There is no question that hamstring injuries are one of the most common injuries seen in 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.

Before we go any further, it should 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, which is typically simply too much, too soon for most athletes. The problem is this is a period that is crucial for both player and team development. Proper progressions in both the amount of running and the type of conditioning leading into the pre-season period 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 athletes is very high. When the number one predictor of future injury is previous injury you have to call our means of rehabilitation into question.

The good news is hamstring issue can be avoided with proper progressions and training. The bad news is they don’t seem to be avoided in most programs.

With that said, 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 athletes healthy and allow the athlete to stay on the field all season. I can confidently say that these things are important because I have seen them work firsthand. In this part competitive season, the teams that I personally work with and program for had a total of zero games missed due to a hamstring strain and we followed these principles throughout both our off-season leading into their competitive seasons and during the in-season period.

1. Proper Plyometric Training
Nothing earth shattering but something that seems to be overlooked and put on the backburner when it comes to programming. Just like anything else, plyometric training should be specific and well thought out yet often times I don’t feel that it is.

As an industry it is clear that we do a great job making athletes more powerful, but what we do a terrible job is making athletes more resilient. We give athletes huge accelerators and terrible brakes. Our plyometric program and less concerned with making athletes more powerful and more concerned with teaching athletes how to land properly and controlled deceleration. Controlling deceleration is going to go a long way in keep athletes healthy – most injuries occur in deceleration.

When it comes to the actual plyometric training, I stick with the KISS principle. We start off by jumping on to something with a stable landing. Move to jumping over something with a stable landing. Once we can land stably we then jump over something with a bounce. Finally, move to a traditional explosive plyometric.

Additionally, it’s important to jump in various planes/directions. Depending on the day, we will typically perform either a bilateral hurdle jump, a 1-leg hurdle hop, a 1-leg medial/lateral hurdle hop, and a lateral bound.

As an example would be a 1-leg linear hurdle hop progression. Phase 1 = to a box. Phase 2 = over an object. Phase 3 = over an object with a mini bounce. Phase 4 = continuous. The same progression holds true for our other various plyometrics.

2. Picking the Correct Exercises
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. Running, in the simplest sense, is a result of bounding from one leg to other. Soccer, field hockey, ice 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, which is why its important to learn to absorb force eccentrically through a plyometric program. Furthermore, cutting, jumping, and decelerating are all single leg movements and essential to the success of an athlete but also commonly when hamstring injuries occur.

With this in mind, in my opinion all athletes need to be trained in a single leg stance the majority of the time. Exercises like the 1-leg RDL, 1-leg hip lift, and slideboard/Valslide hamstring curl need to be included and make up the majority, if not all of the athletes glute/hamstring training protocol. All the bilateral squatting and RDL’s in the world aren’t going to fix the hamstring issue. Simply learning to apply large amounts force in a bilateral stance in the sagittal plane is far from functional for an athlete.

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. The hamstring is essentially what slows you down and stabilizes your knee during sprinting, cutting, jumping and other athletic movements. The slideboard/Valslide leg curl is one of the best exercises when it comes to developing eccentric strength.

3. A Progression Based Program
As with any solid program, hamstring injury reduction focused or not, 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 leading to an injury. In most cases, it’s a simple case of too much, too soon and no one is to blame except the strength coach and/or the sport coach.

A simple and effective Single Leg RDL progression would look something like this;
• Reaching 1-Leg RDL
• 1DB 1-Leg RDL
• 2DB 1-Leg RDL
• Barbell 1-Leg RDL

And for the slideboard/Valslide Leg Curl Progression;
• Barbell Bridge
• Eccentric (bridging) leg curl
• Traditional leg curl
• Weighted leg curl

These are just a few of what I would consider the most important aspects of keeping the hamstrings of athletes healthy. Hopefully some of this will allow you to re-assess your own programming to make it better and keep your athletes healthier.