Puranen-Orava Test | Proximal Hamstring Tendinopathy

The clinical assessment of chronic proximal hamstring tendinopathy in athletes is a challenge to sports medicine.

For this reason, Cacchio et al. (2012) evaluated the reliability and validity of the Puranen-Orava test to diagnose proximal hamstring tendinopathy in athletes with the presence of symptoms for at least 6 months. They compared their findings to the clinical diagnosis of an expert physician confirmed by means of MRI and found both a high intra- and inter-rater reliability above 0.8 and moderate accuracy with a sensitivity of 76% and a specificity of 82%.
Due to these values and the fact that this is the first and only study evaluating this test, we give it a moderate clinical value in practice.

To perform the test, the patient is asked to actively stretch the hamstring muscles in standing position with the hip flexed at about 90 degrees, the knee fully extended and the foot supported on the treatment bench.

This test is rated positive if the patient’s familiar symptoms are exacerbated

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other  orthopedic tests that assess for proximal hamstring tendinopathy are:

• Sign of the Buttock
• Bent Knee Stretch Test
• Modified Bent Knee Stretch Test

Cacchio, A., Borra, F., Severini, G., Foglia, A., Musarra, F., Taddio, N., & De Paulis, F. (2012). Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy. British journal of sports medicine, 46(12), 883-887.