Preventing Hamstring Injuries in Female Athletes

There is no question that hamstring injuries are one of the most common injuries seen in female athletes. While a hamstring strain is not nearly as severe as a torn ACL from a rehabilitation and loss of playing time standpoint, the recovery can and will still take several weeks which could lead to an athlete missing a large portion of their competitive season.

hamstring injury

It should also be noted that the greatest number of hamstring injuries occur in the pre-season period with all the running and training the team is doing (too much, too soon), a period crucial for both player and team development. Proper progressions in both the amount of running and conditioning can go a log way to avoiding many of these hamstring issues.

To further complicate the problem, the re-injure rate for hamstring injuries in female athletes is very high, calling into question current training and rehabilitation practices. The good news is these issue can be avoided. The bad news is they don’t seem to be avoided in most programs.

As a result of these issues, strength and conditioning/sport performance coaches are always on the lookout for training strategies that will reduce the risk of hamstring injuries in their female athletes. Here are what I feel are a few of biggest issues that we as strength and conditioning/sport performance coaches need to focus on to keep the hamstrings of our female athletes healthy and allow the athlete to stay on the field all season.

Tissue Quality

Very simple; the athlete needs to have their tissue quality addressed every single time they step into the weight room. Whether your weapon of choice is a lacrosse ball, foam roller, Tiger Tail, an elbow, or something else, make sure they get in there and take care of their business. This isn’t just the hamstring either, the glutes, calves, quads, and adductors need to be constantly addressed.

Proper Plyometric Training

Again, nothing earth shattering but something that seems to be overlooked and put on the back-burner when it comes to programming. Just like anything else, plyometric training should be specific and well thought out.

When it comes to plyometric training, I stick with the KISS principle (Keep It Simple Stupid). Start off by jumping on to something (box jump). Move to jumping over something (hurdles). Then jump over something with a bounce. Finally, move to a traditional explosive plyometric.

As an example, the plyometric program like the one used at Mike Boyle Strength & Conditioning is simple and effective. Four different plyometric progressions. A box jump/hurdle jump progression, single leg linear hurdle hop progression, single leg medial lateral hurdle hop progression, and finally a lateral bounding progression. Well thought out, simple and effective.

Single Leg Posterior Chain Strength

To me, this may be the most important aspect from a training standpoint when it comes to avoiding hamstring issues.

Running is a single leg movement, it’s a result of bounding from one leg to other. Soccer, field hockey, lacrosse and most other sports are essentially sports that are played on one leg.  For example, striking a soccer ball is a single leg movement, as the athlete plants one leg while the trail leg follows through and strikes the ball, resulting in a massive amount of eccentric hamstring strength in the plant leg. Furthermore, cutting, jumping, and decelerating are all single leg movements and essential to the success of a female athlete.

With this in mind, in my opinion the female athlete (all athletes really) needs to be trained in a single leg stance the majority of the time. Exercises like the single leg RDL, single leg hip lift, slideboard/Valslide hamstring curl, and single leg good morning need to be included and make up the majority, if not all of the female athletes glute/hamstring training protocol.

Furthermore, I feel that the first two movements all athletes should be doing is some type of single leg RDL and a slideboard/Valslide leg curl. We can argue what exercises are next in line, but these two exercises should always be included in any good strength training program.

SL RDL

As a side note, there is nothing wrong with exercises like the traditional bilateral RDL, but the single leg movements need to be the nuts and bolts of your strength training. If you have both a single leg RDL movement in your strength program and a slideboard/Valslide leg curl, I think a bilateral RDL is just fine.

If you still don’t completely buy into these exercises it may help to understand why we would include them in the program. For starters, the hamstrings work to extend the hip in a single leg stance in conjunction with the glute max and adductor magnus. The single leg RDL requires the athlete to extend the hip in a single leg stance in conjunction with the glutes and adductors. Pretty sport specific if you ask me.

Additionally, the hamstrings are asked to act eccentrically during sprinting while the glutes are asked to stabilize during jumping, cutting and decelerating. The slideboard/Valslide leg curl is one of the best exercises when it comes to developing eccentric strength. The Glut-Ham Raise is also a close second in building eccentric strength.

A Progression Based Program

As with any solid program, there needs to be a progression. Far too often athletes are asked to do more then they are capable of doing in the present time. In most cases, it’s a simple case of too much, too soon.

It should be noted that most of these athletes are very capable of doing the advanced progressions that you are asking them to do, you as the coach just need to build them up so that they are ready for that progression.

A simple and effective Single Leg RDL progression would look something like this;

  • ·         Reaching Medball Single Leg RDL
  • ·         1DB Single Leg RDL
  • ·         2DB Single Leg RDL
  • ·         Barbell Single Leg RDL

And for the slideboard/Valslide Leg Curl Progression;

  • ·         Eccentric (bridging) leg curl
  • ·         Traditional leg curl
  • ·         Weighted leg curl (10lbs)
  • ·         Weighted leg curl (25lbs)
  • ·         Single Leg Hip Lift leg curl

Progressive Conditioning

Finally, you need to look at your running/conditioning program, especially in the pre-season period. You need to monitor volume and intensity for all your running/conditioning. You simply can’t keep blindly adding more and more every single conditioning session. A good rule of thumb is to add roughly 10%  from week to week, anything more than that is probably too much too soon and will result in hamstring injuries.

Iron Game Chalk Talk with Robert Dos Remedios

Wanted to share another good listen from a series of great interviews by Cincinnati Bengals strength coach Ron McKeefery’s Iron Game Chalk Talk. This time Coach McKeefery sits down with Robert Dos Remedios, Head Strength & Conditioning Coach at the College of the Canyons in Santa Clarita, CA. As usual, it is a great listen and I’m sure all strength coaches could learn something new from the interview. Enjoy!

Things to Read to Get You Over the Hump 2/5

Another week, another handful of articles, podcasts, and interviews from the previous week. Hope everyone on the East Coast is enjoying this nice little (read huge) snow storm. Enjoy!

Snow Storm

Earners are Learners from Michael Boyle

What I Learned Cin 2013 by Eric Cressey

What Do I Do by Charlie Weingroff

2 Q’s on MSI by Charlie Weingroff

The Secret to Ab Training by Mike Robertson

Interview with Joe Kenn by Mike Robertson

Iron Game Chalk Talk with Zach Even-Esh by Ron McKeefery

8 Ways to Improve Your Training

Here are 8 easy ways to improve your current training program:

Warm-up Thoroughly

Everyone overlooks warming up. It can be boring, tedious, and quite honestly it’s the easiest thing to skip when in a pinch. This isn’t a great idea though. Try to foam roll, stretch, and go through some type of dynamic warm up before every lifting session. You’ll be surprised how much better you feel and how much better you move by just spending 10-15 minutes warming up before you train.

Add Carries to Your Training

I admit I am late to the party when it comes to carries. For the longest time I thought they were really overrated but carries can do a lot for core development – and your traps will be screaming at you the next day! Carries like a suitcase carry is basically a walking side plank while something like a goblet carry is a walking front plank. There are a decent amount of carries you can add…try some, you’ll be surprised how effective they are. This last fall I added some type of carry to some teams at New Hampshire and was pleased with the results.

loaded carries

Give Single Leg Training a Legit Shot

I hate to admit this too, but I was late on the single leg training bandwagon as well (and I worked for Coach Boyle at MBSC!). After a couple years of consistent single leg training, I’m hooked. When it comes to lower body training, I typically start with a bilateral exercise (front squat, goblet squat) and then all of my assistance work is single leg. However, lately I have been sticking to just single leg movements and I’m loving it. Single leg squats, rear foot elevated split squats, slide board lunges and leg curls, single leg RDL and others are not staples in my program. Plus, sometimes its nice to get a great training session without putting a ton of weight on your back or in your hands. And for most athletes, if you train the single leg exercises heavy like the video below, I don’t know if you have to still perform bilateral lower body movements. Doesn’t mean you can’t, just that you don’t have to.

Add Some Explosive Training

Whether it is some hang cleans, hang snatches, dumbbell snatches, kettlebell swings, or even jump squats, add some explosive training to your program. Most people think that losing strength is the biggest concern when it comes to aging, but losing power is actually a bigger issue. Stay ahead of the game and keep training to maintain or increase power.

push up

Use Push-ups as Your Major Pressing Exercise

Shoulder issues are pretty common these days yet people continue to bench. Talk about trying to fit a square peg into a round hole. Try doing some push-ups for your main pressing movement – with a little creativity you can do a lot to make the push up as challenging as a heavy set of benching. Add some chains or weight vests, do eccentric reps, drop sets, max rep sets, the options are endless. Plus, your shoulders will feel better because of it. If you train overhead athletes (baseball, volleyball, swimming) I don’t think benching is necessarily wrong (pitchers probably want to skip benching altogether in my opinion) but I also don’t think you need to bench, making push-ups a great alternative.

Push and Pull Sleds Consistently

There is something about pushing or pulling a heavy ass sled after a training session or on an off day that screams ‘badass’ – and makes your scream for your mom. Get out of your comfort zone and reap the benefits from a conditioning standpoint as well as a mental toughness standpoint.

pushing sleds

Listen to Your Body

Some days and weeks you’re just plain tired. Listen to your body and step off the accelerator a little bit. Using some lighter weights and skipping a tough conditioning session may be better for you in the long haul then beating yourself into the ground. I wouldn’t recommend skipping a session altogether though as something is still better than nothing. Get in, move a little bit, and get out, but listen to your body, it knows better than you!

get up

Don’t Be Afraid to Try Something New

Don’t be scared of change. If you aren’t seeing the results you are looking for, change something. Try a completely different program. Try exercises that you haven’t been doing for quite some time. Maybe you need to start eating a little better? Who knows, but make some changes, it’ll make a difference. Recently the importance of rolling exercise has been all over the place, so I am performing get-ups every single day for the next 10-12 weeks and see what types of changing I see.