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.

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