 
 
Rehabilitation Protocol for Hamstring Injury Non-op 
 
This protocol is intended to guide clinicians and patients through the non-operative course for hamstring injury. This 
protocol is time based (dependent on tissue healing) as well as criterion based, and may vary greatly depending on 
severity of injury, grade of strain and location of injury (muscle, myotendinous junction, tendon).  Specific intervention 
should be based on the needs of the individual and should consider exam findings and clinical decision making. If you 
have questions, contact the referring physician.  
 
Considerations for the non-operative Hamstring injury 
Many different factors influence the injured hamstring rehabilitation outcomes, including chronicity of injury, area 
affected (proximal, mid belly, distal), number of tendons/muscles involved, pre-injury gluteal motor control/strength 
and presence of any concomitant sciatic neural tension. It is recommended that clinicians collaborate closely with the 
referring physician regarding the above.   
 
 
PHASE I: EARLY (0-2 WEEKS AFTER INJURY) 
Rehabilitation Goals 
• Allow healing of injured tissue 
• Initiate early protected ROM 
• Prevent muscular atrophy 
• Decrease pain and inflammation 
Weight Bearing 
• As tolerated, unless otherwise noted by clinician 
Precautions/Guidelines 
• Limit stretching hamstring (trunk flexion, knee extension) 
Range of Motion 
• Active assisted and passive hip and knee flexion 
• Limit stretching and hip/knee ROM to avoid a “stretch/strain” sensation to injured area 
Intervention 
Manual Therapy: 
• STM along hamstring muscle group as needed 
• Myofascial (no lotion) release to posterolateral glute and lateral hamstring fascia/muscle 
(proximal 1/3 of lateral thigh) as needed 
• Attain and maintain neutral ilial position ipsilateral and contralateral to injured side with 
manual posterior rotations to ilium 
 
Stretching: 
• Do not stretch the hamstring, but nerve gliding (sciatic neural flossing) may be needed if 
neural tension exists 
• Hip flexors in Thomas test position (maintain neutral pelvis/spine throughout stretch) 
• Gastrocnemius/calf stretching 
 
Therapeutic Exercise: 
• Quad sets 
• Glute sets 
        *must be mastered before progressing any gluteal or hamstring muscle strengthening* 
• AA and PROM hip and knee flexion 
• Upper body and core circuit training (avoiding positions which lengthen hamstring) 
• Upper body ergometer (UBE) 
Criteria to Progress 
• 1-2 weeks post-injury depending on severity of injury 
 
PHASE II: INTERMEDIATE (2-4 WEEKS AFTER INJURY) 
Rehabilitation Goals 
• Reduce/resolve pain and edema 
• Good motor control and pain-free functional movements  
 
 
Weight Bearing 
• As tolerated 
Precautions/Guidelines 
• Carefully begin gentle, pain-free hip flexion with knee extension 
Range of Motion 
• Active and passive hip and knee flexion may begin 
Additional Intervention 
*Continue with Phase I 
interventions as indicated 
Manual Therapy: 
• Gentle cross friction massage to injured area if tendinous insertion proximally (including 
proximal to attachment on ischial tuberosity) or distally (any or all tendons involved) 
• Manual trigger point release as needed throughout muscle belly 
• Manual trigger point release as needed with ART (active release therapy) to piriformis, 
quadratus femoris 
• Anterior hip glides with and without external rotation at the hip (hip in neutral to slightly 
extended, prone with pillow under thigh can help maintain this position) as needed 
• Posterior/inferior belted hip mobilizations as needed for full flexion (belted quadruped 
position with active movement into child’s pose) as needed 
 
Stretching: 
• Hip external rotation in flexion 
• Gentle, slow, pain-free non weighted hamstring stretching (supine with strap) 
  
Therapeutic Exercise: (continuation of above) 
• Low Double Leg (DL) Bridge  
• Side-lying hip abduction  
• Standing calf raises 
• Strengthening of uninvolved limb ok 
 
Cardiovascular Exercise: 
• Stationary bike 
• Progressive speed walking on level surfaces 
• Elliptical at week 4 if pain-free 
Criteria to Progress 
• 4-6 weeks post-injury depending on severity of injury 
 
PHASE III: TRANSITIONAL (4-8 WEEKS AFTER INJURY) 
Rehabilitation Goals 
• Normalized gait 
• Gradually progress to full ROM 
• Improve neuromuscular control 
• Increase strength 
• Enhance proprioception and kinesthesia 
Weight Bearing 
• Full weight bearing, no assistive device 
Precautions/Guidelines 
• Per tolerance 
Range of Motion 
• Progressive active hip and knee flexion  
• Active stretching all muscle groups  
Additional Intervention 
*Continue with Phase I-II 
Interventions as indicated 
Manual Therapy: 
• Per above phases as needed 
 
Therapeutic Exercise: 
• DL Bridge with thera-band around thighs 
• DL Bridge with ball squeeze 
• DL Bridge with Upper back on the bench  
• Plank with alternating leg lifts 
• Side plank with leg lift (on left knee until stronger) or oblique twists 
• Straight Leg Raise (SLR) 
• Hamstring (HS) curls antigravity  
• Hip extension antigravity  
 
 
 
 
At 6 weeks, add:  
• Single Leg (SL) bridge, back on floor, foot on bench 
• Progress to ankle weight for all leg lifts PRE 
• Wall slides  
• Clam shells  
• Partial squats 
• Step ups 
• Step downs 
 
Cardiovascular Exercise: 
• Stationary bike 
• Swimming arms and legs 
• Progressive speed walking on level surfaces 
• Jog/walk may be initiated at week 6 if full, symmetrical ROM and strength 
Criteria to Progress 
• Good control with functional movements without antalgic movement patterns 
• Hamstring strength 5/5 in prone with knee at 90deg flexion 
• Good neuromuscular control in all planes without pain 
• HHD testing: 
• To initiate plyos: 
- LSI hamstring >70/80% 
- LSI glute med >80% 
- LSI quad >80%  
• To run: 
- LSI hamstring >80/90% 
- LSI glute med >90% 
- LSI quad >90%  
• Single leg hop cluster (distance, triple, cross over, 6 meter timed) >85% 
 
PHASE IV: EARLY RETURN TO SPORT (8-12 WEEKS AFTER INJURY) 
Rehabilitation Goals 
• Full ROM 
• Improve neuromuscular control 
• Improve strength/power/endurance 
• Enhance dynamic stability 
Precautions/Guidelines 
• No pain during strength training or cardiovascular activity 
Additional Intervention 
*Continue with Phase I-III 
interventions as indicated 
Manual Therapy: 
• Per above phases as needed 
 
Therapeutic Exercise: 
• Dynamic and static hamstring stretching 
• Weight training machines: Leg Press, Standing Hip Abduction, Hamstring Curl, Leg 
Extension 
• Single leg closed chain exercises 
• Resisted step ups using sports cord around waist from behind 
• Double Leg Hamstring ball roll out (eccentric portion only) --> DL eccentric and 
concentric --> SL eccentric portion only --> SL eccentric and concentric 
• Double Leg dead lift, short range --> progressing to Single Leg no rotation 
• Double Leg Dead lift – wide abducted leg stance with black band around forefeet – 
pushing into abduction during eccentric trunk lowering deadlift phase 
• Progress to single leg with spine rotation dead lift to work hamstrings three-
dimensionally 
• Bridge on ball – eccentric portion only double leg → progressing to single leg 
 
 
 
 
 
Cardiovascular Exercise: 
• Continue to increase speed and distance for walking, incorporate uneven surfaces 
• Continuous jogging 
• Initiate interval jogging and running 
 
Criteria to Progress 
• Full ROM 
• No pain/tenderness 
• Satisfactory clinical exam including isokinetic testing 
 
PHASE V: UNRESTRICTED RETURN TO SPORT (12+ WEEKS AFTER INJURY) 
Rehabilitation Goals 
• Emphasis on gradual return to recreational activities 
• Progressively increase activities to prepare for unrestricted functional return 
Precautions/Guidelines 
• Neoprene support as needed 
Additional Intervention 
*Continue with Phase II-IV 
interventions as indicated 
Manual Therapy: 
• Per above phases as needed 
 
Therapeutic Exercise: 
• Progressive strengthening avoiding overload to HS 
• Progress speed of resisted steps and add forward lean 
• SL dead lift with Black tband under stance leg and hold for resistance 
• Reverse Lunge on Slider: Progress load bearing and add concentric/eccentric phase: 
- Part 1: Eccentric hamstring with core strength exercise: injured leg is weight 
bearing leg, from standing, lunge backward (weightless leg slides back on 
slide board) into full lunge, bend forward and then push through 
weightbearing leg/heel as raise back up 
- Part 2: in full lunge position: leg slides back as weight bearing knee bends, 
back leg slides forward as weight bearing leg straightens) 
• Short range Nordic HS to physio ball height → progress range to ground depth 
• Kettle bell swing 
• Retro lunge slide (working leg in front, slide board slider for back leg) 
• Jump Training 
 
Cardiovascular Exercise: 
• Continue above, progressing speed, distance  
• Progress step ups to resisted jump onto steps 
• Plyometric progression  
- Double leg up/down 
- Double leg forward/back 
- Alternating lateral bounding 
- Single leg jump 
- Progress plyos to resisted plyos using sports cord around waist 
• Agility using ladder drills 
• Falling start runs (fall forward, then run) - see below for details 
• Mini hurdle runs 
• Sprint progressions (5 times each) 
 
10 yard → 20 yd → assisted deceleration with band around waist → deceleration lean 
• 40 yard sprints at 90% 
 
 
Criteria to Progress 
• To RTP: 
- LSI Hamstring > 95% 
- LSI Glute >95% 
- LSI quad >95% 
- Single leg hop cluster (distance, triple, cross over, 6 meter timed) >95% 
 
 
- Good acceleration, deceleration, change of direction control 
- 60 second timed step-down test 80 bpm, excellent control 
- 60 second timed Lateral leap 60 bpm, excellent control 
• Last stage, no additional criteria 
• Proceed with caution 
   Revised 12/2021 
 
Contact 
Please email MGHSportsPhysicalTherapy@partners.org with questions specific to this 
protocol 
 
References: 
1. 
Brockett CL, Morgan DL, Proske U. Predicting hamstring strain injury in elite athletes. Med Sci Sports Exerc. 2004;36(3):379-387.  
2. 
Chakravarthy J, Ramisetty N, Pimpalnerkar A, Mohtadi N. Surgical repair of complete proximal hamstring tendon ruptures in water skiers and bull 
riders: a report of four cases and review of the literature. British journal of sports medicine. 2005;39(8):569-572.  
3. 
Chu SK, Rho ME. Hamtring injuries in the athlete: Diagnosis, treatment and return to play. Curr Sports Med Rep. 2016; 15(3): 184-190.  
4. 
Elliot MC, et al. Hamstring muscle strains in professional football players: a 10-year review. Am J Sports Medicine. 2011;39(4):843-850.  
5. 
Feeley BT, et al. Epidemiology of national football league training camp injuries from 1998 to 2007. Am J Sports med. 2008;36(8):1597-1603 
6. 
Henderson G, Barnes CA, Portas MD. Factors associated with increased propensity for hamstring injury in English Premier league soccer players. J 
Sci Med Sport. 2010;13(4):397-402 
7. 
Glazer DD. Development and preliminary validation of the injury-psychological readiness to return to sport (I-PRRS) scale. Journal of athletic 
training. 2009;44(2):185-218.  
8. 
Kijowski R, Wilson JJ, Liu F. Bicomponent ultrashort echo time T2 analysis for assessment of patients with patellar tendinopathy. J Magn Reason 
Imaging. 2017;46(5):1441-1447.  
9. 
Klingele KE, Sallay PI. Surgical repair of complete proximal hamstring tendon rupture. AM J Sports Med. 2002;30(5):742-747.  
10. Liu F, et al. Articular cartilage of the human knee joint: in vivo multicomponent T2 analysis at 3.0T. Radiology. 2015;277(2):477-488.  
11. Liu F, et al. Rapid in vivo multicomponent T2 mapping of human knee menisci. J Magn Reason Imaging. 2015;42(5):1321-1328.  
12. Liu F, et al. Rapid multicomponent T2 analysis of the articular cartilage of the human knee joint at 3.0T. J Magn Reason Imaging. 2014;39(5):1191-
1197. 
13. Loegering IF, et al. Ultrashort echo time (UTE), imaging reveals a shift in bound water that is sensitive to sub-clinical tendinopathy in older adults. 
Skeletal Radiology. 2021;50(1):107-113. 
14. Mendiguchia J, et al. A multifactorial, criteria-based progressive algorithm for hamstring injury treatment. Med Sci Sports Exerc. 2017;49(&):1482-
1492. 
15. Opar DA, Williams MD, Shield AJ. Hamstring strain injuries: factors that lead to injury and re-injury. Sports Med. 2012;42(3):209-226.  
16. Orchard J, Best TM, Verral GM. Return to play follow muscle strains. Clinical journal Sport Med. 2005;15(6):436-441.  
17. Orchard J, Best TM. The management of muscle strain injuries: an early return versus the risk of recurrence. Clin J Sport Med. 2002; 12(1):3-5.  
18. Prior M, Guerin M, Grimmer K. An evidence-based approach to hamstring strain injury: a systematic review of the literature. Sports Health. 
2009;1(2):154-164.  
19. Proske U, et al. Identifying athletes at risk of hamstring strains and how to protect them. Clin Exp Pharmacol Physiol. 2004;31(8):546-550.  
20. Reiman MP, Loudon JK, Goode AP. Diagnostic accuracy of clinical tests for assessment of hamstring injury: a systematic review. Journal of orthopedic 
and sports physical therapy. 2013;43(4):223-231. 
21. Reurink G, et al. MRI observations at return to play of clinically recovered hamstring injuries. British journal of sports medicine. 2014;48(18):1370-
1376.  
22. Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. Journal of orthopedics and sports 
physical therapy. 2004;34(3):116-125. 
23. Sherry, MA, Johnston TS, Heiderscheit BC. Rehabilitation of acute hamstring strain injuries. Clin Sports Med. 2015;34(2):263-284.  
24. Van der Made AD, et al. Intramuscular tendon injury is not associated with an increased hamstring reinjury rate within 12 month after return to 
play. British journal of sports medicine. 2018;52(19):1261-1266.   
25. Van Heumen M, et al. The prognostic value of MRI in determining reinjury risk following acute hamstring injury: a systematic review. British journal 
of sports medicine. 2017; 51(8): 1355-1363.  
26. Verral GM, Kalairajah Y, Slavotinek JP, Spriggins AJ. Assessment of player performance following return to sport after hamstring muscle strain 
injury. J Sci Med Sport. 2006;9(1-2):87-90.  
27. Wangensteen A, et al. Hamstring reinjuries occur at the same location and early after return to sport: a descriptive study of MRI-confirmed 
reinjuries. Am J Sports Med. 206;44(8):2112-2121.   
 
 
 
 
 
 
 
 
Functional Assessment 
 
Patient Name:    
 
 
 
 
 
MRN:    
 
 
Date of Injury:    
 
 
 
 
Surgeon:   
 
 
 
 
 
 
Concomitant Injuries/Procedures:   
 
 
 
 
 
 
                 
                
Ready to jog? 
 
 
YES 
 
NO 
Ready to return to sport? 
YES 
 
NO 
Recommendations:   
 
 
 
 
 
 
 
 
 
 
  
Examiner:   
 
 
 
 
 
 
 
 
Range of motion is recorded in X-0-X format: for example, if a patient has 6 degrees of hyperextension and 135 degrees 
of flexion, ROM would read: 6-0-135.  If the patient does not achieve hyperextension, and is lacking full extension by 5 
degrees, the ROM would simply read: 5-135.   
 
Pain is recorded as an average value over the past 2 weeks, from 0-10.  0 is absolutely no pain, and 10 is the worst pain 
ever experienced. 
 
Standing Heel Rise test is performed starting on a box with a 10 degree incline. Patient performs as many single leg heel 
raises as possible to a 30 beat per minute metronome. The test is terminated if the patient leans or pushes down on the 
 
 
 
Operative Limb 
Non-operative 
Limb 
Limb Symmetry 
Index 
Range of motion (X-0-X) 
 
 
- 
Pain (0-10) 
 
 
- 
Standing Heel Rise test 
 
 
 
Hop Testing 
 
Single-leg Hop for Distance 
 
 
 
Triple Hop for Distance 
 
 
 
Crossover Hop for Distance 
 
 
 
Vertical Jump 
 
 
 
Y-Balance Test 
 
 
 
Calculated 1 RM (single leg press) 
 
 
 
Psych. Readiness to Return to Sport (PRRS) 
 
 
 
table surface they are using to balance, the knee flexes, the plantar-flexion range of motion decreases by more than 50% 
of the starting range of motion, or the patient cannot keep up with the metronome/fatigues. 
 
Hop testing is performed per standardized testing guidelines.  The average of 3 trials is recorded to the nearest 
centimeter for each limb. 
 
 
Return to Running Program 
 
This program is designed as a guide for clinicians and patients through a progressive return-to-run program. Patients 
should demonstrate > 80% on the Functional Assessment prior to initiating this program (after a knee ligament or 
meniscus repair). Specific recommendations should be based on the needs of the individual and should consider clinical 
decision making. If you have questions, contact the referring physician.  
 
PHASE I: WARM UP WALK 15 MINUTES, COOL DOWN WALK 10 MINUTES 
Day 
1 
2 
3 
4 
5 
6 
7 
Week 1 
W5/J1x5 
 
W5/J1x5 
 
W4/J2x5 
 
W4/J2x5 
Week 2 
 
W3/J3x5 
 
W3/J3x5 
 
W2/J4x5 
 
Week 3 
W2/J4x5 
 
W1/J5x5 
 
W1/J5x5 
 
Return 
to Run  
Key: W=walk, J=jog 
**Only progress if there is no pain or swelling during or after the run 
 
PHASE II: WARM UP WALK 15 MINUTES, COOL DOWN WALK 10 MINUTES 
Week 
Sunday 
Monday 
Tuesday 
Wednesday 
Thursday 
Friday 
Saturday 
1 
20 min 
 
20 min 
 
20 min 
 
25 min 
2 
 
25 min 
 
25 min 
 
30 min 
 
3 
30 min 
 
30 min 
 
35 min 
 
35 min 
4 
 
35 min 
 
40 min 
 
40 min 
 
5 
40 min 
 
45 min 
 
45 min 
 
45 min 
6 
 
50 min 
 
50 min 
 
50 min 
 
7 
55 min 
 
55 min 
 
55 min 
 
60 min 
8 
 
60 min 
 
60 min 
 
 
 
Recommendations 
• Runs should occur on softer surfaces during Phase I 
• Non-impact activity on off days 
• Goal is to increase mileage and then increase pace; avoid increasing two variables at once 
• 10% rule:  no more than 10% increase in mileage per week 
 
 
 
 
Agility and Plyometric Program 
 
This program is designed as a guide for clinicians and patients through a progressive series of agility and plyometric 
exercises to promote successful return to sport and reduce injury risk. Patients should demonstrate > 80% on the 
Functional Assessment prior to initiating this program. Specific intervention should be based on the needs of the 
individual and should consider clinical decision making. If you have questions, contact the referring physician.  
 
PHASE I: ANTERIOR PROGRESSION 
Rehabilitation 
Goals 
• Safely recondition the knee 
• Provide a logical sequence of progressive drills for pre-sports conditioning 
Agility 
• Forward run 
• Backward run 
• Forward lean in to a run 
• Forward run with 3-step deceleration 
• Figure 8 run 
• Circle run 
• Ladder  
Plyometrics 
• Shuttle press: Double leg→alternating leg→single leg jumps 
• Double leg:  
- Jumps on to a box→ jump off of a box→ jumps on/off box 
- Forward jumps, forward jump to broad jump 
- Tuck jumps 
- Backward/forward hops over line/cone 
• Single leg (these exercises are challenging and should be considered for more advanced 
athletes): 
- Progressive single leg jump tasks 
- Bounding run 
- Scissor jumps 
- Backward/forward hops over line/cone 
Criteria to 
Progress 
• No increase in pain or swelling 
• Pain-free during loading activities 
• Demonstrates proper movement patterns 
 
PHASE II: LATERAL PROGRESSION 
Rehabilitation 
Goals 
• Safely recondition the knee 
• Provide a logical sequence of progressive drills for the Level 1 sport athlete 
Agility 
*Continue with 
Phase I 
interventions 
 
• Side shuffle 
• Carioca 
• Crossover steps 
• Shuttle run 
• Zig-zag run 
• Ladder 
Plyometrics 
*Continue with 
Phase I 
interventions 
• Double leg:  
- Lateral jumps over line/cone 
- Lateral tuck jumps over cone 
• Single leg(these exercises are challenging and should be considered for more advanced 
athletes): 
- Lateral jumps over line/cone 
- Lateral jumps with sport cord 
Criteria to 
Progress 
• No increase in pain or swelling 
• Pain-free during loading activities 
• Demonstrates proper movement patterns 
 
 
0 
 
PHASE III: MULTI-PLANAR PROGRESSION 
Rehabilitation 
Goals 
• Challenge the Level 1 sport athlete in preparation for final clearance for return to sport 
Agility  
*Continue with 
Phase I-II 
interventions 
• Box drill 
• Star drill 
• Side shuffle with hurdles 
Plyometrics 
*Continue with 
Phase I-II 
interventions 
• Box jumps with quick change of direction 
• 90 and 180 degree jumps  
Criteria to 
Progress 
• Clearance from MD 
• Functional Assessment 
- ≥90% contralateral side 
• Achilles Tendon Rupture Score (ATRS) 
• Psych Readiness to Return to Sport (PRRS) 
 
 
 
 
 
1 
Psychological Readiness to Return to Sport 
 
Patient Name:    
 
 
 
 
 
MRN:    
 
 
Injury:   
 
 
 
  
 
Date of Injury:    
 
 
 
Surgeon:   
 
 
 
 
 
 
 
Please rate your confidence to return to your sport on a scale from 0 – 100 
Example: 
0 = No confidence at all 
 
 
50 = Moderate confidence 
 
 
100 = Complete confidence 
 
1. My overall confidence to play is _____ 
2. My confidence to play without pain is _____ 
3. My confidence to give 100% effort is _____ 
4. My confidence to not concentrate on the injury is _____ 
5. My confidence in the injured body part to handle demands of the situation is _____ 
6. My confidence in my skill level/ability is _____ 
Total: _____ 
Score:_____ 
 
Examiner: ________________________________ 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Glazer DD. Development and Preliminary Validation of the Injury-Psychological Readiness to Return to Sport (I-PRRS) Scale. Journal of Athletic Training. 2009;44(2):185-18. 
 
2 
 
References 
 
 
1. 
Opar, D.A., M.D. Williams, and A.J. Shield, Hamstring strain injuries: factors that lead to injury and re-injury. Sports Med, 2012. 42(3): p. 209-26. 
 
2. 
Elliott, M.C., et al., Hamstring muscle strains in professional football players: a 10-year review. Am J Sports Med, 2011. 39(4): p. 843-50. 
 
3. 
Feeley, B.T., et al., Epidemiology of National Football League training camp injuries from 1998 to 2007. Am J Sports Med, 2008. 36(8): p. 1597-603. 
 
4. 
Henderson, G., C.A. Barnes, and M.D. Portas, Factors associated with increased propensity for hamstring injury in English Premier League soccer 
players. J Sci Med Sport, 2010. 13(4): p. 397-402. 
 
5. 
Mendiguchia, J., et al., A Multifactorial, Criteria-based Progressive Algorithm for Hamstring Injury Treatment. Med Sci Sports Exerc, 2017. 49(7): p. 
1482-1492. 
 
6. 
Sherry, M.A., T.S. Johnston, and B.C. Heiderscheit, Rehabilitation of acute hamstring strain injuries. Clin Sports Med, 2015. 34(2): p. 263-84. 
 
7. 
Wangensteen, A., et al., Hamstring Reinjuries Occur at the Same Location and Early After Return to Sport: A Descriptive Study of MRI-Confirmed 
Reinjuries. Am J Sports Med, 2016. 44(8): p. 2112-21. 
 
8. 
Prior, M., M. Guerin, and K. Grimmer, An evidence-based approach to hamstring strain injury: a systematic review of the literature. Sports Health, 
2009. 1(2): p. 154-64. 
 
9. 
Brockett, C.L., D.L. Morgan, and U. Proske, Predicting hamstring strain injury in elite athletes. Med Sci Sports Exerc, 2004. 36(3): p. 379-87. 
 
10. 
Proske, U., et al., Identifying athletes at risk of hamstring strains and how to protect them. Clin Exp Pharmacol Physiol, 2004. 31(8): p. 546-50. 
 
11. 
Chu, S.K. and M.E. Rho, Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Curr Sports Med Rep, 2016. 15(3): p. 184-90. 
 
12. 
Reiman, M.P., J.K. Loudon, and A.P. Goode, Diagnostic accuracy of clinical tests for assessment of hamstring injury: a systematic review. J Orthop Sports  
Phys Ther, 2013. 43(4): p. 223-31. 
 
13. 
van Heumen, M., et al., The prognostic value of MRI in determining reinjury risk following acute hamstring injury: a systematic review. Br J Sports Med, 
2017. 51(18): p. 1355-1363. 
 
14. 
van der Made, A.D., et al., Intramuscular tendon injury is not associated with an increased hamstring reinjury rate within 12 months after return to 
play. Br J Sports Med, 2018. 52(19): p. 1261-1266. 
 
15. 
Reurink, G., et al., MRI observations at return to play of clinically recovered hamstring injuries. Br J Sports Med, 2014. 48(18): p. 1370-6. 
 
16. 
Liu, F., et al., Rapid multicomponent T2 analysis of the articular cartilage of the human knee joint at 3.0T. J Magn Reson Imaging, 2014. 39(5): p. 1191-
7. 
 
17. 
Liu, F., et al., Articular Cartilage of the Human Knee Joint: In Vivo Multicomponent T2 Analysis at 3.0 T. Radiology, 2015. 277(2): p. 477-88. 
 
18. 
Liu, F., et al., Rapid in vivo multicomponent T2 mapping of human knee menisci. J Magn Reson Imaging, 2015. 42(5): p. 1321-8. 
 
19. 
Kijowski, R., J.J. Wilson, and F. Liu, Bicomponent ultrashort echo time T2* analysis for assessment of patients with patellar tendinopathy. J Magn Reson 
Imaging, 2017. 46(5): p. 1441-1447. 
 
20. 
Loegering, I.F., et al., Ultrashort echo time (UTE) imaging reveals a shift in bound water that is sensitive to sub-clinical tendinopathy in older adults. 
Skeletal Radiol, 2021. 50(1): p. 107-113. 
21. 
Orchard J, Best TM, Verrall GM. Return to play following muscle strains. Clin J Sport Med. Nov 2005;15(6):436-441.  
 
22. 
Orchard JW, Best TM. The management of muscle strain injuries: an early return versus the risk of recurrence. Clin J Sport Med. 2002;12(1):3-5. 
 
23. 
Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther. Mar 
2004;34(3):116-125. 
 
24. 
Verrall GM, Kalairajah Y, Slavotinek JP, Spriggins AJ. Assessment of player performance following return to sport after hamstring muscle strain 
injury. J Sci Med Sport. May 2006;9(1-2):87-90. 
 
25. 
Chakravarthy J, Ramisetty N, Pimpalnerkar A, Mohtadi N. Surgical repair of complete proximal hamstring tendon ruptures in water skiers and bull 
riders: a report of four cases and review of the literature. Br J Sports Med. Aug 2005;39(8):569-572.  
 
26. 
Klingele KE, Sallay PI. Surgical repair of complete proximal hamstring tendon rupture. Am J Sports Med. Sep-Oct 2002;30(5):742-747. 
 
 
3 
 
 
