Hamstring injuries

Hamstring injuries are one of the most common sporting injuries & are an injury which many people suffer reoccurrences from due to poor injury management. 



The hamstrings comprise of three muscles:


  • Semitendinosus

  • Semimembranosus

  • Biceps Femoris

  •  Short Head

  •  Long Head

Types of Injury


There are two distinctly different types of hamstring injuries that can be distinguished by different mechanisms of injury – type I and type II strains.


Type 1 

Sprinting related & these injuries most likely occur in the bicep femoris muscle. 


Type 2 

Stretch related injuries that are often seen in dancers or gymnasts.  These injuries may feel less intense to the athlete than a type 1 strain, but they may take longer to heal because of the location and type of injury to the muscle and tendon.  These injuries most likely occur in the semimembranosus muscle.

Risk Factors 

  • Previous injury 

  • Increase age 

  • Height 

  • Ethnicity 

  • Flexibility 

  • Weight/MBI

  • Functional Movement

  • Fascicle length 

  • Quads Strength 

  • Hamstring eccentric strength 

  • Hamstring : Quads ratio 

  • Neuromuscular control 


What to do when you get injured? 


Show the injury some PEACE & LOVE. 


Protection – avoid activities & movements that increase pain during the first few days after injury. 

Elevation – Elevate the injured limb higher than the heart as often as possible 

Avoid Anti-Inflammatories – Avoid taking anti-inflammatory medications as they reduce tissue healing. Avoid icing. 

Compression – Use elastic bandage or taping to reduce swelling.

Education – Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role. 


Load – Let the pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase load.

Optimism – Condition your brain for optimal recovery by being confident & positive 

Vascularisation – Choose pain-free cardiovascular activities to increase blood flow to repair tissues. 

Exercise – Restore mobility, strength & proprioception by adopting an active approach to recovery  


These are really good principles in how to manage your injury, but it is vital you also see a physio for optimum injury management. The physio will complete an assessment & figure out where the source(s) of your pain are. Hip & groin pain can be classified into four main categories.  



Hamstring rehab has gained a lot of attention in recent years among research, physio and S&C communities, on what are the best modes of exercise to rehabilitate the injury and indeed prevent it. 


It is best to adapt a multi-factorial criteria-based approach as we know that there is no singular reason why hamstring injuries occur as factors such as muscle strength/capacity, muscle architecture, biomechanics and training load among others, can be involved. Therefore, rehab should address the most obvious contributory factor(s) to each individual case and whatever performance deficits the athlete presents with.


Rehab Principles 


All of the following must be addressed to insure a successful rehab. 

  • Flexibility 

  • Glutes Strength

  • Hamstring Strength (Isometric, concentric, eccentric) 

  • Hip Dominant 

  • Knee Dominant 

  • Plyometrics

  • Ankle stabilisers

  • Lumbopelvic control 

  • Overall Kinetic Chain 

  • Running Technique & Sprinting 


Prevention or should we say Reduction? 


Hamstring injuries or any injury can’t be totally prevented but we can reduce the injury rates. For hamstrings the main area of research around prevention has come with the Nordic hamstring curl. 


After an initial loading fortnight research has showing that just 8 reps per week may be enough to act as a maintenance phase. This has been implemented most successfully through the FIFA 11+ which has shown up to 60% reduction in hamstring injuries. 

Hamstring injuries are very common in sportspeople & most likely always will be, but the number of incidents can be reduced by effective in season warmups & training. Furthermore, the reoccurrence rate & rehabilitation time frame can be reduced by following a multi-factorial approach as discussed above. 


Take home messages, ensure you manage your training load effectively, perform hamstring strengthening training & sprint regularly. 

These are really good principles in how to manage your injury, but it is vital you also see a physio for optimum injury management. The physios at Active Motion Physiotherapy are equipped to complete an assessment, figure out where the source(s) of your pain are, and prescribe the correct treatment to manage your injury and pain.  Book your appointment today.

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