How To Prevent Hamstring Injuries

Hamstring strains are a common injury in sports. We see these injuries in athletes who participate in track, soccer, football, tennis, lacrosse, baseball, field hockey, basketball and more. This article will cover how the hamstrings get strained and how to train to prevent hamstring injuries.

Hamstring Anatomy

The hamstring muscles are the group of muscles that covers the back (posterior) part of your thigh. As a group, they cross both the hip and knee and primarily perform the actions of hip extension and knee flexion. Three muscles actually make up the hamstring group: the semimembranosus, semitendinosus and biceps femoris. 

What Is A Hamstring Strain?

In basic terms, a strain (also called a pulled muscle) is when a muscle is overstretched or torn. There are varying levels of injury, but the most common are relatively minor. The most frequently used criteria for diagnosing hamstring strains is a grading scale from I-III.

• A grade I strain is mild and likely to recover quickly.

• A grade II strain is more significant. It is more appropriate to think of this as a slight muscle tear.

• A grade III strain is a severe tear and/or complete detachment. 

How Does A Hamstring Strain Happen?

We can all picture what an athlete looks like when they strain their hamstrings. The dreaded “pulling up.” Usually while accelerating quickly and/or running at full speed. 

In these instances, the hamstring is usually injured at the point of maximal stretch. During sprinting (as the leg travels in front of the body), the hamstring has to lengthen over both the hip and knee. 

Recall above that we said the hamstring creates hip extension and knee flexion when it shortens (concentric contraction). This also means it controls hip flexion and knee extension as it lengthens. The recipe for a strain is high velocity, high force in a stretched position.

Check out this slo-mo video of some world class sprinters. Pay close attention to the point when the foot is farthest in front of the body. This is a position that can put a lot of stress on the hamstrings.

You can also imagine why you could strain your hamstring if you are caught in an awkward position during a contact sport or during a sport like gymnastics. 

What To Prevent Hamstring Strains?

If you have already injured your hamstring, it is important to seek out the right Physical Therapist. These can recur and become a long term problem if not dealt with correctly. 

In terms of prevention, there are a few important things we want to do:

• make sure to have good hamstring mobility and flexibility

• get hamstrings really strong (training needs to be challenging and force adaptation)

• train hamstrings in multiple hip and knee positions 

• ensure proper warm up and recovery protocols 

Hamstring Flexibility Training

Let’s start with flexibility. In general, flexibility is a bit overrated in my opinion. There is obviously value in being mobile, but don’t spend too much of your time stretching. Stretching hasn’t been shown to be very effective at increasing range of motion in any durable way and also doesn’t seem to do much from an injury prevention standpoint. 

With that said, dynamic warm ups and more active stretching can have a place in an injury prevention program. Here are a couple of exercises we use with our athletes to warm up and work on improving/controlling the mobility of the hamstrings. 

World's Greatest Stretch

This is an excellent full body dynamic warm up and can really help get your hamstring loose.

Active Straight Leg Raise with Band

This is a more isolated dynamic stretch for the hamstrings. We use this a lot to reintroduce stretching after a hamstring injury.

How to Train Hamstring Strength

To handle the forces of sprinting, running, jumping, cutting, etc. the hamstrings need to be strong. As with any strength training, exercises need to be challenging enough to appropriately overload the muscle and force adaptation.

Eccentric exercises are a great way to make sure we are challenging the hamstrings. Muscles can create more force during an eccentric (lengthening) motion, than during a concentric (shortening) motion. Think of the classic idea of “negatives” in strength training. So, if we can incorporate near maximal eccentric strengthening exercises, we are likely to get a lot of good bang for our buck.

The Nordic hamstring curl is a great example of a near maximal eccentric hamstring exercise. This is a commonly researched exercise that has been show to prevent hamstring strains. 

Nordic Hamstring Curl

This exercise is a staple in our hamstring injury prevention and rehab programs. It is well researched and has been shown to reduce hamstring injuries if done consistently.

Here are a few more exercises we use a lot with our athletes to strengthen hamstrings and decrease risk of injury. These work on not only eccentric movements, but also concentric and isometric contractions. 

Bridge Walkouts

These are a great exercise for the early phases of rehab. We use this to challenge the hamstrings at different knee angles.

Slider Hamstring Eccentrics

This is a progressed version of bridge walkouts. You can increase the challenge by keeping your hips up and curling back in after you extend your knees.

Romanian Deadlift

A classic deadlift variation that is very challenging for the hamstrings.

Single Leg Deadlift

Same concept as the Romanian deadlift, but on one leg to challenge balance and core strength more.

Train The Hamstrings In Multiple Positions

Another important concept to keep in mind is that you want to train your hamstrings in multiple hip and knee positions to make sure you are ready for anything.

To make sure your hamstring strength is well-rounded, think about working in at least two different types of training. 

• Hips fixed with knees moving (Nordics, bridge variations above)

• Knees fixed, hips moving (deadlift variations)

This is certainly not the only way to think about training the hamstrings, but it helps make sure you are not neglecting a major function of the muscle group. You want to train the function of the hamstrings at the hips and knees, train through a full range of motion and with multiple types of muscle contractions (eccentric, concentric, isometric).

A Final Though About Warm Ups

Warm ups are also an important part of the injury risk reduction picture. 

These don’t have to be complicated.

In general, you want to think about a few things when warming up:

• maintaining and/or improving mobility

• working on movement quality

• increasing core temperature, readiness, heart rate, etc.

• priming movement patterns that will be used in that session

For the hamstrings specifically, many of the exercises we have already covered take care of the first two bullet points. Below are some examples of more dynamic hamstring specific warm ups to work on the other points. 

A-Skip

The hamstrings are challenged with high speed running so including running and sprinting drills in your training is a good idea.

B-Skip

This is a great way to work back into full running strides after a hamstring injury.

Frankenstein Drill

A classic hamstring warm up drill for field sport athletes.

Squat To Hinge Drill

A great way to warm up your hamstrings before squatting or deadlifting.

Like most things, reducing the risk of hamstring strains takes consistent dedication and the right training program. These exercises are a good place to start, but no program is one size fits all.

 If you need help recovering from a hamstring injury or improving your readiness for an upcoming sports season, let us know. Click HERE to check out our services for youth athletes and book a free discovery call.