Hamstring slow healing

Number 2 and James have made some great logical points. I agree that massage and specific sprint drills have incredible results in rehabbing a ham pull.
It’s a shame to see the glute ham raise epidemic spreading around the world. It’s sometimes now the first exercise prescribed for hamstring rehab, usually with disastrous results.

He didnt mention anything about it being structural or acquired compensation, he assessed it by measuring from the my hip to my ankle, and no, I havent had any injurues or anything like you speak of.

I’ve taken onboard alot of the advice given here and looked at the links that numbertwo provided, thanks for those. I did a rehab session today following those guidelines, some sub max accelerations over about 15 - 20m. The good news is I felt no pain whatsoever while doing them :slight_smile: definetely a difference from before, so I am starting to make progress! I guess the best thing I can do now is listen to my body and not push it too far while continuing the rehab

Obviously the volumes and types of drills used must be individualized per each athlete relative to their condition.

to give you an idea, however, of what a session could look like:

Last week I worked with two 1st string skill players (one with a hamstring strain, the other with an adductor magnus strain) Both of them were in a condition that impaired their ability to accelerate and change direction and were given the week off of practice by the medical and coaching staff.

Along with what I’ve had them do, they receive various therapeutic modalities in our training room.

Marching A 10x10yd
A Skip 10 x 10yd
Running A 10 x 10yd

Marching A 10x10yd
A skip 10x15yds
Running A 10x15yds
Marching B 10x10yds (used as a test for my hamstring guy and he felt good)
B Skip 10x10yds (hamstring guy felt good)
*note- the B versions are something that are not introduced for a while, depending on the grade of hamstring pull; however, I’ll use the marching version as a test to see where we are at and then if that goes well we see how the skip looks.

A skip 10 x 20yds
Running A 10 x 20yds

*I instruct and ensure that all power-speed drills are performed to near perfection (relative to what the athlete can do)

Friday and Saturday Off

Today they both ran ~1000-1200yds of tempo absolutely pain free with confidence. Both athletes told me they felt very good running.

We have a bye week before our game with Miami so I have ample time to ramp them back up with sub-max accelerations and positional maneuvers unless they are required to practice instead.

Understand that I do not use pre-set volumes. All of this sort of work is individualized according to the athlete and the situation. So as Charlie would say, those drills and volumes are history not philosophy.

Interesting to hear that Revis has a slight hamstring issue. I’ll look forward to watching how they manage that. I have heard pretty good things about the Jets strength and conditioning coaches.

I wasn’t impressed with what I saw in the Hard Knocks episodes. I do understand that it was a small piece of what actually occurs, but watching a guy pull a tire up a dirt hill said it all for me after episode 1.

James and Number 2,

I understand that you both view sprinting and power-speed drills to be the primary means of rehabilitation in the case of a pulled hamstring but I am interested in how you go about reintroducing weightlifting exercises that yield significant stress on the hamstrings (RDL, hypers, etc). How does the reintroduction of these lifts fit in with the power-speed and manual therapy aspects both temporally and physiologically?

Number 2- your article says full lifting is resumed in week 3. Is this common for your athletes with hamstring pulls? How, if at all, are the intensities/volumes/frequencies altered when first getting back to it?


One thing to ask your doctor…Is your leg length discrepancy (LLD) functional or structural? A structural LLD requires a lift, a functional usually doesn’t. You are right, your LLD (if it is structural) probably did not cause your hamstring tear. Your body has probably made some great adaptations to make up for the difference. Now that you are injured though, the LLD may be the factor that keeps your hamstring from healing. Adding a temporary heel lift under your insole to the short side would only cost about $5 to $10 so why not give it a try?

In my experience, we have been able to undertake full intensity lifting earlier than full speed running. These lifts include cleans, snatches, squats, lunges, etc. I am a bit more careful with RDL’s, hypers and lifts of this type - but they are never doing maximal lifts with these types of movements anyways. My feeling is that the hamstring will generally recover strength rather quickly - assuming the appropriate steps have been taken in Week 1. High velocity running, however, places more unique and complex demands on the hamstring including rapid stretching, contraction, relaxation and co-contraction, within a window of a few tenths of a second. Hence, the predominance of acceleration work in rehab - with all other training elements following from the results during these sessions.

In terms of ordering activities and adjust volumes, obviously upper body work takes on an increased role - with bench press providing the main stimulus. This may be the case for 7-10 days. Squatting may be introduced rather early - but we will start with a low to moderate low and squat to a fixed depth (i.e. bench squat). Much of the lower body work depends on the feedback I’m getting from the athlete. “Does it feel stiff, does it feel weak?” In some cases we can introduced muscle cleans or muscle snatches early, and then get into short range cleans or snatches from the hip to minimize tension on the hamstring. Pretty soon we are back to Olympic lifts from the floor.

I’m not a fan of any loaded knee flexion work (i.e. ham curls, glute ham raises) for sprinters or anyone who wants to run fast beyond 10 meters. Anecdotally, any athletes who I witnessed spending a lot of time on these types of exercises tended to have more problems with hamstring strains than those who didn’t. And, knee flexion in sprinting is a low load (or no load) function. Leg recovery is the result of the foot folding up under the body following hip extension.

For athletes who are not pure sprinters (football, soccer, basketball), I also incorporate some co-contraction work into the rehab program (i.e. deceleration, direction change, cutting, etc) to strengthen the hamstring in that regard.

Thanks for the thorough answer.

In my system, it depends on where we are in the year. We only perform RDL’s the first three weeks in Winter and Summer off-season and the rest of the year are back raise variations on a 45 degree or GHR device.

I have a great track record of keeping my skill guys healthy during off-season training even though we do a great deal of speed work. The most I’ll encounter with my guys during those periods is ‘tightness’ not pulls.

It’s during training camps where the pulls occur due to the overload.

Since the hamstring work is already much less structurally demanding at that point, because it’s performed in an auxiliary capacity, most players won’t miss a beat even with a minor pull (no structural defect) because we rarely see a significant hamstring pull even during those times of year.

Obviously it follows that each individual is different and must be treated accordingly and T&F is unique in that the maximal outputs/velocities reached in the sprints are unrivaled relative to the operational outputs seen in the team sports (most of which are in the early acceleration zone) so the severity of pulls sustained in the team sports will rarely rival those of a track athlete.