Hamstrings or Lower Back?

14th March 2017
Treating Headaches?
14th July 2017
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Hamstrings or Lower Back?

Femail runner with pulled hamstring

Hamstrings or lower back?

This month we will be looking at one of the most common sports injuries, which often get misdiagnosed. Hamstring strains happen all the time when playing sport, but often the injury is not related to a muscle strain and can in fact be linked instead to the lower back.


How do we differentiate between a hamstring strain and referred pain from the lower back?

One very easy test, which can differentiate between a hamstrings strain and a lower back issue is called “Slump Test”.

In this test we can put the spinal cord and sciatic nerve on a stretch, whilst increasing the hamstrings stretch. First we can compare the feeling between the left and the right leg, by testing each leg separately. Secondly, by keeping the hamstrings on a stretch, but releasing tension in the spinal cord, a reduction in pain indicates a potential lower back or nerve issue, whereas no change in painful symptoms, will indicate a hamstrings strain.


Other ways to differentiate between a potential lower back and hamstrings strain are as follows:


Hamstrings Strain


  • Possible local or widespread bruising
  • Normally local acute tenderness on palpation
  • Pain on resisted knee bend
  • Pain on hamstrings stretch locally
  • Is normally very painful on exercise
  • Ice packs usually relieve the pain during the acute early phase of a hamstrings strain


Lower back/sciatic nerve


  • No relief or increased pain on attempting to stretch the hamstrings, normally felt like an intense toothache sensation
  • More general less specific pain, often sharp or shooting like in nature
  • Pain when attempting to bend to put socks and shoes on
  • Not always painful when doing exercise
  • Ice packs do not usually help relieve pain and in some cases make it worse


There are many other ways a Physiotherapist or healthcare professional can test for whether you are suffering with a muscle strain or a referred neural pain. If you are unsure of what is causing your pain, then you should consult a physiotherapist, so that you can have your injury correctly diagnosed and can follow an appropriate exercise recovery program.