Mapping tenderness to palpation predicts return to play following acute hamstring strain

Review written by Dr Teddy Willsey info

Key Points

  1. Prognostication for return to sport following hamstring injuries is oftentimes imprecise and impractical.
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Hamstring strains are extremely common in sports that involve high velocity sprinting. At the professional level of sport, they are a leading cause of lost player time due to their unique challenges and high frequency of injury and re-injury (1). Time to return to sport (RTS) is quite variable following hamstring strains, with early estimations oftentimes being imprecise and impractical.

Little evidence exists supporting the utility of tests and measures to determine hamstring strain RTS. The presence of hamstring injury on MRI has shown to be correlated with greater time lost due to injury, however, specific findings have not been shown to assist in prognostication (2). The authors of this study sought to investigate the predictive value of measuring the area and location of tenderness to palpation (TTP) following acute hamstring strain.

Hamstring strains are a leading cause of lost player time in professional sport due to their unique challenges and high frequency of injury and re-injury.
Given the lack of objective measurements and low reliability of imaging to prognosticate hamstring RTS, it appears that hamstring tenderness mapping may be a novel examination technique with clinical utility.


19 male athletes who sustained an acute hamstring strain (defined as sudden, sharp posterior thigh pain causing an immediate cessation of activity and subsequent missed playing time) underwent hamstring tenderness mapping during their initial evaluation and twice more throughout the

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