Hamstring exercises - how a runner's niggling hamstring problem was solved

This runner was training for a marathon, having previously run half marathons. After long runs, or weeks of high mileage his hamstrings would be very sore, preventing consistent training.

First stop was to test his hamstring flexibility. It was OK and he was already stretching religiously in an attempt to reduce the tension in the muscle.

Secondly, we examined his strength at various functional hamstring exercises. Here we discovered where the source of the problem lay: weak hamstrings when extending the hip. Let me explain why this is a problem for a runner.

The hamstrings are a key muscle during the running motion, providing an active forward push off. The hamstrings and the gluteus maximus are both hip extensor muscles, pulling the leg backwards and raising the trunk upright. When the body is in an upright position with the foot in contact with the ground, as in running, the glutes are more active (due to their position) at keeping the body upright, while the hamstrings (as they attach below the knee) are more active at pulling the leg backwards as the runner pushes off the ground. This muscle activity has been proven with electromyographic analysis of the muscles during running and shows that the hamstrings are very active during the second half of the ground contact phase compared to the glutes, which are minimally active. Therefore the hamstrings and not the glutes must be providing the hip extension push. Other recent research has shown that runners with stronger hamstrings are better able to maintain their stride length and are more efficient during maximal treadmill tests.

Weak hamstrings will be strongly tested during distance running and so it was hypothesised with this runner that by following a progression of functional strengthening exercises, the hamstring problem would be improved.

The following progression is taken from Santana 2001 Strength and Conditioning Journal Vol 23 (1) p 18-20. I have found it to be very effective with a number of athletes and runners. All three exercises use the stability ball (aka Swiss Ball).

The exercises

1. The hamstring bridge. Lie on your back, arms out to the side. Your heels are up on the ball. Place your heels about hip width apart. Push your heels down into the ball and raise your hips until they are as high as they can go while keeping the shoulders on the floor. Lower your hips until they are just off the floor and repeat.
2. The leg curl. The start position is the high hip position of the bridge exercise. Keeping your hips high, roll the ball towards you, bending your knees. Then, roll the ball back out, extending the knees. Perform this leg curl movement with the hips high throughout.
3. The hip lift. Lie on your back, arms out to the side. The soles of your feet are on the ball and your knees are slightly bent. Feet should be hip width apart. Push down into the ball and lift your hips, as in exercise one. Lower down until your hips are just off the floor and repeat.

The progression

Week 1: 3 sets of 5 of each exercise. Perform each exercise one after the other without rest. Take 45 seconds rest between each set of 15 reps.

Week 2: 3 continuous sets of 8 of each.

Week 3: 3 continuous sets of 12 of each.

Week 4: 3 continuous sets of 15 of each.

Week 5: 3 sets of 5 of each exercise, single leg only. Perform 5 bridges, 5 leg curls and 5 hip lifts on the left leg, then change to the right leg. Repeat twice with each leg. Don’t bother taking rest between sets because the left leg rests while the right leg works and vice versa.

Weeks 6-8: Increase up to continuous sets of 15 single leg as before.

By the time you can complete 3 sets of 45 reps (3 lots of 15) single leg your hamstrings will be have developed very good strength endurance. What’s more, you have trained them in a way that is functional to running. As the feet pull down into the ball, the hamstrings contract and the hips extend by lifting. Rotate the body 90 degrees and this is exactly the same movement as running, with the feet pushing back and the hips extending by moving forward.

Raphael Brandon