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CONDITION/DISORDER SYNONYM

  • Pulled hamstring

ICD-9-CM CODE

  • 848.9 Unspecified site of sprain and strain

ICD-10-CM CODE

  • T14.9 Dislocation, sprain, and strain of unspecified body region

PREFERRED PRACTICE PATTERNS

  • 4D: Impaired joint mobility, motor function, muscle performance, and range of motion (ROM) associated with connective tissue dysfunction

  • 4E: Impaired joint mobility, motor function, muscle performance, and ROM associated with localized inflammation

PATIENT PRESENTATION

A 21-year-old female presents complaining of right posterior thigh and buttock pain. She indicates the pain began suddenly 3 days ago during the fourth set of high intensity 100-m sprint intervals. She recently added speed work into her distance running regiment. She denies hearing an audible pop. She reports pain is worse with bending forward and running. She presents without ecchymosis or visible edema. Palpation reveals tenderness distal to her right ischial tuberosity. Manual muscle testing reveals significant strength deficits due to pain in both knee flexion and hip extension compared to the uninvolved side. Hamstring flexibility is 65 degrees on right side compared to 90 degrees on left in a straight-leg raise (SLR) position. Testing proves negative for lumbar radiculopathy.

FIGURE 192-1

Dermatomal (A) and cutaneous (B) innervation of the lower limb. (From Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

FIGURE 192-2

(A) Cross-section of the right leg. (B) Movements of the ankle. (C) Muscles of the anterior compartment of the leg. (From Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

KEY FEATURES

Description

  • Stretch injury to biceps femoris or semimembranosus resulting in disruption of muscular or musculotendinous units1

    • Grade I: Mild

    • Grade II: Moderate

    • Grader III: Severe to complete tear or rupture

FIGURE 192-3

Cross-section of the thigh (A) and leg (B). (From Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

FIGURE 192-4

Muscles of the posterior compartment of the leg: (A) superficial dissection, (B) intermediate dissection, (C) deep dissection. (From Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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