Bent Knee Stretch Test

What is proximal hamstring tendinopathy?

Chronic proximal hamstring tendinopathy is a condition characterized by pain and tenderness at the point where the hamstring muscles attach to the bone at the bottom of the pelvis. This condition often affects athletes, particularly those involved in running, sprinting, or activities that involve significant stretching or sudden, intense movements where the hamstring rapidly straightens.

Proximal hamstring tendinopathy can lead to chronic discomfort and limit a person's ability to perform physical activities effectively.

Symptoms of proximal hamstring tendinopathy

The primary symptom of proximal hamstring tendinopathy is pain in the muscle group near the lower buttock, especially near the point where the hamstrings attach to the bone. Like other hamstring injuries, this pain may worsen with activities that involve bending over or stretching the hamstring muscles. Other common symptoms include:

• Increased discomfort during or after running.
• Pain when sitting on hard surfaces for prolonged periods.
• Tenderness at the attachment site on the pelvis.

Causes of this tendinopathy

Proximal hamstring tendinopathy is typically caused by a combination of overuse and muscle imbalance. Frequent and repetitive loading of the hamstring muscles, especially when they are not adequately conditioned or when there is poor flexibility, contributes to strain and microtears in the tendons. Other contributing factors include:

• Sudden increases in physical activity or changes in training routines.
• Underlying biomechanical issues, such as pelvic instability or poor running technique.
• Age-related wear and tear which affects tendon resilience.

What is the Bent Knee Stretch Test?

The Bent Knee Stretch Test is a diagnostic tool used to assess the condition of the hamstring muscles at their proximal attachments. This test is particularly effective for diagnosing issues such as proximal hamstring tendinopathy, offering a simple yet precise method for eliciting symptoms associated with hamstring injuries.

The test is also noted for its high intra- and inter-rater reliability above 0.8. It demonstrates good accuracy with a sensitivity of 84% and a specificity of 87%, making it a reliable and valuable tool in clinical settings.

How is this test conducted?

The test is relatively straightforward and does not require any special equipment. Here are the steps:

1. The patient lies supine on an examination table.
2. The examiner flexes the patient's hip and knee of one leg until it is maximally flexed.
3. While maintaining the hip in flexion, the examiner slowly straightens the knee to increase the stretch on the hamstring muscles.
4. The test continues until the patient's knee is fully extended or the patient experiences discomfort.

How are the results interpreted?

The results of the Bent Knee Stretch Test are interpreted based on the patient’s response to the stretch. A negative test indicates no significant discomfort or replication of symptoms, suggesting the absence of tendinopathy in the proximal hamstrings. A positive test occurs if the patient experiences exacerbation of their familiar symptoms, indicating issues like proximal hamstring tendinopathy.

Next steps after conducting this test

If the Bent Knee Stretch Test results are positive, the patient may be referred for imaging tests such as MRI to confirm the diagnosis and assess the severity of the tendinopathy. You may also get them started on a targeted physical therapy program focusing on stretching, strengthening, and gradually resuming activity to ensure proper healing and prevent recurrence.

How to use our Bent Knee Stretch Test template

Utilizing our Bent Knee Stretch Test template facilitates a standardized approach to assessing and documenting patient evaluations. This resource is particularly designed for healthcare professionals to ensure accuracy and consistency across clinical settings.

1. Access this template: Access the template from our website or through the Carepatron app. You can print it or fill it out digitally, and you can even edit the template on the app.
2. Explain the template: It's essential to familiarize yourself with the layout of the template before administering the test. Clearly explain the procedure to the patient to ensure they understand what to expect and to ease any anxiety, ensuring their cooperation for accurate results.
3. Perform and document the procedure: Conduct the test according to the specified steps. Complete the results section post-test by indicating whether the outcome was positive or negative and noting any specific observations in the additional notes section.
4. Review and follow-up: Ensure all entries are accurate and complete before discussing the results with the patient. Explain the implications of the findings and discuss potential next steps, such as further testing or treatment options.

Benefits of conducting this test

Conducting the Bent Knee Stretch Test provides several significant benefits, particularly in clinical settings where accurate diagnosis and effective treatment planning are crucial. Here are some key advantages:

• Early diagnosis: This test helps in the early detection of conditions such as proximal hamstring tendinopathy by identifying discomfort and exacerbation of familiar symptoms. Early diagnosis can lead to more effective and timely treatment interventions.
• Non-invasive assessment: The test is non-invasive and safe, making it an ideal choice for initial screening without the need for complex equipment or procedures.
• High reliability: With high intra- and inter-rater reliability scores, this test provides consistent results, which are crucial for tracking patient progress over time and making informed clinical decisions.

These benefits highlight the utility of the Bent Knee Stretch Test in both diagnosing and managing lower limb issues effectively. By integrating this test into routine assessments, healthcare providers can enhance the accuracy of their diagnoses and the efficacy of subsequent treatments.