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Physiotherapy Examination of Acute Hamstring Strain Injuries: Flexibility

Physio Ballarat

Written by Shane Pongho (Physiotherapist) – RAD Centre, Ballarat VIC

Why do we measure flexibility after a hamstring strain injury?

Assessing flexibility via the maximum hip flexion active knee extension test (MHFAKE Test) is a nice way to guide your rehab in the early stages. 

Whiteley, et al. 2018 found the MHFAKE Test the most useful flexibility measure to track rehabilitation progress. 

As a rule of thumb we expect the flexibility of your injured leg to return to normal during the first half of your rehab. 

For example – if your flexibility is normal two-weeks after injury this may indicate a four-week injury.   

The Active Knee Extension Test is another way to measure flexibility after hamstring injury. 

We find this particularly useful with more severe injuries as some do not tolerate maximal hip flexion positions. 

Crema et al. 2017 highlighted deficits in this position as a potential clue for intramuscular tendon involvement. 

Take Home: 

  • Flexibility is a useful outcome measure early after hamstring strain injury 
  • Your flexibility should return to normal in the first half of your rehab  
  • As you get closer to return to play – flexibility measures become less relevant 

Do you have a Hamstring injury that needs to be assessed in Ballarat? Click through to our Physiotherapy page to find an appointment time:


  • Whiteley, R., et al. (2018). Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries and their association with running speed and rehabilitation progression. British Journal of Sports Medicine. 52(5): 303-310. 
  • Crema, M. D., et al. (2017). Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries? Orthop J Sports Med. 5(10): 1-8.