Hamstring injuries – A physiotherapist’s perspective

The hamstrings are an incredibly strong group of muscles (biceps femoris, semitendinosus and semimembranosus) that run at the back of the thigh, between your hips and knees, and are responsible for explosive movements (think running, jumping, kicking and climbing). Specifically, movements which require any flexion of the knees engage the hamstrings. Injuries to the hamstrings happen when the tendons or muscles are stretched beyond their limits, usually when performing sudden or explosive movements.

Hamstring injuries can largely be attributed to mis-information. Oftentimes, a minor hamstring pull/strain can be resolved in a couple of days with proper rest. In no time, we find ourselves back on the court again. However, we tend to neglect that hamstring injuries are usually indicators of poor lumbopelvic stability, which refers to the synergy of the core, glutes and hamstrings. Strong lumbopelvic stability is important in explosive movements such as jumps, sprints, lunges and kicks. When performing these movements, a weak core or glutes may result in the overcompensation of the hamstrings, leading to higher risks of over-fatigue and injury. Thus, while a minor hamstring injury might not seem like an issue, it is indicative of poor overall strength, which if ignored will definitely cause further problems.

Another major misconception is that resting and stretching out a hamstring injury is sufficient for return to sports. While these are important, we often fail to acknowledge that the injured muscle is weakened from the long period of inactivity. Without proper strengthening, putting the body right back into the demands of the sport is likely to once again put you out injured on the sidelines, this time probably for far longer.

Especially in semi-professional or casual athletes, improper understanding and implementation of recovery programmes often drastically increase the risk of future injuries. Gradual strengthening is key to full recovery.

Hamstrings strengthening exercises are thus crucial in any training/recovery programme, and should be incorporated together with stretches. Here I have 8 of my favourite basic and intermediate exercises which target the lumbopelvic system (core, glutes and hamstrings), providing you with the strength and flexibility you need.

How do I know if I require Hamstring exercises?

Every athlete, from a casual runner to a seasoned professional can benefit from these exercises. If you’re recovering from a recent hamstring injury, or suffer from weak/tight hamstrings, you will especially need these exercises!

What equipment do I need?

All exercises can be done at home/gym with just a mat and a dumbbell (or any weight).

How often should I do Hamstring exercises?

Ideally, you should include two hamstring strength workouts into your weekly training regime, each time picking 3 strengthening and 3 stretching exercises.

Why do I need to stretch?

Flexibility is often neglected in strength workouts, yet is also crucial in both performance and injury prevention.

Where can I find more detailed information on these exercises?

This guide is meant to be a “prescription” for those who are already familiar with the exercises. If unsure, you can find videos of these exercises on our instagram page @cityosteophysio and on our website www.cityosteophysio.com. Also do remember to consult your physio if you have any doubts or questions.

Stretching exercises:

  1. Standing hip flexor
  2. Hamstring stretch
  3. Adductor stretch

Strengthening exercises:

  1. Glute bridge
  2. Hamstring bridge
  3. Deadlift
  4. Single-leg RDL
  5. Sideplank clamshells

Hamstrings strengthening exercise Hip Flexor Stretch

Hip flexor stretch

  1. Start in a lunge position, right leg forward and left behind
  2. Keep a neutral spine and core engaged
  3. Lean forward onto the right leg
  4. Bring left arm overhead and towards the right and hold in position
  5. Feel the stretch at the front of the left hip

Hold 20s, 2- 3 sets

Repeat the other side

Hamstrings strengthening exercise Hamstring Stretch

Hamstring stretch

  1. Stand with right leg in front of the left
  2. Keep right knee straight and point the toes towards you
  3. Maintain a neutral spine as you hinge your hips
  4. Place your hands in front of the knee and hold in position
  5. Feel the stretch at the right hamstring and calf

Hold 20s, 2- 3 sets

Repeat the other side

Hamstrings strengthening exercise Adductor Stretch

Adductor stretch

  1. Stand with feet wider than shoulder width apart
  2. Shift your hips to the right as you bend the right knee
  3. Keep your left knee straight and feet pressed firmly on the ground
  4. Make sure your hips are not rotated
  5. Feel the stretch at the inner thighs

Hold 20s, 2- 3 sets

Repeat the other side

Hamstrings strengthening exercise Hamstring Bridge

Hamstring bridge

  1. Lie on your back with knees and toes flexed
  2. For the hamstring bridge, position the heels away from your hips
  3. Keep a neutral spine and lift your hips off the floor
  4. You should feel contraction in the core and hamstrings

10 reps, 2-3 sets

Hamstrings strengthening exercise Glute Bridge

Glute bridge

  1. Lie on your back with knees flexed and toes relaxed
  2. For the glute bridge, position the heels closer to your hips
  3. Keep a neutral spine and lift your hips off the floor
  4. You should feel contraction in the core and glutes

10 reps, 2-3 sets

Hamstrings strengthening exercise Glute Bridge

Deadlift

  1. Stand shoulder width apart, knees slightly bent and hold a dumbbell in front of you
  2. Slowly lower your trunk forward, hinge your hips while keeping your knees slightly bent
  3. Lower the weight along your thigh and shin, making sure the weight is close to your body and spine is neutral
  4. Extend the knees and hips as you go back to the starting position
  5. You should feel contraction in the core, glutes and hamstrings

10 reps, 2-3 sets

Hamstrings strengthening exercise Single Leg RDL

Single-leg RDL

  1. Stand on the right leg while keeping the left foot off the floor
  2. Slowly lower your trunk forward, maintain a neutral spine as you hinge your hips
  3. Keep the right knee slightly bent as you reach for the floor
  4. Extend the right knee and hip as you come back to the starting position
  5. You should feel contraction in the core and hamstrings

10 reps, 2-3 sets

Repeat the other side

Hamstrings strengthening exercise Side Plank Clamshells

Sideplank clamshells

  1. Start in a sideplank position with the knees bent 
  2. Keep a neutral spine and lift your hips off the floor 
  3. Rotate the left hip 
  4. Firmly press the right knee on the floor while keeping the ankles together
  5. You should feel contraction in the obliques and glutes

10 reps, 2-3 sets

Repeat the other side