Commentary

Take care of the mighty hamstring

By Dev Mishra, M.D.

We’re learning more and more about the importance of the hamstrings in injury prevention and overall athletic performance. Orthopedic surgeons have long been taught that the hamstrings are the “friend” of the ACL.

Rehab after surgery focuses heavily on the hamstrings, and effective hamstring strengthening is at the core of prevention programs such as the FIFA 11+ for soccer players. A particularly effective exercise (but unfortunately unenjoyable exercise) is the Nordic hamstring curl. The Nordic hamstring curl is a killer to do but a lifesaver for your legs.


The FIFA 11+ Warm-up: Part 9a VIDEO

If you should be unlucky enough to injure your hamstring it can result in many weeks out of play and some upper hamstring detachments will require surgery.

The best way to reduce your chance of a hamstring injury is to avoid one in the first place. Athletes with hamstring injuries will often ask me in the office if they were at risk for a hamstring injury because they were “inflexible” or because they didn’t do a proper warmup.

Certainly it’s possible those are factors, but we’ve never actually been able to prove that those are significant risk factors for a hamstring injury.

But one thing is definitely known: if you’ve had a prior hamstring injury the risk of getting another one might be as high as 30%. This is one sports injury with a high chance of recurrence.

This is why a number of prevention programs have been designed, which focus on improving hamstring strength and endurance. The nice part about these programs (such as the FIFA 11+) is that they’ve been effective in males and females, multiple age groups, and multiple skill levels. They are best when done regularly as part of the normal pre-training and pre-game warmup, and started during preseason training.

From a performance standpoint a stronger hamstring is directly correlated with faster sprint speed. The hamstrings are definitely your friend when they’re healthy and a pain in the backside when they are injured. Do yourself a favor and take good care of the mighty hamstring.

Key Points:
• The hamstrings are crucially important in overall athletic health.
• Strong hamstrings correlate with lower risk to the ACL, and improved sprint speed.
• A hamstring strengthening program is important to perform as part of your normal strength and warmup routine.


From the FIFA 11+ POSTER

(Dr. Dev K. Mishra, a Clinical Assistant Professor of orthopedic surgery at Stanford University, is the creator of the SidelineSportsDoc.com online injury-recognition course, now a requirement for US Club Soccer coaches and staff members. Mishra writes about injury management at SidelineSportsDoc.com blog, where this article first appeared.

5 comments about "Take care of the mighty hamstring ".
  1. stewart hayes, June 28, 2017 at 12:49 a.m.

    Too bad so little is known about risk factors and few studies demostrating the best way to train to avoid these injuries. I personal found that I had to add repeat 300 meter runs to my training to keep my hamstrings strong. With this routine I had no problems playing into my 50's. Dev, any evidence to support this?

  2. Bob Ashpole, June 28, 2017 at 12:56 p.m.

    Taking a risk here talking about something I really know nothing about, but every hamstring injury I can remember was due to overuse. I wouldn't think that strength training (absent a problem) would reduce that risk. But then who is to say that all hamstring injuries have a common cause. My suspicion is that muscle strength is more related to joint strength (and improved performance). The FIFA 11+ exercises are typically performed at the start of training. In this manner the hamstring strength exercise is only one of a set of exercises so it is not training only the hamstrings. Also the rest of the training session provides endurance training. While the article doesn't suggest otherwise, I want to emphasize that the value of the hamstring strength exercise is in its inclusion as part of a training session. What puzzles me most is how is the lower level of physical activity and a tendency to specialize in one sport in the population generally today impacting the risk of injury?

  3. stewart hayes replied, June 28, 2017 at 1:04 p.m.

    We had a player from SDSU playing with the San Diego Sockers. He came to the team after spending part of a summer touring Europe on a bike. He had nothing but hamstring problems. We speculated it had to do with over development of the quads. Strength training has to be done with care.

  4. Nick Daverese, June 28, 2017 at 2:38 p.m.

    If you have a devoloped ham string you better work on your quads and gluts as well or the hamstring will get injured. I had that problem it was ok if I stretch them before a match. If I forgot well I never finished the game. It takes a long time to heal. Danger it feels ok you think your ready to play your not it needs more rest.

  5. James Madison, June 29, 2017 at 7:46 p.m.

    There is little question but that hamstring injuries take longer to heal than quadriceps injuries.

    In US Soccer coach training I was taught, as Stewart Hayes speculates, that excessive development of the quadriceps group in proportion to the hamstrings increases the risk of hamstring injuries. Back-pedaling was advised as a training exercise to compensate for sprinting. I would appreciate Dr. Mishra's comments.

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