The Recognition, Utilization Rates, Barriers, and Application Accuracy of the Hamstring Strain Clinical Practice Guidelines.
Edward Mulligan, Liana Wooten, Tara Dickson and 2 others
PMID 40041536WHAT IT FOUND
Most sports physical therapists know the hamstring guidelines and find them useful, but only 56% actually use them.
The main barrier is not time or access, but a feeling that the guidelines ignore their clinical expertise and autonomy.
Key findings
01While 90% of respondents knew how to access the guidelines, only 56% had read, reviewed, or integrated the recommendations into their clinical practice.
02Perceived threats to provider autonomy and lack of interest in the content were the only significant barriers explaining why therapists used the guidelines less frequently.
03Therapists frequently performed assessments and treatments not strongly recommended by the guidelines, such as routine range of motion checks and soft tissue mobilization.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was small (n=106) and consisted of highly specialized, experienced sports physical therapists, so findings may not apply to general practice PTs or other disciplines. The survey used a convenience sample of AASPT members, which introduces selection bias toward those already interested in sports physical therapy. The study relied on self-reported behavior and vignettes, which may not reflect actual clinical practice. The survey tool was developed by a single author with 40 years of experience, and while face validity was checked, it was not a standardized psychometric instrument. The study did not measure patient outcomes, so it cannot determine if guideline adherence improves recovery.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that the guidelines are ineffective or poorly designed because only 56% of respondents integrated them. The low utilization rate was driven by therapists' preference for clinical autonomy and interest levels, not by the guidelines' lack of utility or evidence quality, which were rated highly by the same respondents.