You can get all of the hands-on treatment in the world but it won’t mean you’ll be racing back to the starting team anytime soon if you don’t do your exercise program. Developing load tolerance of your hamstrings through the entire range of motion is necessary for a successful return to sport process. In the early stages of rehabilitation, we will likely be performing isometric loading of the hamstrings or light isotonic work as well as making sure we are keeping the rest of the body in check by working on the calves, quads, glutes, and core. If we neglect everything else, we simply make our return to sport process harder.
As we work through the rehab program we will be wanting to work the hamstring muscles through a further range of motion as well as add in eccentric work. Eccentrics are essential for hamstring rehabilitation these days. You want your hamstrings to be long and strong, and eccentrics are the best way to achieve it. Nordics have been found to be one of the most effective exercises at reducing your risk profile of sustaining a hamstring injury due to their double effect of improving muscle fascicle length and improving strength. Research has been able to find that introducing early eccentric loading, even into tolerable levels of pain, results in a slightly faster return to sports times, and improved measurements at the time of returning to play. Eccentrics don’t appear to be the cure-all we are looking for with hamstrings, but they certainly appear to be a big part of the picture.
As with every other injury, keeping everything else surrounding the area strong and stable is necessary. As such we always like to keep the quadriceps, gluteals, calves, and core working well and improving. Just because you have a hamstring strain doesn’t mean you neglect everything else.
Last but not least, everyone’s favourite, sprinting. It’s actually one of the best exercises for hamstring strengthening out there showing it has the highest levels of hamstring activity out of typically programmed hamstring exercises. The even better point is it’s incredibly functional. Nearly every person who plays sport has to sprint, and often repeatedly, many times throughout a game. So it both improves hamstring strength, improves tolerance to one of the most common mechanisms for hamstring strains, and makes you a better performing athlete. If only I could find a way to make repeated sprint training enticing and enjoyable for clients.