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Rehab for Hamstring Pulls and Strains (Part 4)

You are here: Home / Training / Injury Prevention / Rehab for Hamstring Pulls and Strains (Part 4)
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September 15, 2011 by Jimson Lee 4 Comments

Last Updated on March 11, 2013 by Jimson Lee

Part 1 started with the article Hamstring Injuries, the Iliopsoas and Imbalances.  Part 2 was titled Controversial Hamstring Workout for Rehab (Part 2).  Part 3 was titled More on Stretching and Movement (Part 3)

So this is Part 4 of Part ?… Thoughts of Lyle McDonald somehow come to mind…

You know that silly expression, “Once a cheat, always a cheat”?  Same rule applies with hamstring pulls. 

Once you pull or strain it, the chance for re-injury is high.  But it doesn’t have to be that way!!!  There are several reasons for this.

Recurrence in Hamstring Injuries

First question, why do we reinjure our hamstrings?  (we talked about why we injure it in the first place)

I have several theories, and none are proven:

  1. adaptive changes in stride biomechanics
  2. decreased flexibility of the muscle tendon unit (MTU) as well as reflex inhibition
  3. decreased strength (absolute, elastic, speed strength, etc) on the muscle as well as surrounding musculature
  4. decreased tensile strength (tensegrity) in scar tissue of muscle and/or fascia
  5. blah blah blah (any Ke$ha fans out there?)

In Part 2, I mention briefly about hamstring injuries occurring during “backside mechanics” and a reader (Mike) made a good point in the comments about this. Hamstring injuries from the running cycle standpoint usually occur in the late forward swing of your stride and the push off (some researchers call this the “toe off”, but I dislike this term, because you don’t run on your toes. There is, however, force applied during contact time and that includes your toes)

See also  Catch-22: Electrical Muscle Stimulation Benefits

Why is this the case? Because in this phase of the cycle, the hamstrings decelerate hip flexion and knee extension resulting in large eccentric loads. (look up the definition if eccentric contraction, and you’ll know why)

So before I get into Specific Exercises for rehab, we need to look at the entire Injury Life Cycle Chart and the progressive steps required to get “back on track”.

Injury Life Cycle Chart

vicious-achilles-cycle

Logical Steps

NOTE: Stretching alone is not sufficient! So here are my first 3 goals in rehabbing the hamstrings:

  1. restore health
  2. restore ROM (range of motion)
  3. restore strength

And here are my 6 steps that I prescribe to my athletes for proper rehabilitation of a hamstring injury

  1. Initial treatment
  2. Restoring ROM
  3. Initial strengthening
  4. Low-velocity eccentric strengthening
  5. High-velocity eccentric strengthening
  6. Sport-specific progressions

Specific Exercises

Here is a sample of exercises that we do, but you can come up with a lot of variations, depending on your weight room or physio clinic.

  1. hamstring stretch
  2. RDL
  3. Nordic hamstring exercise
  4. hamstring bicycles (with foam rollers, physio ball)

You can check out the series on How to Improve Acceleration Part 6 as I discuss a lot of these same exercises

I hope this series of articles helps you (or your athletes) get back on the track as soon as possible from this unfortunate injury!

Category iconInjury Prevention,  Masters,  Recovery,  Track & Field,  Training,  Weight Training Tag iconFascia,  Hamstring Pulls

About Jimson Lee

I am a Masters Athlete and Coach currently based in London UK. My other projects include the Bud Winter Foundation, writer for the IAAF New Studies in Athletics Journal (NSA) and a member of the Track & Field Writers of America.

Reader Interactions

Comments

  1. paul says

    September 17, 2011 at 1:19 am

    How would you treat sciatica nerve aggrivation?
    Apparently you can detect a sciatica nerve injury by laying on your back and having someone lift your leg up straight until you feel the stretch, and then they bend your toe towards you. This is supposed to cause excruciating pain if you have a sciatic nerve injury?

    Reply
    • Jimson Lee says

      September 18, 2011 at 12:14 am

      @paul – honestly? I would go to the UKA HPC in North London and make an appointment to see Gerry Ramogida. Tell him I sent you, and you can get in. He’s the best out there (at least whilst in Canada, and now he’s with UKA!!!)

      Reply
  2. paul says

    September 18, 2011 at 12:27 am

    Thank you very very much! I wll do this first thing Monday.

    Reply
  3. Jimson Lee says

    October 17, 2011 at 8:23 am

    we also added Good Mornings and Reverse Hyperextensions to the routine… an RDL is a Romanian Dead Lift

    Reply

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