If you're not terrified of pulling a hamstring, you should be. Hamstring strains are one of the most common injuries in all of sport and can be disastrous to an athletic career. A pulled hamstring can sideline an athlete for weeks, even months, and can haunt him for his entire career.
In this post, we'll show you how to avoid a hamstring injury before it happens and how to rehabilitate a pulled hamstring and get back on the field more quickly. We'll also show you the necessary training steps to decrease the likelihood of more severe future hamstring injuries.
Anatomy of The Hamstrings:
The three muscles that make up the hamstrings (Semitendinosus [ST], Semimembranosus [SM] and Biceps Femoris [BF]—long and short head) are the most important muscles contributing to athletic performance in the body. These three sleeper muscles help extend the hip, which translates into horizontal movement.
Degree of Hamstring Strain:
The degree of a hamstring strain will ultimately determine how much time an athlete will need to fully recover from the strain. Here's what the research is telling us:
Grade I/Mild: Pain but no loss of strength
- Time Lost: 17 ± 10 days
Grade II/Moderate: Loss of strength and pain with resisted contraction
- Time Lost: 22 ± 11 days
Grade III/Severe: Rupture of muscle and complete loss of strength and function
- Time Lost: 73 ± 60 days (10)
Research has shown that the majority of hamstring injuries are classified as grade I and II strains. Grade III strains account for only 1% of all hamstrings strains. Research indicates it’s unlikely that an athlete will completely rupture his hamstring (1).
Which Muscle is Most Susceptible:
Biceps Femoris (BF):
The BF is the most commonly injured hamstring muscle (2,3). Researchers found that during sprinting, the long head of the BF experienced a peak strain 2.3–3.3% greater than that of either the SM or ST. This shows that damage after an eccentric contraction isn’t simply a function of peak muscle force, but is due to the magnitude of the strain experienced by the muscle.
When A Hamstring Pull is Most Likely To Occur:
Hamstring strains usually occur in the terminal swing phase during sprinting—i.e., just before the foot contacts the ground. This is when the hamstring is near maximum length (3,4,5,6,7). The hamstring eccentrically contracts to decelerate the leg and must, within fractions of a second, produce a rapid, forceful and violent concentric contraction to propel the athlete forward. It’s during the elongated eccentric contraction that the hamstring is most vulnerable.
The length-tension relationship describes a musclo-tendon unit's ability to generate force at various muscle lengths. Typically, muscles are able to generate the most amount of force at resting lengths, i.e. not overly stretched or compressed. As muscle lengths increase, they produce less force. As we've learned; however, muscles do not remain static during sprinting and are placed under heavy demand during the phases of sprinting.
Changing the Length-Tension Relationship:
The ability to manipulate a muscle's length-tension relationship is key to preventing injury and improving performance. If the hamstring muscles are able to product more force at longer lengths, they will ultimately be more durable and powerful.
Research has shown that eccentric hamstring exercises, similar to Eccentric GHRs, are able to shift the optimum angle of human muscle to protect the muscle’s architecture against continued eccentric exercise (8). This shift could lead to more muscle fibers being packed in parallel, which would subsequently increase the muscle’s ability to generate force. Research has also shown that, after eccentric exercise, the optimal length of tension development can be shifted to longer muscle lengths. This resulting adaptation may provide better structural stability for the hamstring muscles at longer lengths, which would help reduce the rate of injury and dramatically improve performance (9).
Pulled Hamstring Recovery:
Unfortunately there is no magic bullet to help with hamstring recovery. R.I.C.E (Rest, Ice, Compression, Elevation) is the primary course of action for most competitive, non-professional athletes. Time is really the most important component as hamstring reinjury rates are high because athlete's "feel okay" and attempt too much, too soon. Even if the hamstring feels ready for action after a pull, it's likely that the muscle(s) will need more time to fully recover.
Gradual Reentry to Hamstring Training:
As mentioned above, trying to do too much too early is the primary cause of hamstring reinjury. Therefore, hamstring strength training should be introduced in a progressive, graduated manner. Here are three exercises to help rebuild strength before returning to more sports specific movements like glute ham raises or RDL's (Romanian Dead Lifts).
- Hamstring Flexion: Begin by laying on your stomach and working on bringing your heel to your butt. The movement should be slow and controlled. As you build strength, focus on Doris flexing your toes at the bottom of the movement. Add an elastic band to increase the difficulty.
- Chair Drags: Sit on a chair with wheels and work on puling yourself forward. Start with both feet and gradually transition to one foot.
- Hip Curls: Attach a band to a door knob and lay on your back with the top of your head pointed towards the door. Flex your hip as high as possible, keeping your knee straight. Attach the band to your ankle. Keeping your leg straight extend your foot towards the floor in a controlled manner.
When you're able to do these exercises without pain. You can move to more dynamic and sport specific exercises.
Incorporating a solid hamstring protocol into your training routine is the best way to avoid a hamstring injuries before they happen. Additionally, proper progressions will not only decrease the likelihood of injury, but dramatically improve performance.
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