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Hamstring Injuries Part 2

Last time we spoke about hamstring injuries, how they occur and why. Today we will look at how to prevent, treat and rehabilitate a hamstring strain. We talked about the injury occurring at the end of the swing phase during running, when the knee is straightening out. If you recall the hamstrings are placed under an eccentric contraction during this phase, which means the muscle is lengthening but still contracting at the same time. It does this in order to control the pace of the movement.

Often with hamstring injuries it is a weakness/imbalance that is the cause of the problem. Strengthening is therefore our objective during rehab in order to prevent reoccurring injury. As the mechanism of the injury is weakness in eccentric strength we will focus on strengthening the hamstring is this way. Eccentric strengthening has been shown to shift the point of peak torque development towards a more lengthened position, in other words it lets the hamstring operate at a longer length at the same strength, making it less vulnerable to repeated injury.  

Nordic hamstring exercises are a great way to help develop eccentric strength: http://www.youtube.com/watch?v=XGQ7NFG0x3o

Eccentric exercises cause delayed onset muscle soreness (DOMS). It is therefore recommended that adequate recovery time is taken in between sessions.

1.  Week 1 (1 session , 5reps x 2sets)

2.  Week 2 (2 sessions, 6reps x 2sets)

3.  Week 3 (3sessions, 6-8reps x 3sets)

4.  Week 4 (3sessions, 8-10reps x3sets)

5.  Week 5-10 (3sessions, 8-12reps x 3sets)

Other muscles that assist the hamstrings should also be considered during rehab. The gluteal muscles are responsible for hip extension and therefore if strength is inadequate, the hamstrings will be overloaded. Hip strengthening exercises such as the bridge hold will help to strengthen the glutes.

The Bridge Hold: lying on your back, bend knees and place both feet flat on the floor, lift hips up off the floor maintaining a neutral spine and not allowing the hips to drop. Hold for 3secs and repeat 10 times. Contraction should be felt in glutes and hamstring region.

Core strength is essential in hamstring rehabilitation also. Your core helps stabilize your low back and hips (lumbopelvic region) offering a stable and secure platform for the hamstrings to work off. Weakness around the pelvic region can lead to changes in length/tension and force/velocity making it more likely for an injury to occur.

Next time we will progress our hamstring rehabilitation by making it more dynamic and functional. 

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