Hamstring Injury: Management and Prevention

What are hamstring strains and how can we prevent them?

hamstring-2The hamstrings are a group of three big muscles in the back of the thigh which help to extend the leg (pull it backward) at the hip and flex (bend it backward) at the knee. They work hard to propel you forward when you run, pull your leg back as you prepare to strike the ball with your foot and then slow the leg’s forward motion on the follow through.

Hamstring strains are usually due to inadequate warm up, poor flexibility, fatigue or an imbalance in strength between opposing muscles. Hamstrings which are significantly weaker than quadriceps are a recipe for injury. A quick start or strong kick can “startle” or overcome the weaker hamstring and tear it.



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What can we do to prevent hamstring strains?

  • Perform dynamic warm up. Be sure muscles are warm before doing kicking, moving lunges, and quick starts
  • Make sustained stretching for flexibility a habit AFTER practice and AFTER games. The hamstring should be stretched along the line of the muscle and is performed best with hip stabilized, and legs straight.
  • Cardiovascular fitness is important.Tired bodies are injury prone.
  • Perform balanced strengthening and build gradual challenge into dynamic power training.

 Simple Hamstring Strengthening Activities:

  • Lunges (forward, backward or diagonal) – step should be long enough and athlete should sink low enough to engage hamstring.  Do not allow hands on the thigh assisting in standing up.
  • Bent knee bridge up — Lying with knees bent 90,º and feet flexed so heels press against the ground, extend one leg “toward sky” and push sole of that foot straight up by squeezing hip and buttocks of the leg with heel on the ground. Keep hips squarely aligned.
  • Nordic (or Russian) hamstring — Player #1 kneels with upper body straight (hands in “prayer” position or at sides) Player #2 kneels behind, holding ankles securely. Player #1 leans slowly forward as far as he/she can while keeping upper body straight.

To Add Challenge and fun:

  • Lunges – have them hold a ball they pass to a teammate as they lunge or move; (strong players can twist as they lunge and pass a ball down the line for a relay)
  • Lying press up – have them try pressing their “grounded” foot on a soccer ball as they press the other leg up
  • Nordic – count how many seconds they can hold it, have a competition or try it with hands held down and back like Kate Winslett on the bow of the Titanic

A note on injury care: Usually we see mild strains (pulling) of the hamstrings which may not be recognized until cool down. Moderate strains where the athlete feels a pop and immediate pain are more serious. DO NOT have your athlete “run it off.” Ice and compression are recommended. If the injury is not mostly recovered in 24 hours, the player should be evaluated by a physician for a more serious hamstring tear.