Narrative review by Noonan and Garrett synthesizing the biomechanics, histology, diagnosis, and treatment of muscle strain injury — asking what the evidence supports for every phase of management from acute injury through return to sport.
When a sprinter pulls up acutely during the swing phase of gait, suspect hamstring strain at the myotendinous junction — diagnosis is clinical, MRI is reserved for diagnostic uncertainty (e.g., ruling out DVT in a swollen calf) or severity assessment in professional athletes.
Advance rehab only after swelling resolves, hold NSAIDs beyond 2–3 days, and don't clear return to sport until the athlete reaches 80% of contralateral isokinetic strength with a full warm-up protocol in place.
Narrative review by Noonan and Garrett synthesizing the biomechanics, histology, diagnosis, and treatment of muscle strain injury — asking what the evidence supports for every phase of management from acute injury through return to sport.
When a sprinter pulls up acutely during the swing phase of gait, suspect hamstring strain at the myotendinous junction — diagnosis is clinical, MRI is reserved for diagnostic uncertainty (e.g., ruling out DVT in a swollen calf) or severity assessment in professional athletes.
Advance rehab only after swelling resolves, hold NSAIDs beyond 2–3 days, and don't clear return to sport until the athlete reaches 80% of contralateral isokinetic strength with a full warm-up protocol in place.