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Key Points From Matt

• When hamstrings get injured

• Too much load too quickly that the muscle can’t handle

• Happens a lot with sprinters because of explosive movement- fast twitch muscle fails

• Mental and physical fatigue are a factor- slow twitch muscles for sustained movements become fatigued and fail 

• Weakness or tightness in other muscles is a big factor. In preseason we had several hamstring injuries, and ATRs determined that poor core activation and tight hip flexors were major causes for several cases

• Hamstring strains are when the muscle becomes overstretched, but they can also tear in the muscle or in worse cases that tendon can rip completely off the bone 

• On recovery

• Eccentrics like the nordbord are useful because they lengthen the muscle

• Nordic curls are definitely a high strain exercise, but a muscle will cramp and the user will fall before the hamstring retears.  If the muscle cannot handle the load being applied the body will use the cramp as a safety mechanism to stop the load from being applied. 

Key Points From Robb Watts 

• 1. Tissue remodeling and muscle hypertrophy: Basically increase muscle mass to the injured muscle and reorganize the newly healed tissue. 

• 2. Improve eccentric strength: A big role of the hamstring is eccentric control when sprinting and jumping. 

• 3. Improve usable range of motion of the hip and ankle: Making sure range of motion is adequate in order to safely get back into running and prevent future injury.
• For all of these things I would use eccentric and isometric tempo's in order to stimulate improvement in all areas. Below are some exercises I would use to target the hamstring.
  • Single leg glute bridge
  • Supine Hamstring curls: (depending upon stage of recovery, may go with single leg, sl bridge to eccentric lower or double leg curl to sl eccentric lower). Usually I would use a stability ball or towel (foot slider) for these.
  • Single leg RDL: bodyweight or dumbbell.
  • Single leg squat or split squat: bodyweight, dumbbell or assisted.
  • Nordic Hamstring eccentrics: only in advanced stages of recovery.
  • Step ups: bodyweight or dumbbell.

Key Points From Scott Spak

•  Avg recovery from hamstring injury is 26 days although the median is lower than that.  According to literature and research the following are best methods for intervention and care: manual Therapy, Eccentric strength training, Dry Needling, Core Activiation exercises, an intentional step by step progression of return to activity with continuous monitoring of clinical examination.
  
  

From New York Dynamic Neuromuscular Rehab

• Agility and sport-specific drills; advanced trunk stabilization exercises; progressive eccentric hamstring strengthening

• Criteria for return to sport: once full range of motion, strength, and function are restored without pain or stiffness, the athlete is ready to return to full sporting activities

US National Library of Medicine

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189266/