{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:29:51Z","timestamp":1777883391091,"version":"3.51.4"},"reference-count":31,"publisher":"International Journal of Sports Physical Therapy","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Hamstring muscle injuries are among the most common lower-extremity injuries in active individuals. Hamstring injuries follow a consistent pattern with a consistent medical history, which includes a sudden, explosive type of movement (sprinting, kicking, jumping, or lunging). The onset of pain is usually acute in the posterior thigh. They may describe a \u201cpop,\u201d \u201csnap,\u201d or sensation as if someone kicked them in the back of the thigh. An accurate diagnosis of medial hamstring overuse, partial tears, or ruptures is essential for appropriate treatment planning and optimizing patient outcomes. Diagnostic musculoskeletal ultrasound (MSKUS) offers a portable, real-time, and cost-effective alternative that is gaining traction in rehabilitation and sports medicine settings. MSKUS has emerged as a valuable, non-invasive imaging modality for evaluating hamstring injuries, including tendinopathy, muscle strains (partial tears), and ruptures. MSKUS is excellent at detecting changes in tendon and muscle composition and continuity. This manuscript will review the utility of MSKUS in evaluating medial hamstring tendon and muscle injuries, including anatomy, common injury mechanisms, sonographic techniques, and clinical implications for the rehabilitation profession. By integrating MSKUS into clinical practice, providers can improve diagnostic accuracy, enhance diagnostic confidence, monitor healing progression, and guide rehabilitation strategies to achieve optimal patient outcomes for those with hamstring injuries.<\/jats:p>\n                  <jats:sec id=\"level-of-evidence\">\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>5<\/jats:p>\n                  <\/jats:sec>","DOI":"10.26603\/001c.161263","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:44:07Z","timestamp":1777599847000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Medial Hamstrings"],"prefix":"10.26603","volume":"21","author":[{"given":"Robert C.","family":"Manske","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Wolfe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phil","family":"Page","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Voight","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11140","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/s1050-6411(98)00041-8","article-title":"Human skeletal muscle architecture studied in vivo by non-invasive imaging techniques: functional significance and applications","volume":"9","author":"M. Narici","year":"1999","journal-title":"J Electromyogr Kinesiol Off J Int Soc Electrophysiol Kinesiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1249\/00003677-198201000-00006","article-title":"Fiber architecture and muscle function","volume":"10","author":"C. Gans","year":"1982","journal-title":"Exerc Sport Sci Rev"},{"issue":"2","key":"ref3","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1055\/s-0030-1253157","article-title":"Hamstring injuries: anatomy, imaging, and intervention","volume":"14","author":"J. M. Linklater","year":"2010","journal-title":"Semin Musculoskelet Radiol"},{"issue":"7","key":"ref4","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1007\/s00167-013-2744-0","article-title":"The hamstring muscle complex","volume":"23","author":"A. D. van der Made","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref5","series-title":"Ultrasound of the Musculoskeletal System","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/978-3-540-28163-4_13","article-title":"Thigh","author":"S. Bianchi","year":"2007"},{"issue":"15","key":"ref6","doi-asserted-by":"publisher","first-page":"2549","DOI":"10.1016\/j.jbiomech.2009.07.011","article-title":"Validity of architectural properties of the hamstring muscles: Correlation of ultrasound findings with cadaveric dissection","volume":"42","author":"E. Kellis","year":"2009","journal-title":"J Biomech"},{"issue":"3","key":"ref7","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.ultrasmedbio.2014.10.011","article-title":"Reliability of panoramic ultrasound imaging in simultaneously examining muscle size and quality of the hamstring muscles in young, healthy males and females","volume":"41","author":"T. B. Palmer","year":"2015","journal-title":"Ultrasound Med Biol"},{"issue":"1","key":"ref8","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.ultrasmedbio.2019.09.013","article-title":"Reliability and validity of ultrasonography for measurement of hamstring muscle and tendon cross-sectional area","volume":"46","author":"A. Kositsky","year":"2020","journal-title":"Ultrasound Med Biol"},{"issue":"9","key":"ref9","doi-asserted-by":"publisher","first-page":"2579","DOI":"10.1016\/j.ultrasmedbio.2021.05.025","article-title":"Reliability of distal hamstring tendon length and cross-sectional area using 3-D freehand ultrasound","volume":"47","author":"C. Sahinis","year":"2021","journal-title":"Ultrasound Med Biol"},{"issue":"10","key":"ref10","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1016\/j.ultrasmedbio.2018.05.022","article-title":"Classification of tendon matrix change using ultrasound imaging: A systematic review and meta-analysis","volume":"44","author":"W. Matthews","year":"2018","journal-title":"Ultrasound Med Biol"},{"issue":"3","key":"ref11","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1249\/01.mss.0000117165.75832.05","article-title":"Predicting hamstring strain injury in elite athletes","volume":"36","author":"C. L. Brockett","year":"2004","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"ref12","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.2214\/AJR.13.12286","article-title":"Ultrasound of the thigh: focal, compartmental, or comprehensive examination?","volume":"203","author":"R. A. Lutterbach-Penna","year":"2014","journal-title":"Am J Roentgenol"},{"key":"ref13","series-title":"Musculoskeletal Ultrasound","first-page":"254","article-title":"Muscles","author":"S. Bianchi","year":"2013"},{"issue":"9","key":"ref14","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1002\/jcu.22088","article-title":"Sonographic examination of the buttock","volume":"41","author":"R. K. L. Lee","year":"2013","journal-title":"J Clin Ultrasound"},{"issue":"11","key":"ref15","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1007\/s00256-019-03208-x","article-title":"Sonographic landmarks in hamstring muscles","volume":"48","author":"R. Balius","year":"2019","journal-title":"Skeletal Radiol"},{"issue":"5","key":"ref16","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1136\/bjsports-2015-094657","article-title":"Time to return to full training is delayed and recurrence rate is higher in intratendinous ('c') acute hamstring injury in elite track and field athletes: clinical application of the British Athletics Muscle Injury Classification","volume":"50","author":"N. Pollock","year":"2016","journal-title":"Br J Sports Med"},{"issue":"12","key":"ref17","doi-asserted-by":"publisher","first-page":"3772","DOI":"10.1016\/j.ejrad.2011.03.099","article-title":"The proximal hamstring muscle-tendon-bone unit: a review of the normal anatomy, biomechanics, and pathophysiology","volume":"81","author":"L. Beltran","year":"2012","journal-title":"Eur J Radiol"},{"issue":"3","key":"ref18","doi-asserted-by":"publisher","first-page":"241","DOI":"10.4103\/jmu.jmu_56_24","article-title":"Ultrasonographic evaluation of the distal medial hamstring tendons and their association with posteromedial knee pain","volume":"33","author":"H. S. Mohammed","year":"2025","journal-title":"J Med Ultrasound"},{"issue":"6","key":"ref19","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.2214\/AJR.07.3385","article-title":"The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI","volume":"190","author":"L. N. Nazarian","year":"2008","journal-title":"Am J Roentgenol"},{"key":"ref20","series-title":"Musculoskeletal Ultrasound","first-page":"178","article-title":"Soft tissue masses","author":"J. Jacobson","year":"2013"},{"issue":"3","key":"ref21","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1148\/radiographics.19.3.g99ma05655","article-title":"Imaging features of avulsion injuries","volume":"19","author":"M. A. Stevens","year":"1999","journal-title":"Radiographics"},{"issue":"4","key":"ref22","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1177\/0363546513476270","article-title":"Results of 2 decades of injury surveillance and public release of data in the Australian Football League","volume":"41","author":"J. W. Orchard","year":"2013","journal-title":"Am J Sports Med"},{"issue":"1","key":"ref23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF00191518","article-title":"Calcific tendinitis: a review of the usual and unusual","volume":"22","author":"P. D. Holt","year":"1993","journal-title":"Skeletal Radiol"},{"issue":"4","key":"ref24","doi-asserted-by":"publisher","first-page":"993","DOI":"10.2214\/AJR.09.3674","article-title":"High hamstring tendinopathy: MRI and ultrasound imaging and therapeutic efficacy of percutaneous corticosteroid injection","volume":"195","author":"M. H. Zissen","year":"2010","journal-title":"Am J Roentgenol"},{"issue":"8","key":"ref25","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/j.1440-1681.2004.04028.x","article-title":"Identifying athletes at risk of hamstring strains and how to protect them","volume":"31","author":"U. Proske","year":"2004","journal-title":"Clin Exp Pharmacol Physiol"},{"issue":"3","key":"ref26","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1249\/00003677-200607000-00008","article-title":"Neuromusculoskeletal models provide insights into the mechanisms and rehabilitation of hamstring strains","volume":"34","author":"D. G. Thelen","year":"2006","journal-title":"Exerc Sport Sci Rev"},{"issue":"2","key":"ref27","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.jshs.2012.07.003","article-title":"Injury rate, mechanism, and risk factors of hamstring strain injuries in sports: A review of the literature","volume":"1","author":"H. Liu","year":"2012","journal-title":"J Sport Health Sci"},{"issue":"8","key":"ref28","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1111\/sms.13437","article-title":"Late swing or early stance? A narrative review of hamstring injury mechanisms during high-speed running","volume":"29","author":"C. J. B. Kenneally-Dabrowski","year":"2019","journal-title":"Scand J Med Sci Sports"},{"issue":"3","key":"ref29","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1249\/MSS.0b013e3181f23fe8","article-title":"Hamstring musculotendon dynamics during stance and swing phases of high-speed running","volume":"43","author":"E. S. Chumanov","year":"2011","journal-title":"Med Sci Sports Exerc"},{"issue":"6","key":"ref30","doi-asserted-by":"publisher","first-page":"397","DOI":"10.2165\/00007256-199723060-00005","article-title":"Hamstring injuries. Current trends in treatment and prevention","volume":"23","author":"U. M. Kujala","year":"1997","journal-title":"Sports Med"},{"issue":"4","key":"ref31","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1016\/j.jelekin.2012.03.012","article-title":"Architectural differences between the hamstring muscles","volume":"22","author":"E. Kellis","year":"2012","journal-title":"J Electromyogr Kinesiol"}],"container-title":["International Journal of Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/161263-diagnostic-musculoskeletal-ultrasound-in-the-evaluation-of-the-medial-hamstrings","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:44:08Z","timestamp":1777599848000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/161263-diagnostic-musculoskeletal-ultrasound-in-the-evaluation-of-the-medial-hamstrings"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.26603\/001c.161263","relation":{},"ISSN":["2159-2896"],"issn-type":[{"value":"2159-2896","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]}}}