MVMNT Physiotherapy

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Recurrent Hamstring Strains

When someone pulls a hamstring, it may often just be the first in a never-ending story of recurrent injuries for years to come. A pulled hamstring for a chess player will have a minimal effect on their life, but a pulled hamstring for anyone who runs can be significantly limiting, and a frustrating injury to recover from.

The Hamstring Complex

The hamstrings are a group of muscles at the back of your thigh. In very basic anatomical terms, the hamstring complex is known as a bi-articular muscle complex, meaning that it crosses and acts on two seperate joints. The hamstrings attach at the ischial tuberosity at the bottom of the pelvis, crosses the back of the hip joint, goes down the back of your femur, crosses the knee, and then attaches to the back of the tibia (shin bone). Due to the bi-articular nature of the hamstring complex, they produce both hip extension (leg going backwards), and knee flexion (bending the knee)

Why do I pull my hamstrings all of the time?

We can train the hamstrings in the gym in order to improve their strength and endurance. We can load the hamstrings in a hip dominant movement, such as a Romanian Deadlift (RDL) or in a knee dominant movement, such as a seated hamstring curl. In the field of play however, the hamstring doesn’t work in this slow, controlled manner. The hamstring helps to propel your body by producing hip extension during sprinting, and also absorbs your bodyweight during heelstrike in running. At high speeds, the hamstrings are producing huge amounts of forces, much greater than during low load, ‘easy’ gym exercises. If someone doesn’t sprint very often, and also has weak hamstrings, then there is a perfect storm to injure your hamstring.

What do I need to focus on to help mitigate future hamstring injuries:

  1. Muscle Strength: Looking at your calf, hamstring, and quad strength is really important. When someone has suffered multiple hamstring injuries, they often fear fully accelerating, and the strength/athleticism of that hamstring may reduce over time and now you have one leg that is much more resilient than the other. Double leg exercises like leg presses and deadlifts are effective for overall strength, but you really need to train with single leg exercises like single leg calf raises and single leg hamstring bridges.

  2. Plyometrics/Ballistic Training: To reduce your risk of injury, you need to be confident jumping and landing on both legs and on a single leg. Plyometric training needs to contain both low amplitude training (ankle-focused) and high amplitude plyometric training (knee and hip-focused). Eventually, this training needs to contain movements in all 3 dimensions of movement: sagittal, frontal, and transverse planes, as this is what is required during sports and exercise.

  3. Microdose Sprint Training: Repetition creates confidence. if you only sprint once a week during your 5-a-side football game, you may never feel fully confident in sprinting. If you add in short, high intent sessions of sprints into your week, particularly in preseason, this can help build resilience in the hamstrings to cope with your sport.

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.