Hamstring Strains: 5 Exercises for Recovery

Hamstring strains occur at high rates in sports which require running and sprinting.One of every 3 injuries in soccer is hamstring strains.  Other sports with high injury rates include baseball, football, and track and field. These injuries can be very frustrating for athletes 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 athletes can back in the game and avoid re-injury.

The hamstrings consist of three muscles: the semitendinosus, semimembranosus, and the biceps femoris. The three muscles originate from a common tendon on the pelvis. The hamstrings cross the hip and knee joints attaching just below the back of the knee. During high-speed running the hamstring muscle is commonly injured as the 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

Research indicates there are 3 types of rehabilitation exercises which assist in recovery from hamstring strains. Agility exercises which involve changes of direction simulating sport movements reduce re-injury rates. These exercises can be initiated early after the acute injury. Trunk or core stabilization exercises are also effective at reducing risk of re-injury.  And exercises which lengthen the injured hamstring can speed up an athlete’s return to play.

The remainder of this article highlights 5 rehabilitation exercises for hamstring strains.  Three of these exercises are intended to progressively lengthen the injured hamstrings.  These are the active hamstring stretch, the “diver”, and the “glider”. Lengthening exercises are performed slowly and through pain-free ranges at first. Aggressive stretching can delay recovery. As the athlete improves, the speed and range of motion of these exercises are gradually increased.

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

Active Hamstring Stretch

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

Cook Hip Lift

Begin by lying on your back with your hips flexed and feet lined up with the shoulders.   Pull the knee of the uninjured leg up to the 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 the other leg. Be sure to achieve the bridge position by extending through the hips, not the 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 by lying on your back with your hips flexed and the feet lined up with the shoulders.  Perform the bridge by lifting both hips from the floor.  Hold the bridge position and alternately walk the feet out away from the body.  It is important to maintain a level pelvis throughout the exercise.  After 2 to 3 steps walk the feet back to the starting position.   Lower the 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 the injured leg with the knee slightly bent. Bend forward at the hip while simultaneously stretching the arms forward. The back should remain flat. The opposite knee remains bent as the hip extends. This exercise should be performed very slowly in the beginning. As a progression, the speed and range of motion can be increased. Typically, 3 sets of 6 to 8 repetitions are performed every other day.

Hamstring “Glider”

Begin from a standing position with one hand holding on to a support. The legs are slightly split. All the body weight is on the heel of the injured (front) leg with the knee slightly bent. The motion is started by gliding backward on the other leg (wearing only a sock) and stopped before pain is reached. The movement back to the starting position is performed with the help of the arms, not using the 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.

Getting Started with Exercise After a Hamstring Strain

Rehabilitation for hamstring strains should begin early after injury. Pain-free agility and trunk stabilization exercise are initiated immediately. Lengthening exercise can be safely performed soon after injury when supervised by 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. The goal is to return the injured athlete 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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