Hamstring Strain Rehabilitation

A Hamstring Strain is where one or more of the muscles or structures comprising of the hamstring tears and becomes painful and may bruise. The strain can vary in severity and in severe cases may require a period of non-weight bearing or surgery.

The hamstring muscle group compromises of three main muscles; Biceps Femoris, Semimembranosus and Semitendinosus. There are also a few other muscles that aid in different movement's, however, we won’t be focusing on any of these today.

Together, these muscles flex the knee when contracting concentrically (shortening) and help to control the rate of knee extension when contracting eccentrically (lengthening). The hamstring muscle group also helps to aid with hip extension along with the glutes.

So now we know the hamstring muscle groups names and how the hamstring functions, let’s get into how you might end up with a hamstring injury such as a strain.

There are three different types of hamstring strain: Myofascial, Muscle-Tendon Junction (MTJ) and Intratendon. Here we are going to be discussing MTJ Hamstring Strains.

MTJ Hamstring strains often occur when performing high velocity (speed) sprinting or when jumping. Because of this, hamstring strains are common in sports where this is required to do so, such as football, rugby and track and field events. In fact, Hamstring injuries account for 41% of all injuries in track and field athletes.

Now, you might be thinking what puts me at risk of a hamstring injury and a big part seems to be fatigue as you are getting tired towards the end of a training session or event. So much so that the majority of all track and field hamstring injuries occur towards the end of a sprint session.

Now you know why you might sustain a Hamstring Injury, let’s get into how your rehabilitation may look.

Stage 1:

You want to avoid muscle inhabitation and promote tissue healing which means we want to work the muscle but not to the point of major irritation, so we want to avoid high levels of stress. The tissue becomes stressed in a lengthened position and our first stage will avoid loading the tissues in this way. The exercises are hip dominant exercises combined with isometric exercises to achieve that goal of avoiding muscle inhabitation.

Isometric exercises are where you load up the weight so you can’t move it, but you can still attempt maximally without succession.

The exercises we will focus on in stage 1 will be:

• Squats (to a pain-free range)

• Step-ups

• Isometric hamstring curls

And if you’re feeling up to it with the correct equipment you may try:

• Isometric Roman chair with both legs supporting you

You will be aiming to complete these exercises with 10-12 reps with 4-5 sets x 3-4 times per week.

Stage 2:

This stage is going to be a little more challenging, focusing on more hip dominant exercises with an eccentric load and developing more fatigue resistance within the muscle.

The exercises are as follows

• Isometric Roman chair with one leg

• 90-90 Glute bridges

• Isometric Hamstring curls (at an increased length)

• single-legged Romanian Deadlifts

As this stage will include more load, we are aiming for 8-10 reps with 3-4 sets x 3-4 times per week.

Stage 3:

Again, this stage is progressing and building on the load from Stage 2 with further stress on the hamstrings. Also, we start developing eccentric load at the lower portion of the hamstring with more knee dominant exercises.

The exercises for stage 3 are:

• single-legged Romanian Deadlifts with increased weight

• Single-legged Roman chair with load

• Nordic hamstring curls

Again, due to the increased load of these exercises, we are aiming for 6-8 reps, 3-4 sets and aiming to complete these exercises 3 times per week.

Stage 4

This stage is going to aim to increase the eccentric load for the knee dominant based exercises to further stress the muscles and cause further increases in strength levels.

The exercises are:

• single-legged Romanian Deadlifts with increased weight

• Single-legged Roman chair with load and a row

• Nordic hamstring curls

• Flywheel

We are working at higher levels now and working within our maximal capacity and should be achieving 2-6 reps with 2-3 sets and completing this programme 2x per week.

By the end of Stage 4, you should be able to incorporate maximal sprinting and jumping with minimal difficulties. However, some will progress quickly through the stages, and some will be much slower. This is because healing is different for everyone based on a variety of factors such as genetics, fitness levels and nutrition.

The use of recovery modalities such as Sports Massage can be incorporated throughout to help aid in recovery between sessions. Click here to book now!

Remember, this may not work for you as you may be suffering from a different type of hamstring strain. It is best to seek the help of a Sports Rehabilitator, Sports Therapist or Physiotherapist to work with you. This will ensure you are doing the exercises right for you, at the correct stage with good form and technique to avoid further injury.

This blog post is to act as a guide only and is not absolute medical advice for you and your injury. It may help you to see where you are up to with your own personal recovery and see where you need to be getting to ensure you do not return to sports too soon.

Thank you for reading this post about Hamstring Strains!

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