TABLE 3.

Common signs and symptoms of a hamstring strain injury compared to those referred to the posterior thigh from another source. Modified from Brukner and Khan.¹⁸

Symptom/Sign	Hamstring Strain Injury	Referred to Posterior Thigh
Onset	Sudden	Sudden or gradual
Pain	Minimal to severe	Minimal to moderate pain May describe feeling of tightness or cramping
Function	Difficulty walking or running	Able to walk or run with minimal change in symptoms during the activity; may even reduce symptoms during the activity but increase after
Local Hematoma, Bruising	Likely with more severe injuries	None
Palpation	Substantial local tenderness Possible defect at site of injury	Minimal to none
Decrease in Strength	Substantial	Minimal to none
Decrease in Flexibility	Substantial	Minimal
Slump Test	Negative	Frequently positive
Gluteal Trigger Points	Palpation does not influence hamstring symptoms	Palpation may reproduce hamstring symptoms
Lumbar/Sacroiliac Exam	Occasionally abnormal	Frequently abnormal
Local Ultrasound or Magnetic Resonance Image	Abnormal, except for very mild strains	Normal