Conditioning: Phase 2

The following is the second of four phases that will guide you from hamstring strain toward healthy running. Progress from each phase as instructed.

Duration: 2 Weeks (at least)
Goal: Introductory Loading and Strengthening
Frequency of Exercises: 3 x per week (day off in between)
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up)

Squats (with Band): 3 x 8-10 reps. With your knees shoulder width apart, slowly come down into mild pain (<3/10 at most), and come back up. If able, place a resistance band around your knees to recruit your glutes with the squat. Purpose: increase load capacity of the hamstring muscle.
Double Leg Bridge: 3 x 10 reps. Place your legs shoulder width apart with knees bent. Bring your hips up and down. If it is too painful on the injured hamstring, bring your foot closer to your body or more weight on the other foot. Gradually put more weight/stress on the affected limb with pain <3/10. You should feel muscles working on the hips and thighs. Purpose: increase circulation and load to the hamstring, increase load on glutes.
Single Leg Balance (Moving): 3 x 30 seconds (each leg). Stand with both hands on your hips and your feet directly under you. Keeping your pelvis as stable as possible, bring one leg up without causing your pelvis to tilt or rotate. Once stable, bring one leg slightly up, moving it out, forward, out, and then back in an arch-like motion. Purpose: improve postural balance and stability.

Kneeling Hip Flexor Stretch: In the kneeling position with arms supported on the wall, engage your abdominals by doing a posterior pelvic tilt (i.e. low back is flattened with a limited curve). This posterior tilt will stretch the hip flexor muscles and decrease strain on the hamstring. Engage your glutes on your kneeling side and keep your body as a unit until you feel a stretch in the front of your hip. You may increase your stretch by leaning away from the side. Purpose: decrease anterior tilt to decrease strain on hamstring.
Rose Hips: 3 x 12-16 reps. On your side with your body straight, bring your lower leg up for stability. Your top leg, with toes biased downward, goes up and down slowly to recruit muscles on the side of your hip. Be careful not to let your top hip come forward (easiest to do this along a wall to prevent compensation). Purpose: increase strength in the hips to support the hamstring.
Front Plank: 3 x 30 seconds or until fatigue. On your elbows and knees, bring your knees off the ground and hold. Try to keep your body level throughout this exercise by keeping your hips level and engaging your abdominals and glutes. Keep your elbow below your shoulders and push up to engage your scapular muscles. Purpose: strengthen core and glutes for running form stability.
Side Planks: 3 x 30 seconds (each side, or until fatigue). With elbow aligned with shoulders, come up on your side. Keep your body straight throughout. Purpose: strengthen hips to prevent internal rotation of the knee when landing.
Walking and/or Biking: walk uphill or bike with more resistance
Ice or Heat: Can place ice or heat on tissue for 10 minutes to reduce pain in hamstring.

TO GRADUATE TO PHASE 3

You should be able to complete squats and double leg bridges with minimal pain (<1/10) for four consecutive exercise sessions.

Principles of Hamstring Strain: A Review

CAUSE – abrupt overload of the muscle/tendon, usually with an explosive activity like sprinting
NEED – offload hamstring and reduce pain
PLAN – avoid overstretching the hamstring as it recovers (2-3 weeks), massage to decrease muscle scar tissue, and progressively load the tissue to improve strength

Still Need Help?

You are welcome to meet virtually with our PT for additional feedback and assessment. Otherwise, continue to the next step to learn how best to manage the pain from your injury.