Group 2B

Winter 2013

Subjective Assessment
(Petty, 2011, pp. 396-399)
Hamstring muscle strains are a common sports related injury,

Body Chart
Map out area of symptoms noting quality, intensity and depth of pain as well as abnormal sensation or whether symptoms are constant or intermittent. Symptoms are most likely to be localised to hip, posterior thigh and knee. Also check for symptoms in the lumbar spine.

History of Presenting Condition

Can you recall an event where you overstretched or strained your hamstrings? When did this occur? Are you able to weight bear on your leg? Do you have any pain in your lower back? How long have symptoms been present?

Behaviour of Symptoms

Have you noticed anything that eases or aggravates symptoms?

Past Medical History

Have you had any previous hamstring strains?

Social and Family History

Is your pain limiting your participation in activities (eg. AFL)? How is your employer/co-workers/family responding to your pain?

Retrieved from: http://runnersforlife.c om/profiles/blogs/reh abilitating-hamstringinjury

Group 2B

Winter 2013

Physical Assessment (Petty, 2011, pp. 370-392)

Observation
Consider the patients posture, gait and performance in functional tasks (eg. sit to stand). Take note impaired balance or unevenness in weight bearing between the limbs in standing and during normal gait.

Active Movement Tests

Examination with the patient lying in prone position is ideal, and allows for easy identication of the characteristic knee exion weakness observed with this injury (Abebe, Moorman & Garrett, 2012). Perform active movement tests of knee and hip; including flexion, extension, abduction and adduction. Observe the quality and range of movement as well as the behaviour of pain and presence or absence of resistance. Take note of pain during knee flexion.

Palpation
Palpate the hip, posterior thigh and knee paying attention to the presence of swelling, temperature, mobility and feel of superficial tissues and tenderness. Abebe, Moorman and Garrett (2012), noted that in the case of an avulsion or complete tear, a gap may be palpable along the muscle belly or at the proximal or distal attachment sites.

Passive Movement Tests

Perform passive movements tests of the knee; including flexion, extension. With complete avulsions, an appreciable increase in knee extension with hip flexed at 90in the injured knee is found when compared to opposite limb (Abebe, Moorman & Garrett, 2012). Also take note of pain during knee extension.

Muscle Integrity Tests

The hamstring length test gages the integrity of the hamstring muscle group by assessing the length of the muscle, presence of pain as well as the presence of resistance or the absence of resistance. (Opar, Williams & Shield, 2012).

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Winter 2013

References
Abebe, E.S., Moorman, C. D., & Garrett, W. E.(2012). Proximal hamstring avulsion injuries: Injury mechanism, diagnosis and disease course. Operative Techniques in Sports Medicine, 20(1), 2-6. doi:http://dx.doi.org/10.1053/j.otsm.2012.03.001 Ali, K., & Leland, J. M. (2012). Hamstring Strains and Tears in the Athlete. Clinics in Sports Medicine, 31(2), 263272. doi:http://0-dx.doi.org.alpha2.latrobe.edu.au/10.1016/j.csm.2011.11.001. Opar, D. A., Williams, M. D., & Shield, A. J. (2012). Hamstring strain injuries. Sports Medicine, 42(3), 209-226. doi:http://dx.doi.org/10.2165/11594800-000000000-00000 National Institutes of Health. (2012). Hamstring Strain Aftercare. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000551.htm Petty, N. (2011). Neuromusculoskeletal examination and assessment: a handbook for therapists (4th Ed). Sydney: Churchill Livingstone.