Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries

This new study is fresh out yesterday by Rod Whiteley and team at Aspetar. They investigated the association between different outcome measures taken daily and the corresponding rehab progression. The full title is quite long, but you can find it at the link at the bottom of this post.

Published online: 30 Oct 2017

Open-access: NO

So this is new data from 131 athletes with acute hamstring injuries. Phil Jacobsen and colleagues at Aspetar published a study back in Feb 2016 which was similar, they investigated the physical examinations measured at the first session and 7 days after the first session and were able to calculate the RTP time to ±5 days accuracy, and were able to explain 97% of the variance.

I made a visit to Aspetar a couple of months ago, so I was fortunate to see Rod and Nicol do some of the measurements mentioned in this study. And to see them treat hamstring injuries over there.

So I think this particular study takes a slightly different angle, in that they are evaluating the association of the different outcome measures taken daily and looking at the corresponding rehab progression and also the running speeds.


“The progression of the daily measures was seen to be non-linear and varied according to the measure. Intra-rater reliability for the strength and flexibility measures were excellent (95% CI ≥0.85 for all measures).”

Strength (in the outer range position) and flexibility (in maximum hip flexion with active knee extension (MHFAKE) in supine) were best associated with rehabilitation progression and perceived running effort.

“Additionally, length of pain on palpation was usefully associated with rehabilitation progression. At lower perceived running effort there was a large variation in actual running speed.”


“Daily physical measures of palpation pain, outer range strength, MHFAKE and reported pain during daily activity are useful to inform the progression of rehabilitation.”

So not surprisingly the findings of this study are somewhat similar to the Jacobsen et al study in that the two most relevant outcomes measures that showed close association to rehab progression were the strength in outer range, and the ROM in the MHFAKE position. Palpation of the length of pain was also useful according to the results.

So for those who are not familiar with these measurements, you can find them all in the   Aspetar Hamstring Protocol video, which I highly recommend.

But here are the two measurements in question:


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Unfortunately this paper is not open-access, I would love to read more about the details in the study. But please click the link below to access the abstract of the study:

Whiteley, R. et al (2017) Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries and their association with running speed and rehabilitation progression. BJSM


One thought on “Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries

  1. Pingback: Top Resources of the Week (29 Oct – 4 Nov) | Physio Research to Practice

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