Hamstring strains. Can you avoid them?
Recently, I have come across numerous cases of hamstring strains, especially in professional sports. There are numerous variables which will contribute to the cause of hamstring strains; the two most common in my opinion are strength imbalances between the hip flexors and hip extensors and length and tension imbalances of the hip.
Quad dominant training is rampant in all levels of training programs today. The majority of training programs will prioritize quad dominant movement patterns meaning squats and variations over hip dominant movement patterns meaning deadlifts and variations. When this occurs, the hip flexors anteriorly rotate the pelvis impinging the lumbar plexus. When these nerves impinge, the hamstrings are put on stretch due to weakness in the hip extensor group. When aggravation in this areas occurs, most will treat the site of pain neglecting to treat the cause, which in the majority of cases will be the hip flexor group.
A common excuse I hear when injury arises is ‘I was probably using bad form, or I didn’t warm up enough.’ I do agree that specific warm-up protocols will decrease the likelihood of hamstring strains occurring. Although you can lift with correct form all you like, if you lift in an imbalanced manner creating strength imbalances around the hip which then acts on the lower back, dysfunction will occur whether you like it or not. How technique is executed is not the only variable to take into account when avoiding injury. Lines of movement in program design is a very critical variable in training and significantly neglected.
So the question remains, how do we avoid hamstring strains?
Firstly, assess the frequency, and prioritization of your lower body training. Do you train the quadriceps first and the hamstrings second? If this is the case, reverse the prioritization to focusing on hamstrings first in the workout. Do you address the length imbalances of the quadriceps and hip flexors regularly via stretching and soft tissue work? It is common to stretch the hip extensors and neglect the hip flexor group. A common reason is due to the excessive tension in the hip flexor group; the body gives feedback that your hamstrings are tight. While the hip flexors continue to tighten from imbalances in training, the hamstrings are continually put on stretch. As you continue to stretch the hip extensors, the pelvis anteriorly rotates, further exacerbating dysfunction around the hip and lower back. I could count on one hand the number of times I have treated the hamstrings as they were the cause of dysfunction. I have lost count as to how many times I have increased the length of the hamstrings from treating the hip flexor group first. I am not saying do not stretch your hamstrings or hip extensors. I am simply stating prioritization is crucial whether you are addressing length, tension, and joint stability.
Steps I suggest you take to avoid hamstring strains all together:
– Address length imbalances of the hip flexor group and muscles acting on the hips by stretching.
– Address tension of the hip flexor group and muscles acting on the hip by someone highly skilled in this area. General massage by someone who does not understand biomechanics will not suffice.
– Prioritize hamstring variations first in training. If you have been doing four quad exercises and only one hamstring exercise, reverse the prioritization and implement four hamstring exercises and one quad exercise to correct the imbalance.
The points mentioned are very a general approach to avoid hamstring strains. I have come across cases where poor foot biomechanics and tight lats were also contributing factors.