In hamstring injuries, which finding is typically elicited on examination?

In hamstring injuries, which finding is typically elicited on examination?

• A. Tenderness over posterior thigh
• B. Pain with contraction of hamstrings
• C. Delayed firing or weakness in gluteals
• D. Pain with passive SLR

Answer: (B)

Pain when the hamstrings are actively contracted is the hallmark finding. In a hamstring injury the muscle-tendon unit is damaged, so loading the muscle during knee flexion against resistance directly stresses the injured fibers and reproduces pain (and often reveals weakness). This resisted knee flexion test pins down the painful, injured muscle more specifically than simply touching the–posterior thigh where tenderness can be present for many reasons. Tenderness over the posterior thigh can occur with many conditions and isn’t as specific to an active injury of the hamstrings. Weakness or delayed firing in the gluteal muscles isn’t the primary sign of a hamstring strain, since it reflects hip-extension control more than direct hamstring pathology. Pain with passive straight leg raise may indicate hamstring tightness or other posterior thigh issues but is less specific for a strained muscle, whereas pain with contraction directly implicates the injured hamstrings.

Pain when the hamstrings are actively contracted is the hallmark finding. In a hamstring injury the muscle-tendon unit is damaged, so loading the muscle during knee flexion against resistance directly stresses the injured fibers and reproduces pain (and often reveals weakness). This resisted knee flexion test pins down the painful, injured muscle more specifically than simply touching the–posterior thigh where tenderness can be present for many reasons.

Tenderness over the posterior thigh can occur with many conditions and isn’t as specific to an active injury of the hamstrings. Weakness or delayed firing in the gluteal muscles isn’t the primary sign of a hamstring strain, since it reflects hip-extension control more than direct hamstring pathology. Pain with passive straight leg raise may indicate hamstring tightness or other posterior thigh issues but is less specific for a strained muscle, whereas pain with contraction directly implicates the injured hamstrings.