Strength Testing with the Leg Curl

assessment Feb 15, 2018

The hamstrings are a group of muscles comprising the biceps femoris (long and short heads), semitendinosus, and semimembranosus. Together, these assist in various combinations to extend the hip, and flex and rotate the knee.

They are also especially important in walking, running, and participating in many forms of sport and exercise. Testing the hamstrings group can be achieved via the prone leg curl, whereby the patient lies face down and flexes the knees against a pad, ensuring full range of motion with the movement being taken through full knee extension and flexion.

As the hamstrings cross both the hip and knee joints (except for the short head of biceps femoris), they may be subject to higher rates of injury due to the increased joint interactions such as in athletic events requiring great degrees of acceleration, deceleration and lower limb strength (Wright, Delong, & Gehlsen, 1999).

Hamstring injuries are the most common non-contact injury throughout soccer, Australian Rules football, rugby union, track and field events, and American football (Maniar, Shield, Williams, Timmins, & Opar, 2016). 

Some things to consider with testing the hamstrings:

  • Previous hamstring injury is the number one risk factor for subsequent injury (Verrall et al., 2001).
  • Deficits in hamstring isometric strength and range of motion, as measured by the leg curl test upon return to play, are independent predictors for hamstring re-injury (De Vos et al., 2014).
  • Reduced quadriceps-to-hamstrings maximal muscle strength ratio is linked to increased risk of lower limb injury (Evangelidis, Massey, Pain, & Folland, 2016)
  • When assessing whether an athlete is ready to return to sport, 57% of clinicians reported tolerating ≤10% difference compared to the uninjured side whereas only 22% of clinicians reported tolerating ≤5% difference compared to the uninjured side. (Lauren N.EricksonMarc A.Sherry 2017).

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