Hamstring strains are one of the most common athletic injuries we see. As with any injury, the goal shouldn't be to simply get out of pain, but to improve confidence and strength of the area in to prevent longer lasting movement compensations (that lead to future injuries) and improve functional performance.
The following progressions are designed to take anyone suffering from a hamstring injury from pain to performance.
1. Static Stretching
An easy, gentle stretch of the hamstring muscle is the best way to initially decrease pain and ensure that muscle tissues are healing in the correct orientation (to prevent future injuries).
While the traditional forward bend is a good place to start, a simple change in positioning can be used to target the hamstring muscle belly vs. the hamstring tendons (back of the knee). Video shows you how to perform, but be sure that you FEEL the stretch move from the back of the knees to the muscle belly.
2. Isometric Contractions
Strengthening exercises should be added in as pain/swelling/bruising decreases. Isometric contractions are a safe place to begin the strengthening process as they allow for muscle activation without going through a full range of motion.
3. Eccentric Contractions
Eccentric contractions are the most effective tool to strengthen and retrain muscles and tendons. The beginner eccentric strengthening exercise for the hamstrings (best for the beginning stages of rehabilitation) is most easily performed with a partner. A more difficult progression will be added later on in the rehab process (see Nordic Hamstring Curls)
4. Military Kicks
With isolated strength gains it’s time to progress to more dynamic and ballistic stretching of the hamstrings with Military Kicks
The next step is progressing to multi-joint strengthening exercise of the hamstring/glute complex. Easily progressed from isometric holds, to concentric contractions, single leg isometric holds, and then single leg concentric contractions
6. Good Mornings
A full body, eccentric hamstrings stretch/strengthening exercise that incorporates fundamental movement patterns (hip hinge).
7. Nordic Hamstring Curls
Nordic Hamstring Curls are an advanced eccentric strengthening exercise. Best performed with partner or weight/bar holding the ankles.
The next step is progressing to standard hamstring rehabilitation into performance training. With isolated strengthening of the hamstring muscle complete, it’s important to incorporate strengthening exercises into full body, functional exercises.
9. Single Leg Deadlifts
Unilateral training is vital in correcting side to side imbalances that occur after an injury. Single leg deadlifts combine, posterior chain strengthening with balance and hip hinging to strengthen the entire posterior chain of muscles.
10. Jump Squats or Lunge Hops
The final stage of the rehabilitation process is plyometric training. Quick eccentric contractions followed by concentric contractionS to produce a powerful movement. There are plenty of ways to take this but these simple movements are some of our favorites as they do not require any equipment and are functional movements that we use in everyday life.
It’s important to note that the exercises described in this article relate specifically to the hamstring. There are almost always contributing factors that play into (deficiencies in core or hip strength, faulty movement patterns, etc). A full rehabilitation plan would incorporate exercises to correct these movement and strength deficiencies as well.
Evolve Performance Healthcare specializes in creating customized conservative medicine and therapeutic to transition our clients from pain to performance.