During a martial arts demonstration a 16-year-old black belt taekwondo practitioner heard a popping sound and felt a pull in the posterior upper thigh while performing an axe kick. The axe kick motion involves a rotation and flexion of the trunk assisting in a quick flexion of the coxal joint through a swing phase raising the foot at, or above the practitioners’ head height. The motion is immediately followed by extension of the trunk and the coxal joint accelerating the descent of the foot onto its target. The practitioner experienced the occurrence of the injury at the terminal swing phase. She experienced an immediate onset of pain in the right upper hamstring and an inability to remain in an upright position. Flexion, extension, and medial and lateral rotation of the coxal joint results in pain and significant guarding.

Diagnosis performed by a sports medicine doctor was a secondary hamstring strain injury (HSI) at the musculotendinous junction of the biceps femoris on the ischial tuberosity. Clinical testing ruled out other pathologies. Initial prescription involved RICE (Rest, Ice, Compression, Elevation) protocols while inflammation is present. During the proliferation phase MICE (Movement, Ice, Compression, Elevation) are implemented to increase range of …show more content…
The terminal swing phase is considered the most hazardous as the hamstring muscle-tendon units are at their longest length of the gait cycle and are most heavily activated (Opar et al., 2012, pg. 212). At this point the eccentric contraction of the hamstring muscles elicit a high force to decelerate knee extension and hip flexion. The results of previous studies demonstrate that muscle strain in eccentric contraction is the primary cause of the muscle strain injury affected by muscle strength and contraction velocity (Liu, et al., 2012, pg.