Written by Dr. Quinn Henoch
Hamstrings injuries are very common. In runners, strains frequently occur in the mid-belly of the muscles. High hamstring irritation (up near the glute fold) can be prevalent in power sport athletes and lifters. I encounter the latter in the clinic often, which can make the deadlift and squat difficult to perform.
When recovering from injuries like this, it helps to be stricter with your movement and position. Reducing the length and eccentric contraction of the hamstring during a lift can take stress off the muscle as it heals; and allow you to continue to train. Anterior pelvic tilt/lumbar extension is necessary to lift heavy weights, but increased anterior tilt puts more stress and stretch on the hamstrings. So it may be necessary to bring the pelvis back underneath you a little bit more, to a more neutral position. This can be done by posteriorly tilting the pelvis. Now, under load, you do not want to perform that posterior tilt to the point of lumbar flexion, obviously. However, if you are recovering from a hamstring issue, a slight posterior tilt to neutral can make a profound difference in your symptoms. As your injury resolves, you will slowly be able to increase the amount of anterior tilt you are able to tolerate.
In addition to modifying your pelvic position during your lifts, modifying the lifts themselves can aide in keeping you in the gym, while dealing with a hammy. For the squat, this is where a box comes in handy to reduce the depth and allow you to control your position easier. This doesn’t mean that you sit way back and try to keep your shins vertical, with your toes off the ground. Keep your squat movement the same. The box will just allow you to squat to a depth that’s comfortable, and will also allow you to control your pelvis.
You can also use the pins and perform Dead Squats. Set the height of the pins at a height you are comfortable with, and get under it to the point where you feel balanced and stacked, then explode up. Again, this decreases the eccentric loading, but still allows you to feel some weight. Here’s a video.
For the deadlift, rack pulls or pin pulls are the obvious choice. Any height above the knee will likely be much more manageable with a hamstring strain. As discussed, work on pulling the pelvis underneath you slightly, as opposed to pulling with a hard arch. As with the squat, you will be able to incorporate more arch as you heal. The hex bar or trap bar is also a good alternative when dealing with this type of injury, because you can more easily control the amount of hip hinge.
Warm-Up Movement Prep
It will be important to facilitate the hamstrings in lower threshold activities as well, in order to normalize muscular tone. Abdominal facilitation and stability is also paramount in the recovery process. The hamstrings and abs work together to control the pelvic and trunk position. Performing some ground-based warm up drills will help you stabilize the more “neutral” position that you will likely have to lift with for a while, especially if such a position is foreign to you.
Below is a quick run-down of some drills that can build you up to standing. Some of them bias posterior pelvic tilt with hamstring and abdominal facilitation.
As a side note, posterior pelvic tilt and lumbar flexion is completely safe in these unloaded positions, and will aide to de-load the injured hamstring and build it back up – after all, a posterior pelvic tilt is performed by contracting the hamstrings and abs, which are the muscle groups we are trying to facilitate in the first place.
90-90 Hip Lift
I’d rather have less sets and reps with higher quality. Watch the first video for cues of the drill. The second video is a version that facilitates the hamstrings even more. Exhale fully. When you think you have exhaled all the way, exhale more. Catch the ab shake. Then pause for 2 seconds before your next inhale. 3-4 sets of 4 breaths.
It’s called this because it mimics an infants position at 3 months. It is wildly effective as improving anterior core control. Use a STRONG exhale to set position. Try one of these two variations for sets of 5 breaths or reps:
A clear choice for hamstring facilitation. Perform 1-3 sets of 6-8 reps of the double leg version. If you are feeling saucy, perform single leg holds for 5 breaths.
(start at 4:30 mark)
This one looks funny, but when performed correctly, is a great way to train the abdominals. If the one-handed version is too difficult to breathe in to, start with two hands on the ground. You can also add some leg kick backs (bird dog ish) to train hip extension.
Bear Position To Squat
Think of this as developing the bottom of your squat from the bottom-up instead of the top-down. It’s a really effective way to relearn the bottom position. 1-2 sets of 5 reps.
This position is really effective to gain an isometric contraction of the hamstrings with both knee flexion and hip extension. You can add upper body components to reteach the hamstrings to stabilize under external perturbation
As you progress, your drills can become more dynamic and incorporate more hamstring length and anterior pelvic tilt, as well as eccentric loading; such as the following:
Active Straight Leg Raise Correction
This will help you learn to hinge from either hip. Work through a comfortable range only. To get the most out of this drill, you should have regained your ability to perform a toe touch. 1-2 sets of 5 each side.