Preventing Hamstring Strains

Hamstring strains are a common sports injury. So far the research has focused mostly on hamstring strengthening exercises, however I believe that maintaining healthy hamstrings requires a multifactorial approach. In order to prevent hamstring injuries one should work on strength, flexibility, posture, and motor control.

Derek Redmond at the 1992 Olympics in Barcelona was a favourite in the 400 m until injuring his hamstring in the semi-final.

According to a recent review all hamstring strains occur during high speed running (Guex and Miller, 2013). While there is some debate over which part of the running stride the injury occurs, Guex and Miller focused their discussion around injuries during the terminal swing phase of the running stride. The terminal swing phase occurs when the lead leg is swinging back toward the body in preparation for ground contact. During this phase the hamstrings are contracting at their fastest while being elongated by 9-12%.

The aftermath of a medial hamstring tear

Hamstring Strength Exercises

Guex and Miller (2013) suggest that the key to avoiding hamstring strains is to perform hamstring exercises at greater than 80% load from about 80 degrees hip flexion. They realize that this is difficult to do in practice, so combining a variety of hamstring exercises may suffice. Some good choices are variations of the deadlift (both bilateral and unilateral), hamstring curl, and pull-through.

The Romanian Deadlift trains the hip extension function of the hamstrings and glutes. This exercise should only be performed with instruction from a qualified trainer.

The Valslide Leg Curl trains the hip extension and knee flexion function of the hamstrings with the glutes extending the hips.   

Glute Strength Exercises

Another viewpoint comes from the works of Vladimir Janda and Shirley Sahrmann. Janda said, “He who treats the site of pain is often lost.” Sahrmann said, “When a muscle is injured, look for the weak synergist.” Both concluded that a weak gluteus maximus led to hamstring dominance. Thus, no matter how strong the hamstrings are they could become strained if the glutes aren’t assisting with hip extension.

The idea of weak glutes coincides with my own experiences. My hamstrings used to be sore for several days after every Monday interval session in grade 12 XC running. Hamstring curls worked for a while, but it wasn’t until I began performing isolated glute training that I began to notice something more permanent. For glute training exercises check out my post The Importance of Developing the Glutes.

Tight Hamstrings

Having short or stiff hamstrings may also lead to hamstring strains. Before you go about overstretching your hamstrings though make sure they’re indeed short. Interestingly, my wife has tremendous flexibility, but her hamstrings often feel tight.

Tight Hip Flexors

Having shortened or stiff hip flexors inhibits the function of the glutes and anteriorly tilts the pelvis. This places both the glutes and hamstrings in a stretched position thereby decreasing their function. Stretching as well as foam rolling of the hip flexors can be performed.

Poor Posture

While muscle activity can have an effect on posture, posture can also have an effect on muscle activity. I won’t elaborate too much on how to use this method as I’ve just recently started performing postural drills on myself. If you have an anterior pelvic tilt, spending time in a neutral spine position can decrease the tension in the hip flexors while restoring it to the hamstrings and glutes. In addition, the hamstrings and glutes no longer have to work from that stretched position.

Poor Motor Control

Gray Cook – creator of the Functional Movement Screen – has done a lot to teach us about muscle coordination (i.e. motor control). When we develop an anterior pelvic tilt it causes us to shift our weight forward leaving us with the lower back, hamstrings, and/or calves feeling tight. This would give us a poor active straight leg raise and toe touch pattern. Fix the dysfunctional pattern and these muscles magically get longer.

Leg Lowering Progression (not sure why this wouldn't embed)

In summary, preventing hamstring injuries is a multifactorial approach involving strength, flexibility, posture work, and motor control training.

Stay fit,

Jonathan Pratt

Pratt's Pro Fitness