Blog Post Hamstring Strain

Hamstring strains are the bane of existence for athletes involved in sports that require sprinting, high-speed skilled movements and kicking. Recovery time can be significant and often lengthy, with a high probability of recurrence.1 Almost 33% of athletes with a prior hamstring strain will reinjure it within a year!1 Acute strains have been found to be more common in field sports such as football and soccer, during preseason. In the experience of this author, I have also seen hamstring strains happen in high school football players who switch to track and field in the spring. There are multiple risk factors that can be taken into consideration. Although, there is no consensus on the exact hamstring injury mechanism, researchers agree that muscle weakness and balance, lack of a warmup, decreased flexibility, previous injury, and fatigue may play a role.2 Most but not all therapist working with hamstring injuries focus solely on the strain (pathoanatomical viewpoint). However, from a kinesiological perspective, the hamstrings originate from the sacrotuberous ligament into the lumbar spine. In Figure 1 you can see the tendon of the long head of the biceps femoris (lateral hamstring) attaches into this ligament.

Hence, it is reasonable to also assess the lumbo-pelvic-hip complex and not just the quadriceps and hamstrings as a risk factor.3,4 Considering there are numerous confounding factors, besides previous injury history, take into consideration the following:

1. Does the athlete have an anterior pelvic tilt in static posture?

2. Do they have poor squatting and running mechanics?

3. Do they have a lack of flexibility in the hip, knee and ankle?

4. Is their gluteus maximus not so maximus?

Again, it is the experience of this author that upon palpitation or feeling the top and bottom ends of the strained hamstring, both ends are taut and unyielding, but the muscle belly feels yielding.

I have a movement theory about the hamstrings. The upper fibers are closer to the gluteus maximus and are more active in hip extension to assist that muscle in walking, running and sprinting. Whereas the fibers of the hamstring at the knee are more involved in knee flexion. Again, it is just a theory and when both the proximal (top) and distal (bottom) aspects of the muscle become taut or tight, it becomes a tug-of-war with the muscle belly. Why would this be the case?

Hamstring involvement in running

Once mid-stance occurs in running and the hip is extending to accelerate the body forward, the gluteus maximus shortens, along with assistance from the hamstrings to produce hip extension.5 If there is weakness in the gluteus maximus, the hamstrings are put under more stress than normal. The prime mover (gluteus maximus) is not strong enough to accelerate the body forward so the synergists have to pick up the slack. This could be a possible mechanism for a hamstring strain. Chumanov et al, concluded that the swing phase of the running gait, makes the hamstrings more susceptible to strain injury due to the muscles trying to decelerate knee extension.6 Overall, like all muscles, the hamstring dynamically stabilizes the knee, assists in force production in hip extension and deceleration of knee extension.

What do I do to avoid hamstring strains?

First if you are an athlete involved in speed, agility and quickness, find a good strength and conditioning coach that also can speed train. Our staff here at Sports Academy is excellent. Also, have a movement and range of motion assessment completed by our manual therapy staff. Through the assessment process, we can identify areas of improvement in posture, movement, flexibility and strength.

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1 Erickson LN, Sherry MA. Rehabilitation and return to sport after hamstring strain injury. J Sport Health Sci. 2017;6(3):262-270. 2 Hoskins WT, Pollard HP. Successful management of hamstring injuries in Australian Rules footballers: two case reports. Chiropr Osteopat. 2005;13(1):4. 3 Woods C, Hawkins RD, Maltby S, Hulse M, Thomas A, Hodson A. The Football Association Medical Research Programme: an audit of injuries in professional football – analysis of hamstring injuries. Br J Sports Med. 2004;38:36–41. 4 Goldman EF, Jones DE. Interventions for preventing hamstring injuries: a systematic review. Physiotherapy. 2011;97(2):91-99. 5 Ferber, R, Macdonald S. Running Mechanics and Gait Analysis. Human Kinetics, 2014. P. 52 6 Chumanov ES, Schache AG, Heiderscheit BC, Thelen DG. Hamstrings are most susceptible to injury during the late swing phase of sprinting. Br J Sports Med. 2012 Feb;46(2):90.