Hamstring Examination

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Gait

• Limited hip flexion on the affected side
• Lack of full hip extension
• Decreased lift in the swing phase
• Antalgic gait

Inspection

• Swelling
• Ecchymosis
• Muscular defects
• Atrophy

Palpation

• Pay attention to the origin at the ischial tuberosity, and popliteal fossa, looking for focal tenderness
• Palpate all muscles
  • Biceps femoris
  • Semimembrinosis
  • Semitendinosis

Movement

• Strength testing
  • Hamstring concentric strength at 90 degrees of flexion
  • Hamstring eccentric strength with 15-30 degrees of knee extension
  • Biceps femoris tested by externally rotating the leg
  • Semimembranosus testing by internally rotating the leg
• Range of motion
  • Hip flexors
  • Hip Extensors
  • Hip Abductors
  • Hip Adductors

Special Tests

• Modified bent knee test - supine with hip and knee maximally flexed, the examiner then quickly passively extends the knee. A positive test is pain felt near the ischial tuberosity
• Slump test and straight leg raise test if radicular symptoms present

Other

• Lumbar Spine Examination
• Sacroiliac Joint Examination
• Hip Examination