Hamstring Strains – A Proven Rehabilitation Approach

Posted 5 years ago on

Hamstring strains are one of the most common injuries in sports, resulting in a significant loss of training and competition hamstringtime. The hamstring muscles are 3 muscles in the back of the thigh, composed of the semitendinosus, semimembranosus, and biceps femoris. These muscles serve as knee flexors and hip extensors. It has been suggested that hamstring injuries account for roughly 8-25% of all sports related injuries resulting in 2-6 weeks of absence from competition.[1]


At Ascent our team does a lot of work with dancers and dance companies educating them on preventive steps to take as well as treating dance related injuries. Many of these injuries are related to the hamstring. Interestingly, a study in 2002 by Askling and his co-researchers indicated that 34% of dancers have experienced acute hamstring strains, while 17% experienced overuse injuries of hamstring muscles.[2] However, even more alarming is that without effective and timely rehabilitation treatment the injury was 30% more likely to reoccur with the majority (60-70%) occurring the following season.[3] Reoccurrence of hamstring strains are also more common when the injuries involve the biceps femoris muscle.[4]

A reoccurring hamstring injury is also influences by the number of previous hamstring injuries, active knee extension deficit, decreased isometric knee flexion strength, and localized discomfort with touch.[5] Emerging evidence suggests that eccentric hamstring strength is reduced following a hamstring strain, and is likely a factor in subsequent hamstring injuries. Two other studied performed by Askling demonstrated that a rehabilitation protocol (L-Protocol) consisting of mainly lengthening-type of exercises was highly effective in returning athletes to competition following an acute hamstring injury.

Below we have demonstrated the exercises shown to be effective in rehabilitating hamstring injuries.

The ‘Extender’ (L1)
Click link for video













The patient lies on his/her back and holds the thigh at approximately 90 degrees of flexion. The knee is slowly extended but stopped prior to pain. Complete this exercise twice daily (3 sets of 12 reps).


The ‘Driver’ (L2)
Click link for video













The patient stands on the injured leg with the knee flexed 10-20 degrees. Both arms are reached forward as the opposite leg is reached backwards. The lifted leg is held at 90 degrees of flexion and the goal is to lift the leg as high as possible. Complete this exercise every 2nd day (3 sets of 6 reps).


The ‘Glider’ (L3)
Click link for video












The patient starts with one hand holding a rail or support and 90% of the weight on the injured leg with 10-20 degrees of knee flexion. The uninjured leg is glided backwards, stopping before pain on the injured leg. The arms are then used to return the athlete to the starting position (avoid contraction of the hamstrings). Complete this exercise every 3rd day (3 sets of 4 reps).


For additional information contact a qualified member at Ascent Health 403-262-1121


Post provided by Dr. Roger Menta, DC and Dr. Scott Fisher, DC

[1] Prior et al., 2009
[2] Askling et al. (2002)
[3] Prior et al., 2009
[4] Hallen et al., 2014
[5] De Vos et al., 2014