Hamstring Injuries : Prevention - Rehabilitation Part 1

Hamstring Strain Exercises

The following strengthening exercises for the rehabilitation of hamstring injuries should be done progressively as part of our hamstring strain rehab program.

Hamstring rehabilitation exercises

The following is for information purposes only. We recommend seeking professional advice. Below are a number of progressively more difficult hamstring exercises. They should always be done pain free. Where you start and how fast you progress will depend on how bad your injury is and how long ago it was injured.

Isometric contractions

The athlete lies on their front in the prone position.  The partner or therapist provides resistance as the athlete contracts the hamstring muscles, holds for 3 or 4 seconds then relaxes. The angle of knee flexion is changed and the exercise repeated. Once a range of angles have been worked the whole process is repeated with the foot first turned first inwards then outwards. This exercise targets the inner and outer hamstring muscles at varying angles of flexion or knee bend.

Standing knee flexion

The athlete stands on one leg and bends the other one using gravity as resistance. This can be done gently and slowly to start with as an early stage exercise. Aim for 3 sets of 10 repetitions once a day building to 4 sets of 20 reps. Ankle weights can be used to increase the load further. As the athlete returns to running this exercise can be performed more explosively.

Hamstring catches

The leg is allowed to fall and the hamstring muscle catches the leg before it falls to the horizontal. It may take a while to get used to this one. The athlete must stay relaxed as the leg falls under the influence of gravity and only contracts the hamstring muscles to prevent the foot landing. This starts to work the muscles eccentrically with a very light dynamic training effect.
This should be done pain free both during, afterwards as well as the next day. A little bit of natural muscle soreness the following day is OK but if it is uncomfortable then take a step back. Again begin with 1 set of 10 reps and build up each day to 3 sets of 15 reps. An ankle weight can be used to increase the load on the muscle.

Bridge exercises

The athlete lies on their back, knees bent and pushes the hips upwards to work the gluteual miuscles and hamstrings. Use both feet on the floor pushing up to begin with. Hold the position briefly and then lower. Begin with 3 sets of 8 reps building to 3 sets of 12 reps then progress the exercise to single leg bridges.
Single leg bridges are done in the same way ensuring you squeeze the gluteal muscles and aim to maintain a straight line from the shoulder on the ground to the knee at the top point of the exercise. Again, begin with 3 x 8 reps and build up.

Seated hamstring curl

This is a deceptively difficult exercise which works the hamstring muscles specifically in a very contracted close range of movement.One end of a resistance band is tied to a fixed point or held by a partner and the other end secured to the foot. The athlete pulls the heel into the buttocks contracting the hamstring muscle to do so. Aim for 3 sets of 8 reps to begin building up to 3 sets of 12 or 15.

Single leg hip extensions

This is a more advanced version of a bridge. Using a step or box the athlete rests on their elbows and alternates each leg putting the heel down on the floor maintaining good core stability. It is important to keep the hips and shoulders still. As the heel touches the ground the gluteal muscles and hamstrings have to work isometrically to keep the body stable. This also works the hamstring muscles in a similar position as they are in when sprinting or accelerating.

Single leg ball pick up

This is another deceptively difficult hamstring exercise which looks easy at first glance. However with this one it is important to judge muscle soreness the next day before over doing this one. It works the hamstring muscles in a very stretched position, particularly the muscle fibers nearer the buttocks.
The athlete places on foot in front of the other and bends down to pick up the medicine ball. They then repeat the movement to put the ball back down. Repeat this 5 to 10 times.

Lunge with ball

A basic lunge is performed while holding a ball to aid balance. This exercise strengthens the glutes, hamstring muscles and quadriceps muscles. The athlete stands with the injured leg a wide stance in front of the other. Holding a medicine ball close to the chest the weight is shifted onto the front leg and back knee bent dropping it down to the floor.

Good mornings

Another deceptively difficult exercise which looks easy but checking the level of muscle soreness the next day is important before doing to many of these is important. This exercise is a more advanced version of the single leg ball pick up and works the lower back and hamstring muscles eccentrically, especially the fibers towards the top of the thigh. The athlete bends forwards at the waist keeping the back straight. This also works the hamstrings as they stretch..

Norwegion leg curl

One of the most advanced hamstring exercises. The athlete kneels down while the therapist holds the ankles. They then slowly lean forwards as far as they can under control using the hamstrings to resist the forwards movement. A super advanced version of this is to use the hamstrings to curl back up again.
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