{"id":155122,"date":"2026-07-15T13:23:23","date_gmt":"2026-07-15T13:23:23","guid":{"rendered":"https:\/\/pabau.com\/?p=155122"},"modified":"2026-08-13T10:41:48","modified_gmt":"2026-08-13T10:41:48","slug":"90-90-hamstring-test","status":"publish","type":"post","link":"https:\/\/pabau.com\/nl\/templates\/90-90-hamstring-test\/","title":{"rendered":"90-90 hamstring test"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"90-90 Hamstring Test: Clinical Assessment Template for Physical Therapists\",\"description\":\"Step-by-step 90-90 hamstring test guide with normal values, measurement techniques, and a free downloadable template for physical therapy practices. Learn popliteal angle assessment and clinical interpretation.\",\"url\":\"https:\/\/pabau.com\/templates\/90-90-hamstring-test\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Clinical Assessment\",\"Physical Therapy\",\"Musculoskeletal Testing\",\"Clinical Documentation\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"mainEntity\":{\"@type\":\"DigitalDocument\",\"name\":\"90-90 Hamstring Test\",\"description\":\"A ready-to-use assessment template covering patient details, an equipment checklist, single-leg test instructions, a findings section, and a binary positive\/negative outcome at a 20-degree threshold for standardized hamstring flexibility evaluation.\",\"encodingFormat\":\"application\/pdf\",\"url\":\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/templates\/90-90-hamstring-test\/90-90-hamstring-test.pdf\",\"inLanguage\":\"en\",\"isAccessibleForFree\":true,\"offers\":{\"@type\":\"Offer\",\"price\":\"0\",\"priceCurrency\":\"USD\",\"availability\":\"https:\/\/schema.org\/InStock\"},\"hasDigitalDocumentPermission\":{\"@type\":\"DigitalDocumentPermission\",\"permissionType\":\"https:\/\/schema.org\/ReadPermission\"},\"author\":{\"@type\":\"Organization\",\"name\":\"Pabau\",\"url\":\"https:\/\/www.pabau.com\"},\"datePublished\":\"2026-07-15\"},\"datePublished\":\"2026-07-15\",\"dateModified\":\"2026-07-15\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The 90-90 hamstring test measures hamstring muscle length and flexibility by positioning the hip and knee at 90 degrees and recording the popliteal angle or knee extension deficit.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Normal hamstring length is typically less than 20 degrees of knee extension deficit in adults; deficits over 30 degrees indicate significant tightness requiring intervention.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Measurement requires a goniometer or inclinometer placed at the knee joint, with standardized patient positioning (supine, hip at 90\u00b0) to ensure reliable bilateral comparison.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau lets you document 90-90 results directly in the patient record, track trends across your patient population, and flag results for follow-up without manual file management.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<div style=\"background: linear-gradient(135deg, #E2F2FD 0%, #DFE3FD 100%); border-radius: 16px; padding: 40px; margin: 32px 0;\">\n<h2 style=\"margin: 0 0 12px 0; font-size: 22px; color: #121d36;\">Download your free 90-90 hamstring test template<\/h2>\n<p style=\"margin: 0 0 20px 0; color: #444; font-size: 15px;\">A ready-to-use assessment template covering patient details, an equipment checklist, single-leg test instructions, a findings section, and a binary positive\/negative outcome for standardized hamstring flexibility evaluation in your practice.<\/p>\n<a style=\"display: inline-block; background: #037CD2; color: #fff; padding: 14px 28px; border-radius: 8px; text-decoration: none; font-weight: 600; font-size: 15px;\" href=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/templates\/90-90-hamstring-test\/90-90-hamstring-test.pdf\" target=\"_blank\" rel=\"noopener\">Download template<\/a>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Clinicians assessing hamstring flexibility need a standardized, reliable tool that captures consistent measurements across visits and enables meaningful comparison between limbs. The 90-90 hamstring test meets that need with a simple, evidence-based assessment that takes under 5 minutes yet provides actionable data for treatment planning and progress tracking.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This guide walks you through the test procedure, normal values, clinical interpretation, and how to integrate the assessment into your practice workflow.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What is the 90-90 hamstring test?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-90 hamstring test is a clinical assessment that measures hamstring muscle length and flexibility by quantifying the range available when the hip and knee are positioned at 90-degree angles. The clinician passively or actively extends the patient&#8217;s knee and records the popliteal angle \u2014 the remaining angle at the knee joint \u2014 or calculates the knee extension deficit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Higher deficits, or larger angles, indicate tighter hamstrings. Lower deficits suggest better flexibility.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Why this matters: hamstring tightness contributes to lower back pain, limits performance in running and jumping sports, and restricts hip mobility during functional activities like bending or sitting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This test has demonstrated good reliability across repeated measurements, making it a trusted baseline for monitoring progress.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Also known as: Active knee extension test and 90-90 straight leg raise<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-90 hamstring test goes by several names in clinical literature, which can cause confusion when reviewing research or consulting practice guidelines.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Active knee extension test (AKE)<\/strong> &#8211; emphasizes the active knee straightening component when the patient performs the movement without manual resistance.<\/li><li><strong>90-90 straight leg raise test<\/strong> &#8211; highlights the supine starting position with straight-leg positioning at 90 degrees.<\/li><li><strong>Popliteal angle test<\/strong> &#8211; names the measurement outcome (angle behind the knee) rather than the movement.<\/li><li><strong>Hamstring flexibility test<\/strong> &#8211; the broadest descriptor, used interchangeably in sports medicine and general PT contexts.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Understanding these aliases helps you search the literature, communicate with referring physicians, and locate the assessment in electronic health records (EHR) systems where terminology varies. When documenting in Pabau&#8217;s digital assessment forms, standardized naming ensures your data is searchable and comparable across time and team members.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/downloadable_template_article\/90-90-hamstring-test\/digital-forms.webp\" alt=\"Digital forms\"\/><figcaption class=\"wp-element-caption\"><em>Digital forms<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<h2 class=\"wp-block-heading\">Equipment required for the 90-90 hamstring test<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Treatment table or firm surface<\/strong> &#8211; standard height 18-24 inches; patients lie supine with buttocks near the edge of the table.<\/li><li><strong>Goniometer or inclinometer<\/strong> &#8211; the primary measurement tool; goniometers have two arms pivoting on a center point (place the center at the knee joint, align arms along the shin and thigh). Inclinometers (digital or mechanical) measure angle directly by placing on the shin.<\/li><li><strong>Measuring tape (optional)<\/strong> &#8211; some practices record the linear distance from heel to buttock as an alternative quantification if goniometry is unavailable.<\/li><li><strong>Towel or pillow<\/strong> &#8211; placed under the non-tested knee to maintain hip\/knee at 90\u00b0 while preventing pelvic tilt.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Pro tip: goniometry accuracy depends on correct anatomical landmark identification and joint alignment. Mark the lateral epicondyle of the femur, fibular head, and lateral malleolus lightly with a pen or palpate clearly before each measurement to ensure consistency.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In <a href=\"https:\/\/pabau.com\/industry\/occupational-therapy-software\/\">software built for occupational therapy practices<\/a>, scores from scales like this feed straight into progress notes.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to perform the 90-90 hamstring test: Step-by-step procedure<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Standardized positioning is essential for reproducible results. Here&#8217;s the protocol:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Patient positioning:<\/strong> Patient lies supine with buttocks near or at the table edge. Place a pillow or towel under the non-tested leg&#8217;s knee to maintain that knee and hip at 90 degrees, preventing pelvic tilt or lumbar extension.<\/li><li><strong>Tested leg setup:<\/strong> Flex the tested hip to 90 degrees (thigh vertical, perpendicular to the table). The knee begins at 90 degrees flexion (shin parallel to the ground, perpendicular to the thigh).<\/li><li><strong>Knee extension:<\/strong> Instruct the patient to actively straighten the knee as far as comfortable (active test) OR apply gentle, steady overpressure to the shin to passively extend the knee to the patient&#8217;s end range. Stop at the point of gentle resistance \u2014 do not force the movement.<\/li><li><strong>Angle measurement:<\/strong> With the knee at end range, place the goniometer with the center point at the lateral knee joint. Align one arm along the lateral femur (toward the hip) and the other along the lateral tibia\/fibula (toward the ankle). Read the angle formed \u2014 this is the <strong>popliteal angle<\/strong>. Record to the nearest degree.<\/li><li><strong>Bilateral comparison:<\/strong> Repeat steps 1-4 on the opposite leg. Calculate the <strong>knee extension deficit<\/strong> by subtracting each side from 0\u00b0 (or subtract the measured angle from 180\u00b0, depending on your practice&#8217;s notation). A knee extension deficit is the angle of remaining knee flexion; lower numbers mean better hamstring length.<\/li><li><strong>Document:<\/strong> Record the bilateral angles and the deficit for each side. Note whether testing was active or passive (passive is standard for reliability). Flag any asymmetry (>10\u00b0 difference between sides) for follow-up investigation.<\/li><\/ol>\n\n\n\n<h3 class=\"wp-block-heading\">How to measure the popliteal angle<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The popliteal angle \u2014 the angle formed behind the knee when the hamstring is stretched \u2014 is the key measurement. Goniometry is the gold standard but requires proper technique.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Landmark identification:<\/strong> Palpate and lightly mark the lateral epicondyle of the femur (bony bump on the outer knee), the center of the knee joint (just below the lateral epicondyle), and the head of the fibula on the tibia side. These are your anatomical anchors.<\/li><li><strong>Goniometer placement:<\/strong> Center the goniometer&#8217;s protractor at the lateral knee joint. Lay one arm along the lateral femur (point toward the hip); lay the other along the fibula\/tibia (point toward the ankle). The angle between the two arms is your reading.<\/li><li><strong>Inclinometer alternative:<\/strong> Place a digital inclinometer on the anterior tibial surface (shin) with the knee extended. Read the angle directly. This method is faster but may be less precise if the patient moves during measurement.<\/li><li><strong>Intra-rater reliability:<\/strong> Take multiple measurements (typically 2-3) and average them to reduce measurement error. Always use the same measurement tool and anatomical landmarks for consistency across visits.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Normal values and interpretation of results<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Reference norms vary slightly by age, activity level, and population. The table below provides widely accepted benchmarks for adult populations based on clinical literature.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Knee extension deficit<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical interpretation<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Recommended action<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">0-20\u00b0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Normal hamstring length; minimal tightness<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Maintain flexibility with regular stretching; no intervention required<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">20-30\u00b0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mild to moderate hamstring tightness<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Prescribe targeted hamstring stretching 3-5 times weekly; consider hip mobility work<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">30\u00b0+<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Significant hamstring contracture or tightness<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Intensive stretching program; rule out neural tension or structural pathology; consider manual therapy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">>10\u00b0 asymmetry between sides<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Limb-to-limb difference suggests unilateral tightness or hip asymmetry<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Investigate cause (posture, injury history, strength imbalance); address dominant-side differences<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Important caveat:<\/strong> These norms are population-specific. Athletes may show naturally lower deficits (tighter hamstrings are normal); patients with spinal cord injury or stroke may have values outside this range due to spasticity. Always interpret results in clinical context, not in isolation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What does a positive 90-90 hamstring test indicate?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A &#8220;positive&#8221; result (high knee extension deficit or popliteal angle >25-30\u00b0) signals hamstring tightness or contracture. Clinically, this tells you:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Hamstring inflexibility<\/strong> &#8211; the muscle is shorter than the functional range needed for normal movement, increasing injury risk and limiting performance.<\/li><li><strong>Potential pain generator<\/strong> &#8211; tight hamstrings are a known contributor to lower back pain, especially in sitting-heavy occupations, and can worsen pelvic tilt during bending.<\/li><li><strong>Return-to-sport readiness<\/strong> &#8211; athletes with significant hamstring tightness may not be cleared for high-speed running or ballistic activities until flexibility improves, reducing re-injury risk.<\/li><li><strong>Postural adaptation<\/strong> &#8211; chronically tight hamstrings can drive posterior pelvic tilt or lumbar flattening, affecting spinal mechanics and contributing to referred pain patterns.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-90 hamstring test supports clinical decision-making \u2014 it is one assessment among many and does not diagnose a condition on its own. Combine results with clinical history, other mobility assessments, strength testing, and imaging (if indicated) before making treatment recommendations.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related templates<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/templates\/alberta-infant-motor-scale-template\/\">Alberta Infant Motor Scale Template<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/templates\/a1c-conversion-chart\/\">A1C conversion chart<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/templates\/a1c-goals-by-age-chart\/\">A1c Goals By Age Chart<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/templates\/abandonment-issues-quiz\/\">Abandonment issues quiz<\/a><\/li>\n<\/ul>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Ready to streamline your clinical documentation?                <\/h3>\n\n                <p class=\"description\">\n                    Integrate the 90-90 hamstring test into your patient records with Pabau&#8217;s customizable assessment templates. Document results, track trends, and flag follow-ups in one system.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management system dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Clinical applications in physical therapy and sports medicine<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-90 hamstring test is used across physical therapy and sports medicine settings to assess, track, and guide treatment:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Pre-season athletic screening:<\/strong> Sports teams use the test to identify flexibility deficits early and prescribe preventive stretching programs before training load increases.<\/li><li><strong>Post-injury rehabilitation:<\/strong> After hamstring strain or lower back injury, serial testing documents recovery of hamstring length as a clearance milestone for progressive loading and return-to-activity.<\/li><li><strong>Functional restoration:<\/strong> Patients with chronic lower back pain or hip mobility restrictions benefit from hamstring stretching guided by baseline and follow-up 90-90 measurements.<\/li><li><strong>Pediatric scoliosis screening:<\/strong> Some centers include hamstring flexibility assessment in pre-operative evaluation for scoliosis correction, as tight hamstrings can affect spinal posture.<\/li><li><strong>Occupational health:<\/strong> Office workers or laborers with postural strain are assessed for hamstring flexibility as part of ergonomic and injury prevention programs.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Reliability, validity, and psychometric properties<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Clinical adoption of the 90-90 hamstring test is supported by research on its measurement properties. Multiple studies published in peer-reviewed journals including the <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/\" target=\"_blank\" rel=\"nofollow noopener\">Journal of Orthopaedic &#038; Sports Physical Therapy<\/a> and on <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/\" target=\"_blank\" rel=\"nofollow noopener\">PubMed Central<\/a> demonstrate good intra-rater and inter-rater reliability when standardized procedures are followed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Key findings:<\/strong> Intraclass correlation coefficients (ICC) for the 90-90 test typically range from 0.80 to 0.95, indicating excellent reliability. Passive testing (clinician-applied overpressure) shows slightly higher reliability than active testing (patient self-correcting).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Goniometry is the gold-standard measurement tool; inclinometry and tape-measure methods are valid alternatives when goniometers are unavailable but show slightly lower ICC values. The test correlates well with other hamstring flexibility measures, such as straight-leg raise and sit-and-reach, and demonstrates sensitivity to changes in hamstring length over a 4-week stretching program.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Isometric hamstring strength testing at 90\/90: When to use it<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">An important variation practices should know about: the 90-90 position can also be used for <strong>isometric strength testing<\/strong>, distinct from the flexibility assessment described above. Here the patient performs a maximal isometric contraction (pushing against clinician resistance) rather than passively stretching.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>When to use the isometric variant:<\/strong> Post-rehabilitation clearance for athletes, return-to-sport protocols, and strength imbalance detection (comparing limb symmetry index via dynamometry). This requires a handheld dynamometer and is more time-intensive than the flexibility version but provides quantified strength data alongside flexibility baseline.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to use the 90-90 hamstring test template<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The downloadable template above is structured to capture all essential data points from your 90-90 assessment in a standardized format. Here&#8217;s how to integrate it into your practice workflow:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Name and date:<\/strong> Record the patient&#8217;s name and the date of the assessment.<\/li><li><strong>Equipment checklist:<\/strong> Confirm you have a goniometer, a spirit level, and an examination table on hand before starting.<\/li><li><strong>Test instructions:<\/strong> Follow the printed step-by-step positioning and measurement instructions for the leg being tested, recording the thigh angle in degrees at end range.<\/li><li><strong>Test findings:<\/strong> Use the free-text box to note the measured angle and any relevant observations from the test.<\/li><li><strong>Positive\/negative outcome:<\/strong> Select \u201cPositive\u201d if the patient cannot reach within 20 degrees of full knee extension, indicating hamstring contracture. Select \u201cNegative\u201d if they can straighten the leg within 20 degrees of full extension.<\/li><li><strong>Additional notes, assessor name, and signature:<\/strong> Record any further observations, then have the assessor print their name and sign to complete the form.<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">When using Pabau&#8217;s AI-assisted clinical documentation, you can dictate your findings and the system auto-populates this template, saving transcription time. Many practices bill the standalone assessment under 97799 when no more specific evaluation code applies. Results are stored in the patient&#8217;s permanent record alongside prior assessments, allowing you to track hamstring flexibility trends over months and years. That&#8217;s a powerful tool for longitudinal outcome tracking and demonstrating progress to patients.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/downloadable_template_article\/90-90-hamstring-test\/ai-powered-patient-letters.webp\" alt=\"AI powered patient letters\"\/><figcaption class=\"wp-element-caption\"><em>AI powered patient letters<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-90 hamstring test is a quick, reliable, and evidence-supported assessment that belongs in every physical therapist&#8217;s and sports medicine clinician&#8217;s toolkit. Standardized measurement of hamstring flexibility guides stretching interventions, supports return-to-sport clearance, and helps prevent lower back pain and injury recurrence.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use the template above to ensure a consistent, repeatable assessment. Store results in your electronic health record system, like Pabau&#8217;s integrated clinical records, so you can monitor outcomes and build a population-level picture of your patient cohort&#8217;s musculoskeletal health. <a href=\"https:\/\/pabau.com\/book-demo\/\">See how Pabau integrates flexible, customizable assessment templates<\/a> into your practice&#8217;s workflow without adding paperwork.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Looking for other musculoskeletal assessment templates?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/ottawa-ankle-rules-calculator\/\">Ankle injury assessment templates<\/a> follow the same standardized approach to capture fracture-risk data in sports medicine.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Assessing other joint complaints?<\/strong> The <a href=\"https:\/\/pabau.com\/templates\/ac-resisted-extension-test\/\">AC resisted extension test<\/a> uses a similarly quick, single-movement protocol to isolate acromioclavicular joint pain.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need a template for a different regional exam?<\/strong> The <a href=\"https:\/\/pabau.com\/templates\/abdominal-physical-exam\/\">abdominal physical exam<\/a> template captures inspection, auscultation, and palpation findings in one standardized form.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1\"><h3 class=\"schema-faq-question\">What is the 90-90 hamstring test used for?<\/h3> <p class=\"schema-faq-answer\">The 90-90 hamstring test measures hamstring muscle length and flexibility by quantifying the popliteal angle or knee extension deficit when the hip and knee are positioned at 90 degrees. Clinicians use it for baseline flexibility assessment, progress tracking during rehabilitation, return-to-sport clearance, and injury prevention screening in athletic and occupational health settings.<\/p><\/div><div class=\"schema-faq-section\" id=\"faq-question-2\"><h3 class=\"schema-faq-question\">What are normal values for the 90-90 hamstring test?<\/h3> <p class=\"schema-faq-answer\">Normal knee extension deficit in adults is typically 0-20 degrees. Deficits of 20-30 degrees indicate mild to moderate tightness; above 30 degrees suggests significant hamstring contracture. Values vary by age, activity level, and population, so always interpret results in clinical context alongside other findings.<\/p><\/div><div class=\"schema-faq-section\" id=\"faq-question-3\"><h3 class=\"schema-faq-question\">How do you perform the 90-90 straight leg raise test?<\/h3> <p class=\"schema-faq-answer\">Position the patient supine with buttocks near the table edge and the non-tested leg&#8217;s knee at 90 degrees. Flex the tested hip to 90 degrees (thigh vertical), then passively or actively extend the knee as far as comfortable. Measure the popliteal angle at the knee with a goniometer or inclinometer, record to the nearest degree, and repeat on the opposite leg.<\/p><\/div><div class=\"schema-faq-section\" id=\"faq-question-4\"><h3 class=\"schema-faq-question\">What does a positive 90-90 hamstring test indicate?<\/h3> <p class=\"schema-faq-answer\">A positive result (knee extension deficit greater than 20-30 degrees) indicates hamstring tightness or contracture. This can contribute to lower back pain, limit athletic performance, increase re-injury risk, and drive postural compensation patterns. Combine the finding with clinical history and other assessments before making treatment decisions.<\/p><\/div><div class=\"schema-faq-section\" id=\"faq-question-5\"><h3 class=\"schema-faq-question\">What is the difference between active and passive 90-90 hamstring testing?<\/h3> <p class=\"schema-faq-answer\">Active testing (patient straightens the knee themselves) is less reliable but useful for home exercise instruction. Passive testing (clinician applies gentle overpressure) is the clinical standard \u2014 it has higher inter-rater reliability, controls for muscular effort, and is better for tracking serial change during treatment.<\/p><\/div><div class=\"schema-faq-section\" id=\"faq-question-6\"><h3 class=\"schema-faq-question\">How is the popliteal angle measured in the 90-90 hamstring test?<\/h3> <p class=\"schema-faq-answer\">Place a goniometer&#8217;s center point at the lateral knee joint with the knee at end-range extension. Align one arm along the lateral femur (toward the hip) and the other along the fibula (toward the ankle). Read the angle formed \u2014 this is the popliteal angle. Alternatively, use a digital inclinometer placed on the anterior shin for faster measurement with acceptable accuracy.<\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Download your free 90-90 hamstring test template A ready-to-use assessment template covering patient details, an equipment checklist, single-leg test instructions, a findings section, and a binary positive\/negative outcome for standardized hamstring flexibility evaluation in your practice. Download template Clinicians assessing hamstring flexibility need a standardized, reliable tool that captures consistent measurements across visits and enables [&hellip;]<\/p>\n","protected":false},"author":77,"featured_media":155121,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"87","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1125,1126,32,4138],"tags":[2820,3087,1973,1382],"class_list":["post-155122","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-musculoskeletal-pain-management","category-physical-therapy","category-practice-management-tips","category-templates","tag-clinical-assessment-template","tag-physical-therapy-assessment","tag-physical-therapy-template","tag-template"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Free 90-90 hamstring test template and normal values guide<\/title>\n<meta name=\"description\" content=\"Normal hamstring length is 0-20 degrees of knee extension deficit. 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