Hamstring Strains: 5 Important Exercises for Recovery

Hamstring strains occur at high rates in sports that require running and sprinting. One of every 3 injuries in soccer are hamstring strains.  Other sports with high injury rates include baseball, football, and track and field. These injuries can be very frustrating for athletes.  This is because of the long rehabilitation time. Return to sport may take several weeks or 2 to 3 months based on the severity of the injury. Also, nearly 1 in 3 hamstring injuries will recur and many of these happen within the first 2 weeks of returning to sport.  Thankfully, rehabilitation exercises can help get you back in the game and avoid re-injury.

Your hamstrings consist of three muscles: the semitendinosus, semimembranosus, and the biceps femoris. These 3 muscles start from a common tendon on your pelvis. The hamstrings cross your hip and knee joints attaching just below the back of your knee. Hamstring injuries commonly occur during high speed running.  This occurs as your leg is swinging from a bent to an extended position in preparation for landing. During this phase of running, hamstring muscle activity is extremely high to control the length of the muscle.

Hamstring Injury

The Most Effective Approach to Rehabilitating Hamstring Strains

There are 3 types of rehabilitation exercises which assist in recovery from hamstring strains. Agility exercises involve changes of direction simulating sport movements.  These exercises reduce re-injury rates.  Always initiate these exercises early after your injury. Trunk or core stabilization exercises are also effective at reducing your risk of re-injury.  Finally, exercises that lengthen your injured hamstring can speed up your return to play.

The remainder of this article highlights 5 rehabilitation exercises for hamstring strains.  Three of the exercises progressively lengthen your hamstrings.  These are the active hamstring stretch, the “diver”, and the “glider”.  Perform lengthening exercises slowly and through pain-free ranges at first. Aggressive stretching delays recovery. As you improve, gradually increase the speed and range of movement.

Trunk stabilization exercises target your spine, hip, and pelvic muscles.  To reduce your risk of re-injury, it is important to strengthen your hamstrings and all surrounding muscles. Keep in mind, your hamstring muscle group originates from your pelvis. The position of your pelvis during running can influence the length and activity of your hamstring muscles. Increasing the strength of your injured hamstring itself builds resilience and promotes a safe return to sport.

Active Hamstring Stretch

Lie on your back holding your thigh. Your opposite leg remains straight. With your upper thigh in a vertical position, slowly extend your knee.  At the point where a mild stretch is felt pause and hold. The stretch should not be painful. Gentle stretching of your hamstring is helpful for recovery. Aggressive stretching of your hamstring will delay your recovery. Hold this position for 3 to 5 seconds, and then lower your leg back down.  Perform 3 sets of 12 repetitions once per day.

Cook Hip Lift

Begin lying on your back with your hips bent and feet lined up with your shoulders.   Pull your knee of the uninjured leg up to your chest. It is helpful to place a small towel roll or ball in the crease of your hip. Lift your toes off the floor and perform a bridge from your other leg. Be sure to achieve the bridge position by extending through your hips, not your low back. Hold this position for 2 to 3 seconds then return to the starting position. Typically, 2 to 3 sets of 10 to 15 repetitions are performed on each side once per day.

Bridge Walk-Out

Begin lying on your back with your hips bent and the feet lined up with your shoulders.  Perform the bridge by lifting both hips from the floor.  Hold the bridge position and alternately walk your feet out away from your body.  It is important to maintain a level pelvis throughout the exercise.  After 2 to 3 steps walk your feet back to the starting position.   Lower your body back down in a slow and controlled manner between each repetition.  Typically, 3 sets of 6 to 8 repetitions are performed once per day.

Hamstring “Diver”

This exercise resembles a simulated dive. Stand on your injured leg with your knee slightly bent. Bend forward at the hip and simultaneously stretch your arms forward. Your back should remain flat.  Your opposite knee remains bent as your hip extends.  Perform this exercise very slowly in the beginning. As a progression, you can increase the speed and range of motion. Typically, 3 sets of 6 to 8 repetitions are performed every other day.

Hamstring “Glider”

Begin in a standing position with one hand holding on to a support. Your legs are slightly split. All your body weight is on the heel of your injured (front) leg with your knee slightly bent. The motion is started by gliding backward on your other leg (wearing only a sock).  As always, stop just before pain is felt. The movement back to the starting position is performed with the help of your arms, not using your injured leg. Begin slowly in a pain-free range of motion. Progression is achieved by increasing the gliding distance and performing the exercise faster. This exercise requires slightly more recovery between each session. Typically, this exercise is performed 3 times per week for 3 sets of 6 receptions.

Get Started Soon

Your rehabilitation after a hamstring injury should begin as soon as possible. Initiate pain-free agility and trunk stabilization exercises immediately.  Also perform lengthening exercise soon after your injury, but be gentle.  It is best to perform these under the supervised of a licensed physical therapist. The progression of an athlete’s rehabilitation program is based on specific criteria. Your physical therapist will continually assess your injury and progress your program.  Our goal is to get you back as quickly and safely as possible. Contact us today if you have had a hamstring strain or simply have questions about which treatments are right for you.


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