Hamstring Rehab Program

Ryan Timmins and colleagues have produced a tremendous body of work in the hamstring injury rehab and injury prevention space.

Timmins et al 2016 paper looking at risk factors of future hamstring strain injuries in professional soccer players was a groundbreaking paper that identified shorter fascicle lengths of the long head of biceps femoris (<10.5cm) had a 4x greater risk of future hamstring strains in the next season; but increasing the length of the fascicles by 0.5cm had a profound effect on injury risk reduction.

Such information is important to know; but what would a rehab program look like to elicit a change in the hamstring tissue?

Don't worry I got you..

In Bourne et al 2017 paper on the impact of Nordic Hamstring Exercise and 45deg Hip Extension Exercise on Hamstring muscle architechture, they found the following hamstring exercise program (see below to see) increased long head of biceps fascicle length from 10.6cm at baseline to 12.8cm in the Nordic group and 12.0cm in the 45deg Hip Extension group after 10 weeks of progressive overload training.

Important to note is that progressive overload was a key feature here.

Body weight only exercise for the entire 10 week program would not be sufficient to evoke these changes to reduce injury risk.

For Nordics, load was added to the chest incrementally starting at 2.5kg when the person had sufficient strength to stop at the end of range of motion.

For 45deg Hip Extensions, 60-70% 1RM loads were used for the first 2 weeks, 70-80%1RM loads for week 3-4, then from week 5-10 maximal intensity effort was required with load gradually added to achieve maximal.

Take home message here is that both Nordics and Hip Extensions can play a huge role in reducing hamstring injury risk when done in a progressive overload manner.

The Nordics did however come out slightly in front by increase fascicle length nearly 1cm more than 45deg HipExt.

What do you think of this programming? Do you overload Nordics or just use person's body weight?

If you're interested in learning more, take Dr Ryan Timmins and Dr Peter Brukner's Hamstring Masterclass by clicking on the link here