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