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Hamstring Stretches and Rehabilitative Strength
C. Schurman, MS, CSCS
In our September, 2003 newsletter we introduced an article titled �Hamstring Strains and Preventing Recurrence� linked at www.bodyresults.com/e2hamstringstrains.asp. There we discussed common causes of strains, symptoms, immediate care for strains, and suggested that an athlete include stretching and strengthening as soon as he or she is able to, in order to return to normal activity levels as quickly as possible. In this article we go one step further and highlight three specific stretches that can help the athlete who has recently strained a hamstring regain normal range of motion. We also discuss ways to incorporate progressively more difficult strengthening exercises for the hamstrings.
Following any first-degree strain, be sure to include hamstring stretches the first day after occurrence in order to prevent any scarring, as scarring can decrease the muscle�s flexibility and increase the time it takes to return to full performance. Examples of such stretches include the Triangle Pose, Downward Dog (both borrowed from yoga), and Band Hamstring Stretch. Hold each stretch anywhere from 30-60 seconds to get the maximum benefit from your stretching efforts.
Try the Triangle Pose up against a wall if you like. Lean against the wall with one hip, and stand with feet very wide, one set of toes aligned with the wall and the other set of toes almost perpendicular to the wall, as though your feet create an "L". Extend arms out to the sides. Slowly reach one arm down the front leg (the one with toes parallel to the wall) and the other reaching up toward the ceiling, keeping both shoulders back against the wall as long as possible. Both legs should be straight but not locked out. See www.bodyresults.com/e2trianglepose.asp for more advanced variations.
To increase flexibility in the hamstrings, chest, shoulders and calves, start on hands and knees (knees can be padded if you prefer). Curl your toes underneath you, and gently lift your hips, pressing back onto both feet, with heels down to the floor. Straighten your arms and relax your head between your shoulders, pressing your chest back toward the thighs so that you form an inverted �V� with the hips high up in the air. Contract the quadriceps to help increase the stretch through the hamstrings. If this stretch is too intense, you can place your hands on a low step or bench, or bend one leg at a time so that you hold more weight through one leg while the other can relax. If you feel any discomfort in shoulders, lower back, or hamstrings, try one of the other hamstring stretches instead.
Band Hamstring Stretch
Lie on your back with one knee bent, foot on the floor, and the other leg extended straight in the air. Use a band, towel, sweatshirt or jump rope to loop over the ball or arch of the extended foot. Gently pull the straight leg toward your head, avoiding the temptation to bend the knee or stretch too far. If you have access to a JumpStretch band, ease the leg back down to the floor as you loosen your grip on the band, then use the band to actively stretch the hamstring again, getting closer to the head with each application of the stretch. Repeat to the other side.
For more information about full body stretching routines you can do at home using videos with excellent instruction and visual cues on proper form, please feel free to visit www.bodyresults.com/e2yogastretch.asp. Remember to avoid going to the point of strain or pain on any of these stretches, or you run the risk of re-injuring the leg. Work up to being able to hold the stretches for 30-60 seconds each.
As soon as the pain subsides and you are comfortable walking, start to add gentle cardiovascular exercise including swimming, biking, elliptical cross training or gentle walking on flat terrain. You may also find backward walking to be of use to strengthen the entire leg (see www.bodyresults.com/e2backwardswalking.asp on how to incorporate that into your program.) 3-5 days after a first-degree strain, begin slowly adding some home strengthening exercises including those below:
- Good Mornings (see www.bodyresults.com/e2alpinecore.asp for picture and description) can be performed as pictured using a resist-a-band, medicine ball, dumbbell or weight plate either at the chest or behind the head or back.
- Hip Extensions (exercise #4 at www.bodyresults.com/e2gluteusmedius.asp) describes how to do bridges, one of many variations on this exercise.
- Iron Cross Superman (see www.bodyresults.com/e2startexerprogram.asp ), as well as other hamstring exercises (see www.bodyresults.com/e2hamstrings.asp for suggestions of exercises you can do at home) can also be good to include in your routine. Begin with 1-2 sets of 8 repetitions per exercise in the pain-free range and gradually increase to 3 sets of 10-15. In the case of a second- or third-degree strain, include stretching and strengthening within a week or two of initial injury as pain allows and in whatever range of motion you can tolerate.
Start with a version of the prone Superman exercise and its variants; you may even want to start with just lifting the legs off the floor rather than legs and arms, or even doing one leg at a time until you regain your strength. Once that improves, you can add ankle weights. Add a version of the Hip Extension exercise, and work up to the point where you can add weight, holding a plate or dumbbells across the hips whenever these get easier. Next, add Good Mornings to simultaneously stretch and strengthen the hamstrings and lower back. Finally, add some of the home strengthening exercises such as the stiff legged deadlift or even one-legged deadlift variations. As your strength increases, gradually return to your sporting activity as noted previously in www.bodyresults.com/e2hamstringstrains.asp.