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The hamstring index
1Department of Paediatric Orthopaedics, Prince of Wales Children's Hospital, Randwick, New South Wales, Australia.
Insights
This study assessed hamstring tightness in children using three common tests. Results established age-specific normal ranges, identifying significant tightness when specific angle or distance measurements are not met.
Area of Science:
- Pediatrics
- Orthopedics
- Sports Medicine
Background:
- Hamstring tightness is a common concern in pediatric populations.
- Establishing normative data for hamstring flexibility across different age groups is crucial for clinical assessment.
- Previous research has not comprehensively evaluated common hamstring tightness tests in a large pediatric cohort.
Purpose of the Study:
- To assess the limits of hamstring tightness in 369 children.
- To establish age-specific reference values for three common hamstring flexibility tests.
- To investigate correlations between hamstring tightness, ligamentous laxity, and puberty.
Main Methods:
- Utilized three common clinical tests: straight leg-raise, popliteal angle, and touching-toes test.
- Recruited 369 children for the study.
- Analyzed data to determine age-related changes and establish normative limits for each test.
Main Results:
- Established age-specific normal ranges for straight leg-raise (birth: 100°, 1yr: 110°, 5-6yr: 80°), popliteal angle (birth-2yr: 180°, 6yr: 155°), and touching-toes test (minimal variation, < -5cm or <-15cm indicates tightness).
- Defined criteria for hamstring tightness based on age-specific angles and distances.
- Observed less hamstring tightness in girls and a positive correlation with ligamentous laxity, but no association with puberty.
Conclusions:
- Provided age-specific normative data for evaluating hamstring tightness in children using the straight leg-raise, popliteal angle, and touching-toes tests.
- Highlighted the importance of age-appropriate interpretation of hamstring flexibility measurements.
- Suggested that ligamentous laxity, but not puberty, is associated with hamstring tightness in children.
Abstract:
The purpose of this study was to assess the limits of hamstring tightness in 369 children by using three common tests. The straight leg-raise test averaged 100 degrees at birth, increasing to 110 degrees at age 1 year, before decreasing to 80 degrees by age 5-6 years. It then remained constant to skeletal maturity. Hamstring tightness is present if this angle is < 80 degrees in children younger than 2 years. After this age, the limit decreased steadily to plateau at 60 degrees by the age of 6 years. The popliteal angle measured the maximum 180 degrees from birth to age 2 years. This angle then decreased to average 155 degrees by age 6 years and remained steady. An angle < 125 degrees suggests significant hamstring tightness. The touching-toes test showed minimal variation between age groups averaging, 1 +/- 3 cm. Distances reached < -5 cm in children aged up to 6 years and < -15 cm in those older than 6 indicate excessively tight hamstrings. Little difference was seen between sides, although girls demonstrated less hamstring tightness. All tests showed a positive correlation with the grade of ligamentous laxity, but no association with the child's stage of puberty could be detected.