General Guideline Principles for Hamstring and
Hip Flexor Strains for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Hamstring and Hip Flexor Strains.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Introduction of Hamstring and Hip Flexor Strains

Strains to the hip flexor and hamstring are considered to be real muscle strains (i.e., disrupted myotendinous junctions). The most common physical findings are pain at the origin or insertion of the muscle, along with edema or significant ecchymoses in more severe cases.

Complete ruptures occasionally occur in situations requiring surgical correction. In most cases, clinical tests are not required. NSAIDs, heat or cold, ace bandages, work restrictions, rehabilitation, gradual agility, and trunk stabilisation are all possible treatments.

Diagnostic Studies of Hamstring and Hip Flexor Strains

1. Ultrasound

   Ultrasound of Hamstring and Hip Flexor Strains are recommended for determining the severity of hip flexor strains and hamstring injuries.

   Indications: Patients with at least moderately severe hamstring strains, rips, and hip flexor strains Mild strains typically get better with the right care and without the need for diagnostic tests.

   Frequency/Dose/Duration: Once.

   Rationale: It is advised to use ultrasound in order to assess and validate these diagnoses.

    

2. MRI

   MRI is recommended to identify hip flexor or hamstring injuries in a few more serious situations.

   Indications: cases of fairly severe strains that are particularly severe, in which surgery may be considered. Justification: Can aid in determining surgical eligibility by aiding in the assessment of severity in more serious cases. MRI is therefore advised.

Treatments of Hamstring and Hip Flexor Strains

1. Cryotherapy/Heat Hot or Cold or Ace Wrap Therapies

   Cryotherapy/Heat Hot or Cold or Ace Wrap Therapies are recommended for the treatment of hip flexor or hamstring strains.

   Indications: Most patients with sufficient pain from hamstring or hip flexor strains needing treatment and medication, especially in the acute and peri-operative stages.

   Frequency/Dose/Duration: Generally tailored according to severity and patient preferences.

    

2. Rehabilitation Therapy of Hamstring and Hip Flexor Strains

   In the event that rehabilitation is necessary as a result of a job-related injury, the main goal should be to help the patient regain the functional ability needed to carry out daily tasks and return to work, with the goal of returning them as closely as possible to their pre-injury condition.

   Active therapy calls for the patient to put in an internal effort to finish a particular activity or assignment. This type of therapy necessitates professional supervision, such as verbal, visual, and/or tactile instructions (s).

   The majority of the energy needed to perform the job is executed by the patient, while the therapist may occasionally assist in stabilising the patient or directing the movement pattern. In order to maintain progress levels, the patient should be advised to continue active therapies at home as an extension of the therapeutic process.

   Over passive interventions, active initiatives should be prioritised. Passive interventions are those that rely on modalities administered by a therapist rather than requiring the patient to expend any effort. Passive therapies are typically seen as a way to speed up an active therapy programme and achieve concurrently objective functional gains.

   In order to facilitate functional gains, assistive devices may be used as an adjuvant measure in the rehabilitation strategy.

    

   • Therapeutic Exercise – Physical or Occupational Therapy

     Therapeutic Exercise – Physical or Occupational Therapy are recommended for more severe hip flexor and hamstring strains, especially to address any weakness in the lateral hip musculature.

     Frequency/Dose/Duration – Exercises are typically tailored to the individual and progressed over time. Many therapists use exercises into their arsenal of therapeutic techniques. Exercises that go from stretching to strengthening are commonly included.

     The frequency of visits is often determined individually based on the severity of the disorder, prior treatment response, and employment responsibilities. For the first two weeks of a fitness programme, two to three visits per week are typical. For mild individuals, the total number of visits may be as low as 2 to 3 or as high as 12 to 15 when there is documentation of objective functional improvement.

     Patients should be advised to continue both active and passive therapy at home as part of the rehabilitation plan in order to extend the healing process and sustain progress.

     Indications for Discontinuation – Symptoms disappearing, healing after surgery, intolerance, ineffectiveness, or non-compliance.

Injection Therapy of Hamstring and Hip Flexor Strains

1. Intraarticular Glucocorticosteroid Injections

   Intraarticular Glucocorticosteroid Injections is recommended for the relief of hip flexor or hamstring strains.

   Indications: for hamstring or hip flexor injuries that are not adequately controlled by NSAID(s), acetaminophen, weight loss, or exercise.

   Frequency/Dose/Duration: One injection should be administered, and the outcomes should be assessed. Signals of Discontinuation Typically, just one injection is made. If there is incomplete improvement (improved function and decreased discomfort), a second injection might be suggested.

    

2. Intraarticular Hip Viscosupplementation Injections

   Intraarticular Hip Viscosupplementation Injections is not recommended for the relief of hip flexor or hamstring strains.

   Intraarticular Platelet-Rich Plasma Injections

   Intraarticular Platelet-Rich Plasma Injections is not recommended for the treatment of hamstring or hip flexor strains.

    

3. Prolotherapy Injections

   Prolotherapy Injections is not recommended for the purpose of hip flexor or hamstring strains.

    

4. Botulinum Injections

   Botulinum Injections not recommended in order to treat hamstring or strained hip flexors.

    

5. Glucosamine Sulfate Intra-Muscular Injections

   Glucosamine Sulfate Intra-Muscular Injections is not recommended for the purpose of hip flexor or hamstring strains.

    

6. Glucosamine Sulfate Intra-Articular

   Glucosamine Sulfate Intra-Articular is not recommended in order to treat strains in the hip flexor or hamstring.

Surgery of Hamstring and Hip Flexor Strains

Surgical Repair

Surgical Repair is recommended for the treatment of a full or big hamstring or, in a few people, hip flexor strains.

Indications/Rationale: large or total hamstring rips hip flexor strains, or functional limitations felt amenable to treatment. surgical procedure. Typically, there are severe or total hamstring rips. need to be repaired surgically to aid in healing.

Other of Hamstring and Hip Flexor Strains

1. Bed Rest

   Bed Rest is not recommended for the treatment of hip flexor or hamstring strains.

    

2. Walking Aid: Cane / Crutches / Walker

   Walking Aid: Cane / Crutches / Walker is recommended for specific mild to severe hip flexor or hamstring strains.

   Indications: Disabling, moderate to severe hamstring or hip flexor strains where the benefits of increased mobility outweigh the hazards of deteriorating condition.

   Indications for Discontinuation: Resolution (e.g., post-operative recovery).

   Rationale: Crutches and canes may be beneficial for acute injuries during the recuperation and/or rehabilitation phase to improve functional status (e.g., from wheelchair to walker to cane).

    

3. Electrical Therapies of Hamstring and Hip Flexor Strains

   Electrical Therapies of Hamstring and Hip Flexor Strains are not recommended for the relief of hip flexor or hamstring strains.

    

4. Transcutaneous Electrical Stimulation (TENS)

   Transcutaneous Electrical Stimulation (TENS) is not recommended for hip flexor or hamstring injuries.

What our office can do if you have Hip Flexor Strains

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.