Hamstring Injuries: A chain reaction

hamstring injury

Hamstring pulls, strains, tweaks… Recently, they’ve been everywhere. Why? There’s a long list of possible culprits. Just ask a physical therapist. Improper warmup, poor strength ratio between the quads and hamstrings, lack of hamstring flexibility, etc.

I want to discuss one that’s often overlooked, and thanks to a phenomenal physical therapist, Dr. Shirley Sarhmann, and a phenomenal strength coach, Mike Boyle, has been brought to light over the last few years. It’s also one that can easily be prevented by a good strength training program.

Tight Hip Flexor = Pulled Hamstring

According to Dr. Sahrmann, a tight hip flexor can and most likely will lead to a weak glute. If the glute is weak, the hamstring will take on the majority of the work at extending the hip (sprinting, jumping, etc). Over time, the work can become too much, and strain, tweak, or even tear the hamstring. The glute should be the primary hip extensor, not the hamstring.
A baseball player I just started working probably had this very problem. Although I can’t be 100% it was the exact cause, I’d be willing to bet on it.  During his last 2 weeks of his fall baseball season (he plays baseball close to 9 months out of the year), he strained his hamstring.  He couldn’t remember an exact incident. He just felt it come on  over the last few weeks. He knew he did something to it, and his physical therapist agreed: strained hamstring. Season over.

When I first saw him, we performed a simple mobility-type warmup to assess his flexibility and mobility. His hips were completely locked up. It was amazing he could hit and pitch as well as he could. He was constantly substituting lumbar flexion for glute/hip extension, he had trouble touching his toes, and his body weight squat was pathetic . From a foundational movement standpoint, he was a complete mess. Lucky for him, he was athletic and strong enough to compensate for it. However, it finally caught up to him…. hamstring strain, knee problems,  etc.

What we’re doing to fix the problem

  • Stretch. Stretch. and More Stretch. Our primary focus is on the hip flexors, but we’re stretching the entire hip: adductors, abductors, quads, hamstrings, etc.
  • Foam roll: Hamstrings, IT Band, glutes, quads
  • Dynamic warmups and mobility drills: ankles, knees, and t-spine
  • Movement pattern grooving: Goblet Squats and Wall KB Deadlifts
  • Glute maximus and medius activation: Cook Hip Lifts, Quadraped Ext with a dowel rod across his back, lateral band walks, lying clams

We also had one of our basketball players strain her hamstring during her high school team’s basketball practice. I honestly don’t think it was due to a tight hip flexor or weak glute, as she was extremely mobile and had great glute activation. For some “odd” reason, she was not performing any dynamic warmups prior to basketball practice, and decided to go 0-60 in a cold gym. Bam! Tweaked hamstring.

Remember, the body is linked from head to toe. Don’t just focus on the weak and/or injured muscle. It maybe weak or injured because of a compensation somewhere else in the body.

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