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Running Injuries: The Hamstring

2/8/2021

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The good old hamstring.

It certainly does have its fair share of strains in the running community.

The reasons why, may be different than you think. 

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A common position runners tend to adopt over time is that of an anterior pelvic tilt (shown below).
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This adaptation occurs as a result of poor force production and pelvic control when striding.

When the pelvis is rotated forwarded, your body is trying to accommodate to drive more force into the ground so you can bounce back off quickly. It also decreases the amount of time you are in flight in running (even if this is milliseconds) by making the advancing leg slightly longer due to the pelvis orientation.

All of that may sound great, but it comes at a cost, and one of those costs are hamstring strains.

The hamstring is a two-joint muscle, meaning it creates actions at the hip and the knee. Those actions at the hip allow the hip to extend (leg getting behind the body) and its action at the knee allows flexion (knee bending).

As the leg swings, the hamstrings lengthen to some degree towards the hip, but with the knee bending as well, they gain relative slack so it does not reach a maximal length. (Maximally stretched muscles have a very hard time to overcome and produce force).

When you go towards complete push-off and the hip is maximally extended, the hamstrings contract and shorten proximally at the hip and lengthen as the knee extends. 

As you can see, there is a rhythm in the hamstrings length that stays in a relative length, producing forces at either the hip or the knee.

If you look at the gait cycle below, the take off and initial swing transition demonstrates the full extension of the hip on one side (shorter hamstring up top, longer down at the knee) and the complete opposite on the swing leg (Shorter down low, longer at the hip). 
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hen we revisit the anterior pelvic tilt position, the hamstrings start with a lengthening effect already at the hip in standing, with the knee extended, further putting stretch/strain on the muscle before running even starts.

As the leg goes towards push-off, the hip extension component is limited due to the pelvic orientation. This places the hamstring at stretch in the hip component, where it should be contracting more, and it is stretching towards the knee (refer to a couple paragraphs ago about the rhythm during gait).

The strain more times than not comes from this push off phase as the hip is trying to contract in order to overcome the stretched position. It can also happen in the swing phase as the foot lands due to the forward hip, the proximal portions of the hamstring, again, cannot control the forces coming in and overcome the maximally stretched position.

Whether the strain feels like it is down towards the knee, below the butt check, or right in the middle of the thigh, it can all stem from the same problem.

So how do we take care of this mess?

I’m glad you asked 😊

We need to reestablish proper pelvic positioning and control, before having increased loading and speed.

We can utilize the hamstrings in this scenario to actually assist in the pelvis orientation and give them a chance to succeed by shortening both ends in a box bridge (shown below) This can assist with the hip extension components of your gait as well.

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You can also use standard bridges, as long as the whole foot stays on the ground, and progress to one-legged moves
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Once we establish good hip control, we can go back to our good friends the split squat (see previous posts) with a goblet load.

Following control under load, reintroduce higher speed based components of running like skipping for height and distance.

You can also use a sprinter step up (shown below) focusing on stepping and driving the leg onto the box straight through the ground with full foot contact
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After you established all of these, you can implement the box bridges, skips, and sprinter step-ups as part of your running warm-up.

Now you should have a good idea of how the hamstrings can be affected during running with real solutions to combat the excessive stress they may take on.

If you have questions, please send an email to staff@dynamicprri.com and we will be more than happy to answer them.

Now make those hamstrings strong and get running!
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    Author

    Dr. Peter Dionisopoulos is the owner and founder of Dynamic Performance & Rehab. He has worked with many high-level athletes and military personnel, but his true passion is to help active adults maintain their lifestyle by providing  information and potential solutions to their aches and pains so they can continue with the activities they love.

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