Hamstring Pull Recovery: The Rehab, Part 3

This is part 8 of a multi-part series on hamstring pulls and rehabilitation.

Click here for Part 1 of Hamstring Pull Recovery: The Rehab. Part 2 can be found here.

I also discussed hamstring pulls in several past articles:

Hamstring Rehabilitation and Running Mechanics, Part 3

Written by Derek Hansen

Week Two

By the end of Week 2, we were in very good shape. The runs were getting faster, and we were moving further out in distance for each workout. By the end of Week 2, we were running out to 30 meters at about 85-90% of top velocity with only very minor extension issues with the left leg. After a number of nights with the athlete wearing the light wrapping with Tiger Balm, along with our continued soft-tissue work before, during and after workouts, it seemed we had turned the corner on any hamstring stiffness or discomfort and his natural stride seemed to return. Now it was a matter of working into maximum velocity and getting a good number of repetitions under his belt so that we could be assured that the hamstring would be ready for the rigors of and duration of competition.

The video clip below shows the athlete at the end of Week 2, with some apprehension still visible in his stride. This was before we had him doing the nighttime wrapping of the hamstring.

Click here for the video on Vimeo.

There are a couple of questions that arise from this scenario. Is the athlete’s stride pattern affected because of weakness or an inability to contract properly? Or, is the stride pattern affected by the pain, irritation and discomfort, resulting in inhibition and muscular coordination issues? I would argue in favor of the latter argument. How do I know this? Well, the evidence is really quite striking. One day, the athlete is obviously struggling with his stride, and the very next day after trying the overnight wrapping process he is running smoothly. The explanation can only be that the muscles were loosened, the tightness dissipated, the pain and discomfort removed, and natural motion and coordination is restored. Is he stronger? Most certainly. But not because he underwent a magical adaptation process overnight. He is simply allowed to be as strong as he should be. The shackles have been removed.

Click here for the video on Vimeo.

Week 3-4

By the third and fourth week of rehabilitation, our goals were to refine sprint mechanics and accumulate a foundation of sprint work to strengthen the hamstring and consolidate technique. The athlete had felt no stiffness or irritation in the hamstring, and his stride pattern looked smooth and unforced. Thus, we were able to assign runs of intensities between 90 and 100 percent of top velocity, over distances of 30 to 60 meters. We also maintained regular hands-on therapy throughout the workout as part of the warm-up routine and in between sets. The manual therapy not only helps to fend off fatigue and keep the muscles supple, but also serves as a psychological boost, letting the athlete know that you are staying on top of things.

Click here for the video on Vimeo.

Speed work with flying 20?s and speed change drills (i.e. fast-easy-fast over 60m) also help to strengthen the hamstring. The stress of the speed changes will not only test the hamstring, but also further enhance it’s abilities to coordinate high intensity flexion, extension and co-contraction. With all of these drills, I emphasize the work of the upper extremities in initiating the speed change. If the arms become lazy, extra stress is shifted to the legs resulting in a higher incidence of fatigue, and possible flaws in running mechanics. The arms help to initiate, steer and assign rhythm. If you are a person that always looks to find a silver lining whenever the injury cloud rears its ugly head, you can sometimes use this time to correct technical problems that may have typically been unnoticed. Experience has shown me that rehabilitation runs are predominantly performed at sub-maximal efforts and lend themselves to technical intervention and refinement.