.jsams.2022.06.002. Epub 2022 Jun 9. PMID: 35794049.
Hickey JT, Timmins RG, Maniar N, Rio E, Hickey PF, Pitcher CA, Williams MD, Opar DA. Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. J Orthop Sports Phys Ther. 2020 Feb;50(2):91-103. doi: 10.2519/jospt.2020.8895. PMID: 32005093.
Aspetar Orthopaedic & Sports Medicine Hospital. (n.d.). Hamstring strain rehabilitation protocol. Aspetar. https://www.aspetar.com
Pollock N, James SL, Lee JC, Chakraverty R. British athletics muscle injury classification: a new grading system. Br J Sports Med. 2014 Sep;48(18):1347-51. doi: 10.1136/bjsports-2013-093302. Epub 2014 Jul 16. PMID: 25031367.
Hickey JT, Opar DA, Weiss LJ, Heiderscheit BC. Hamstring Strain Injury Rehabilitation. J Athl Train. 2022 Feb 1;57(2):125-135. doi: 10.4085/1062-6050-0707.20. PMID: 35201301; PMCID: PMC8876884.
Images
- Cardenas, D. (2010, October 2). *2010-10-02 pulled hamstring.jpg* [Photograph]. Wikimedia Commons. Licensed under CC BY 3.0. Retrieved September 1, 2025, from https://commons.wikimedia.org/w/index.php?curid=11664111
- Hamstring image: Rodgers CD, Raja A. Hamstring Muscles [Internet]. Updated 2023 Apr 1. In: Anatomy, Bony Pelvis and Lower Limb, Hamstring Muscle. StatPearls Publishing; 2025 Jan–. Figure, Hamstring Muscles. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546688/figure/article-36086.image.f1/