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  • Writer's pictureChang Min Lee

Hamstring Strain Injury in Athletes

Updated: Apr 2, 2022

The clinical practice guidelines for hamstring strain injuries has been published by Martin et al. on 2/28/22. The summary & interpretation of this practice guideline is as follows:

1) (Moderate Evidence): A hamstring strain injury is a risk factor for a future re-injury; therefore it is highly recommended that a patient completes an appropriately progressed, comprehensive functional exercise program including eccentric training. Factors to consider when determining a patient's readiness to return-to-play includes pain level at the time of injury, number of days from injury to pain-free walking, and area of tenderness measured on initial evaluation.

2) (Moderate Evidence): Clinical signs of a hamstring strain injury includes: 1) a sudden onset of posterior thigh pain during activity, 2) pain reproduced when the hamstring is stretches and/or activated, 3) muscle tenderness with palpation, and 4) loss of function

3) (Strong Evidence): It is recommended to use a hand held dynamometer to quantify knee flexor strength and use an inclinometer to assess hamstring length by measuring the knee extension deficit with the hip flexed to 90 degrees.

4) (Strong and Moderate Evidence): It is recommended to use the Nordic hamstring exercise as part of a hamstring strain injury prevention program, along with other components of warm-up, stretching, stability training, strengthening, and functional movements (sport specific, agility, and high-speed running) to improve return-to-play time and reduce rein jury rate after an individual sustains a hamstring strain injury.

I hope this information is helpful to you. The body of literature strongly emphasizes the importance of proper rehabilitation after a hamstring strain injury. If you have sustained a hamstring strain injury and are seeking for treatment, please contact us or your local physical therapists.

Please comment below for any questions.


  1. Martin RL, Cibulka MT, Bolgla LA, et al. Hamstring Strain Injury in Athletes. Journal of Orthopaedic & Sports Physical Therapy. 2022;52(3):CPG1-CPG44.

Chang-Min (Skye) Lee, PT, DPT, MS, OCS, COMT 8000 Locust Mill Street Suite P Ellicott City, MD 21043 (667) 309-5610

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