Hamstring injury happens frequently in running-based sports such as athletics, football, rugby etc. Over 80% of these occur in the outer hamstring when the leg is swinging through.
It is often thought that hamstrings are injured from changes in direction, pushing off and explosive movements but in reality, most hamstring injury happens when the leg is swinging through, just before the foot touches down.
Which Muscles are the Hamstrings?
Here is a quick few stats and anatomy refresher to ground you:
The hamstrings are made up of three muscles
The Biceps Femoris, which has two parts to it. The long head which cross’ both the hip and then knee joint and the short head which only crosses one joint
Semitendinosus that helps with hip and knee rotation as well as knee flexion
And Semimembranosus at the inner thigh that helps with hip extension and knee flexion
What is the cause of Hamstring injury?
Hamstring injury happens when any of these muscles get injured. It usually happens during a sudden strenuous movements which impact one of the hamstring muscles or any of the tendons.
Most hamstring injuries are thought to happen in late swing phase of running, just before the foot lands.
Check out the video below to see how the hamstring works in walking:
As you can see in the video, the hamstrings fire into action before, during and after the foot lands. At this point when the knee is extended, the muscle is working while at it’s peak length and at maximal force development working hard eccentrically to slow leg swing down.
What is eccentric contraction?
An eccentric contraction is where the muscle controls lengthening out, which is far harder on the muscle than a concentric contraction where it contracts to push-off.
Biceps Femoris’ role in Hamstring Injury
The Biceps Femoris long head (BFlonghead) is involved in almost 80% hamstring injuries.(1). So what is the link between the mechanism of hamstring injury described above and BFlonghead taking the brunt of injuries?
Recent studies have shown that the Biceps Femoris is more active when the hip is extending, rather than when the knee is flexing. Which means that BFlonghead has to work harder with eccentrically slowing the leg down as compared to other hamstring muscles.
This also means that exercises performed using knee flexion do not often strengthen Biceps Femoris as much as say Semitendinosus, which is more active in knee flexion where it works to bend the knee
A lot of hamstring strengthening is done at the knee (nordic curls, hamstring curls etc) which has been shown to be more the work of the medial hamstrings than Biceps Femoris.
So there you have it, the BFlonghead of the hamstrings works harder eccentrically slowing down the momentum of the leg swinging forward and often gets missed in strengthening sessions – Stuck between a rock and a hard place!
This gives athletes and health professionals better guidance as to what rehab exercises to add in post injury and also in injury prevention programs depending on injury, leading to decreasing the nearly 30% re-injury rate.(1)
Click here to learn more about hamstring injury and find information about healing faster and stronger from it.
Movements that many of us take for granted at some can become harder with age,weight-gain or injury and it isn’t until we can’t do them that we really appreciate how important they are. Regular strengthening exercises and using the right technique can make the world of difference and give you the freedom you deserve.
A follower of PhysioPrescription emailed me last week asking me what he can do to help him get up off the floor and out of a chair better. Well let me tell you, you are not alone, not by a long shot and there are some easy exercises that you can do to get better at it. It limits our lives so much when we can’t do the simple things like getting put of a chair without a lot of pain and effort, let alone getting off the ground – a lot of people actually just don’t get onto the ground for fear of getting stuck there!
Fortunately, there are some great techniques and easy exercises that you can use to improve these.
We are going to run through
The best techniques for getting up off the ground and out of a chair
Exercises to strengthen the muscle that should be powering you out of a chair or off the floor.
Technique – Lets get the basics right
First of all, you need to be doing it the right way (which is the easiest and most efficient way). If you aren’t, you will just be battling away and wasting energy – potentially leading to injury.
1. Sit – To – Stand
Getting up out of a chair is something that is very, very often done wrong and there are some great tips to improve how you do it.
Lean forward at the hips
Nose over toes
Tip: This technique utilizes your body weight going froward – hence why you need to lean forward so that you nose goes over past your toes. This will start you falling forward, and then all you need to do is push up with your legs to stand up-right.
Note: remember if you are looking down, you might go down, so keep you chest up-right and focus on the top of the wall.
2. How to get up off the floor
The main thing here is to:
Roll onto your side and plant your hands on the floor
push your upper body up, so that your arms and straight
Pivot onto your knees so that your hip comes off the ground – This will get you into four-point kneeling
From there you need to bring one foot forward and plant it – from there you can drive up with that leg.
Watch the video here for a good demo of how to get both down safely and up again:
Exercises to strengthen
Strengthening exercises, when done regularly can make so many daily activities a lot easier. And I don’t mean going to the gym and throwing iron around – There are some great exercises that you can do from home!
Great functional exercise. If you are finding it difficult to stand up out of a seat, then one of the best ways to improve is practice – build up the muscle memory using the correct technique.
sitting down into a chair and standing up again is almost like doing a good squat and you can use the same technique to do it right.
Now, I know that not everyone can start doing this straight away, so I have included two levels:
Level 1: Modified sit-to-stand
Here, we make it easier by adding a pillow or cushion to the chair – This raises up the platform and means less distance for you to go up, making it easier on your legs.
Now, I want you to use the correct sit-to-stand technique I taught you above, to do this exercise. Stand up from the chair, not using your arms (your legs are only going to get stronger by working at it) and then slowly sit back down again using the same technique as when you came up (except in reverse!)
This is a great one for strengthening your posterior chain and is very functional. Remember to make it easier just place cushions, or solid books etc on the chair seat to raise the platform.
Do 3 lots of 10 – that means do ten sit-to-stands, have 1 minute break and repeat 2 more times.
Level 2: full sit-to-stand
This the same as above but without the cushion or pillow to raise it up – you are doing it right onto the chair seat.
tip: to make it harder hold, a small weight in your hands in front of you , start with 1-3kg.
Bridge – increase leg strength, glute activationa dn decrease back pain.
Your extensors (Glutes, back muscles, hamstrings etc) are what really drive you upwards and straighten you up at the hip and torso. This is a great exercise to do to get them working for YOU and the good thing is that it can be done on a firm bed or bench, as well as the ground.
Lying on your back, on the ground, firm bed or bench, bend your knees up and place your feet on the ground.
Pushing through your heels and keeping your back straight, lift your bottom off the ground
Lower down again, in control the entire time
Repeat 10 times for 3 sets.
Tip: If you get back pain doing this or hamstring spasm, try moving your feet in closer to your bottom – this will likely make it easier.
This exercise builds great control and strength through your hips.
From a standing start, take a step forward, planting your front foot
As shown in the picture, bend the back knee towards the ground, keeping your toes on the ground.
Control this all the way with your front leg – this will be doing a lot of the work
Only go down as far as you can comfortably and safely
Push off with your front leg so that you come back to standing
Repeat 5 times on each side for 3 sets.
4. Wall squats
These exercises are easier than the name lends to thinking and is great for targeting your quads (thighs), these, along with your extensors help drive you upwards, straightening out your knees.
Again, there is two levels here, so that you aren’t thrown straight in the deep end and can start where you feel comfortable:
Level one: Squat and hold
Lean against a wall with your feet at least a foot out from the wall
Slide your back down the wall, controlling this with your legs until you are about halfway down
Only go down as far as you are comfortable with!
Hold this for 5 seconds and then slide back up again
Repeat 10 times
Level two: Swiss ball wall squats
You will need a swiss ball (also called gym balls among other things) for this good little exercise
Place the ball against the wall and lean against it at the height of your low-back – make sure your feet are out from the wall
Slowly squat down, keeping the pressure against the ball
Only go down as far as is comfortable.
Return back up and repeat 10 times for 3 sets
5. Single leg standing – For balance and hip control
Stand on one leg on the floor
Don’t let your legs touch each other
Goal: hold for 1 minute
Tip: if you cannot hold this very well, you can start with one finger on a wall or bench close to you
Stand on a wobble board, dura disc or bosu ball on one leg
Aim to hold this for 1 minute or build up to it
If you cannot afford one of these you can also fold up a towel and stand on that – rolling it up firm to make it harder
As I mentioned above, these exercises are effective if they are done regularly, so make it routine and stick to it.
Aim to do these exercises at least 4 times per week and you will really notice the difference.