Runners often neglect their hamstrings, only giving attention when injuries strike. Hamstring problems typically stem from muscle weakness, whether the muscles are long and weak or short and tight. Imbalances with overpowering quadriceps can also contribute to the risk of injury. Comprising three muscles running down the back of your thigh, hamstrings play a crucial role in flexing the knee and extending the hip joint. While active throughout each stride, they are particularly engaged during uphill climbs and sprints, making up around 7% of running injuries. Ignoring hamstring pain can escalate into a debilitating tear, categorised as either a common hamstring strain or an overuse injury known as hamstring tendinopathy.
Hamstring Strain
An acute injury occurring during dynamic running activities such as sprinting, jumping, or abrupt stops.
Symptoms:
- Sudden pain while running
- Sharp, stabbing sensations or a snap/pop sound
- Bruising and swelling on the back of the thigh
- Possible associated back and buttock pain
- Difficulty walking in Grade 2 or 3 injuries
Management:
Acute phase:
- R.I.C.E (rest, ice, compression, elevation), and consult a physiotherapist in Leeds or surrounding areas after 48-72 hours
- Physiotherapy to promote healing and minimise scar tissue
- Massage and manual therapy to release tight structures and address underlying issues
- Exercise therapy, progressing based on tear severity
Rehabilitation:
- Strengthening pelvic and core muscles, including glutes, in conjunction with hamstrings
- Correcting muscle imbalances through exercises
- Neural mobilisation stretches
- Gradual progression to full leg strengthening exercises
Training:
- Complete rest may be advised or reduced intensity depending on injury severity
- Avoid speed and hill work
- Opt for softer surfaces like grass
- Cross-train with cycling, water running, swimming, or elliptical training
- Address contributing factors like biomechanics or leg length discrepancies
Hamstring Tendinopathy
An overuse injury affecting the muscle tendon attachment at the origin of the hamstring, deep in the buttocks.
Symptoms:
- Buttock pain
- Specific pain near the ischial tuberosity
- Chronic stiffness
- Aggravated by sitting, deep lunges, hamstring stretches, and high-speed or uphill running
- Morning stiffness followed by a pain-free period
Management:
Early stages:
- Regular icing, avoid hamstring stretching, minimise sitting, physical therapy for mobilisation and tissue healing
- Isometric exercises 2-3 times per week if painful
Rehabilitation:
- Load modification, addressing muscle imbalances
- Strengthening core, pelvis, and gluteal muscles
- Neural mobilisation stretches
- Eccentric strengthening in later stages
Prevention:
Healthy hamstrings are essential for running performance, and injuries can take months to fully recover. Prevent injuries by:
- Strengthening hamstrings, back, glutes, and core
- Maintaining good flexibility and neural mobility
- Regular massage for tissue health and early issue detection
- Wearing compression tights during or after running
- Addressing underlying back problems through physical therapy
- Incorporating eccentric strengthening exercises 2-3 times a week
- Warming up before runs
- Gradually increasing training load and intensity.