How to Diagnose a Hamstring Strain (Tips from a Sports Physical Therapist)
To go along with today's video I have a nice infographic to share...
Sign up to receive FREE: Hamstring Strain "Cheat Sheet"
Click HERE to Download FREE
Grab the rest of the Mini Course and Sign up for the Certification Pre-sale list:
- FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
- The Fitness Pain Free Certification
In today's video we go over, How to Diagnose a Hamstring Strain (Tips from a Sports Physical Therapist):
As a sports physical therapist, hamstring strain injuries are the #1 most common injury you see, but a sub-optimal exam leads to two massive pain points:
🎯 Frustrating re-injuries that damage patient trust.
🎯 Missing serious red flags (like Grade 3 tears or avulsions) that require surgical referral.
In this video, I walk you through the complete, evidence-based clinical examination for hamstring strain injuries. Learn the exact tests and palpation techniques to quickly differentiate between a simple muscle belly strain, a tricky musculotendinous junction injury, and a career-threatening avulsion.
🔑 What you will master in this video:
✅ Palpable Defects & Bruising: The critical visual and tactile cues to instantly flag a potential Grade 3 tear.
✅ The Anatomy Roadmap: Precision palpation (medial vs. lateral, belly vs. tendon) to accurately classify the injury and predict recovery time. We review research showing tendon involvement significantly slows return to sport.
✅ Strength & ROM Testing: The 3-point strength testing sequence (Stretch, Mid-Range, Shortened) and how to interpret side-to-side differences.
✅ Differential Diagnosis Deep Dive: How to confidently rule out the two most common diagnostic pitfalls:
🟢 Adductor Magnus Strain (the "Hamstring Imposter")
🟢 Lumbosacral Radicular Pain (Neuro Screen & Slump Test interpretation).
✅ Functional Assessment: When to progress patients to walk/jog and the 4/10 pain threshold for starting a Return-to-Run progression.
TIMELINE
- 0:00 - Intro
- 0:20 - Why Care?
- 0:32 - Red Flags
- 0:58 - History
- 1:37 - Bruising
- 1:52 - Presence of Defect
- 3:00 - Tenderness to Palpation
- 5:05 - ROM Testing
- 5:23 - Maximal Hip Flexion & Knee Extension Test
- 5:57 - Strength Testing
- 6:57 - Mid-range Position
- 7:14 - Shortened Position
- 7:45 - Functional Assessment
- 8:38 - Walking / Jogging Assessment
- 9:24 - Differential Diagnosis
- 10:27 - Radicular Lower Back Pain
- 10:54 - Slump Test
- 11:42 - Conclusion
Pulled my ham sandwich,
- 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
- Evidence-Based Hamstring Strain Protocol: Which Exercises + Exact Progression
- What Physical Therapists Need to Know About Femoral Acetabular Impingement Syndrome
- Femoral Acetabular Impingement Treatment WITHOUT Surgery! [Physical Therapist's Guide]
Want to earn some CEUs for physical therapists, physical therapy assistants & ATCs for watching this content? Click HERE to sign up for FPF "Insiders Academy" for just a dollar. You can earn CEUs for watching this content. Plus, you'll gain access to over 14 MASTER courses, 50+ cheat sheets, 100+ webinars, e-books and complete guides. You'll also get private access to the "Insiders Academy" community where you can have all of your questions answered by me.
Looking for other ways to support me that are 100% free?
- Like, comment and share on youtube, facebook and instagram
- Leave a 5-star review on apple podcasts
Thank you!
Dan Pope DPT, OCS, CSCS
References:
- Oleksy Ł, Mika A, Pacana J, Markowska O, Stolarczyk A, Kielnar R. Why Is Hamstring Strain Injury so Common in Sport Despite Numerous Prevention Methods? Are There Any Missing Pieces to This Puzzle? Front Physiol. 2021 May 13;12:586624. doi: 10.3389/fphys.2021.586624. PMID: 34054562; PMCID: PMC8155520.
- 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.
- Hamstring Strain Injury in Athletes Robroy L. Martin, Michael T. Cibulka, Lori A. Bolgla, Thomas A. Koc, Jr., Janice K. Loudon, Robert C. Manske, Leigh Weiss, John J. Christoforetti, and Bryan C. Heiderscheit Journal of Orthopaedic & Sports Physical Therapy 2022 52:3, CPG1-CPG44
- 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, 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.
- Hamstring Bruising - Image credit: Cardenas (2010), CC BY 3.0 (13)