What are the guideline sources, guidelines and references for Hamstring injury ?
Guideline sources The following summarized guidelines for the evaluation and management of hamstring injury are prepared by our editorial team based on guidelines from the American Physical Therapy Association (APTA 2022), the National Institute for Health and Care Excellence (NICE 2020), and the Italian Society of Muscles, Ligaments and Tendons (ISMuLT 2014). 1 2 3 Calculator Ottawa knee rule Guidelines 1. Screening and diagnosis Diagnosis: diagnose hamstring strain injury in patients presenting with a sudden onset of posterior thigh pain during activity, with pain reproduced when the hamstring is stretched and/or activated, muscle tenderness with palpation, and loss of function. B https://web.pathway.md/diseases/recg2Ora4uJMKLCem 1/4 6/24/23, 12:31 PM Hamstring injury Pathway 2. Diagnostic investigations Physical examination: use a handheld or isokinetic dynamometer to quantify knee flexor strength following hamstring strain injury. A Show 2 more 3. Medical management Analgesics: offer acetaminophen or topical NSAIDs (such as ibuprofen gel) as first-line therapy for pain management. Consider offering oral NSAIDs (such as ibuprofen) if needed. Consider offering short-term codeine as an 'add-on' medication. E 4. Nonpharmacologic interventions Conservative management: Advise on initial 'PRICE' self-management strategies for the first 48- 72 hours after injury: Situation Guidance Protect from further injury (for example, by using a support or high-top, lace-up shoes) Protection Avoid activity for the first 48-72 hours following injury Rest Apply ice wrapped in a damp towel for 15-20 minutes every 2-3 hours during the day for the first 48-72 hours following the injury (not left on whilst asleep) Ice Apply snug (but not tight) compression with a simple elastic bandage or elasticated tubular bandage to help control swelling and support the injury (remove before going to sleep) Compression Keep the injured area elevated and supported on a pillow until the swelling is controlled Elevation Avoid prolonged periods with the leg not elevated if the leg is injured Consider offering a short period of immobilization for a few days after injury for severe sprains and strains. E https://web.pathway.md/diseases/recg2Ora4uJMKLCem 2/4 6/24/23, 12:31 PM Hamstring injury Pathway Walking aids: advise using crutches and avoiding excessive lengthening of the injured muscle in patients with severe lesions. E 5. Preventative measures Injury prevention: offer 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). A 6. Follow-up and surveillance Serial clinical assessment: Obtain objective measures of the patient's ability to walk, run, and sprint when documenting changes in activity and participation over the course of treatment. B Use the Functional Assessment Scale for Acute Hamstring Injuries before and after interventions, intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions in patients diagnosed with an acute hamstring strain injury. B Rehabilitation: As per APTA 2022 guidelines, offer eccentric training to the patient's tolerance, added to stretching, strengthening, stabilization, and progressive running programs, to improve return-to- play time after hamstring strain injury. B Show 2 more As per ISMuLT 2014 guidelines, offer training and rehabilitation programs supervised by an experienced physiotherapist after the first 2-3 days following the injury. Deliver rehabilitation programs in the absence of pain, respecting the healing process, and time of recovery. E Return to play: As per APTA 2022 guidelines, consider assessing the length of muscle tenderness and proximity to the ischial tuberosity to assist in predicting the timing of return to play. C Show 3 more As per NICE 2020 guidelines, advise on safe return to usual activities and sports and provide sources of information and support: start active mobilization and flexibility (ROM) exercises as soon as tolerated without excessive pain consider advising athletes to return to play when there is full, painless range of movement and muscle strength is restored. E References https://web.pathway.md/diseases/recg2Ora4uJMKLCem 3/4 6/24/23, 12:31 PM Hamstring injury Pathway 1. Nicola Maffulli, Francesco Oliva, Antonio Frizziero et al. ISMuLT Guidelines for muscle injuries. Muscles Ligaments Tendons J. 2014 Feb 24;3 4 241 9. Open 2. Robroy L Martin, Michael T Cibulka, Lori A Bolgla et al. Hamstring Strain Injury in Athletes. J Orthop Sports Phys Ther. 2022 Mar;52 3 CPG1 CPG44. Open 3. NICE. Sprains and strains. NHS. 2020 Sep. Open https://web.pathway.md/diseases/recg2Ora4uJMKLCem 4/4