The Hamstring Injury Epidemic: How To Prevent Injury?

Hamstring injuries are a constant thorn in the side of athletes and the professionals who support them. They’re among the most common and frustrating injuries in sports, and chances are, you’ve dealt with them more times than you’d like to admit. The data speaks volumes: in professional football, nearly a quarter (24%) of all injuries are hamstring-related, according to a 20-year study by UEFA. It’s not just football, across six popular team sports, including rugby and field hockey, hamstring injuries account for about 10% of all injuries, with athletes sidelined for weeks on end.

The consequences? They go far beyond missed games. A study on Spain’s LaLiga revealed that muscle injuries, including hamstring strains, cost clubs €365,811 every single month. Think about the ripple effects: disrupted training schedules, derailed team performance, and players struggling with not just physical recovery but the mental toll of being out of the game.

It’s no wonder that preventing hamstring injuries is a top priority for coaches, trainers, and physios everywhere. And yet, despite the countless hours spent on prevention programs, the problem persists. Clearly, something’s missing.

So, what’s really causing these injuries, and more importantly, how can we stop them? Let’s dig deeper into the root cause and why the usual approach to training might be doing more harm than good.

Why do hamstring injuries occur?

Hamstring injuries might seem straightforward, but they’re anything but simple. The truth is, they are the result of a tangled web of factors, what we call a "multifactorial" issue. On the surface, a seemingly minor misstep can have catastrophic consequences, much like a small crack in a dam leading to a flood.

When it comes to training, one major culprit stands out: backside running mechanics.

Imagine an athlete leaning forward as they sprint. This posture causes the recovering leg to swing backward in an elongated arc before planting, creating a slow and inefficient recovery phase. This backward swing leads to an eccentric stretch of the hamstrings just before the foot strikes the ground - an incredibly vulnerable moment for the muscle. Combine this with poor pelvic control and inactive abdominal muscles, and you’ve got a recipe for disaster. The pelvis tilts forward, further stretching the hamstrings and putting them at significant risk of injury.

The Flawed Solution

To combat hamstring injuries, coaches have traditionally turned to eccentric hamstring training - heavy, isolated exercises that focus on lengthening the muscle under load. While this method may build strength, it’s like reinforcing the walls of a sinking ship without fixing the hole. It addresses the symptom, not the root cause.

This approach was born out of the misconception that the hamstrings primarily function eccentrically during the late swing phase of running to slow knee extension before foot contact. While this is partially true, it ignores the larger context of how the hamstrings interact with other parts of the body.

There are two critical considerations that many coaches overlook when training the hamstrings:

1. Anatomical Design for Isometric Function: The hamstrings are anatomically structured to function isometrically, meaning they are optimized to generate force without changing length. This is due to their steep force-length curve, which allows them to produce high force levels at or near their optimal length. Deviations from this length, either shorter or longer, result in a rapid decline in force production, increasing susceptibility to injury during peak external forces. Additionally, the hamstrings' multipennate fiber arrangement contributes to this isometric preference. This structure limits changes in sarcomere length during movement, a concept known as muscle gearing. Muscle gearing refers to the relationship between muscle fiber shortening and overall muscle shortening, influencing how muscles produce force and movement. In the case of the hamstrings, their design favors maintaining a constant length under tension, rather than actively lengthening or shortening.
   
   
2. Bi-Articular Nature and Joint Coordination: The hamstrings cross both the hip and knee joints, classifying them as bi-articular muscles. This positioning means their length and function are influenced by movements at both joints, as well as by pelvic positioning. Effective functioning of the hamstrings requires precise coordination between hip extension, knee flexion, and pelvic stability. Any imbalance or misalignment in these areas can lead to inappropriate lengthening or shortening of the hamstrings, heightening the risk of injury. This necessitates a training approach that enhances inter-muscular coordination and joint coupling, ensuring the hamstrings operate within their optimal length-tension parameters during dynamic activities.

The problem with eccentric training? There’s no transfer.

Eccentric training doesn’t teach the hamstrings how to coordinate with the pelvis, hip, and knee during dynamic movement. While it may build muscle strength, it fails to address the real-world demands of running, where the hamstrings are expected to hold a steady length while stabilizing multiple joints. Instead of enhancing their function, this approach often leaves the hamstrings vulnerable to the very injuries coaches aim to prevent.

The New, Improved Approach

To effectively prevent hamstring injuries, it is essential to shift the focus from isolated hamstring strengthening to a more holistic approach that addresses the underlying causes. Improving pelvic control and enhancing abdominal strength are pivotal in this strategy.

The sequence leading to injury typically follows this pattern:

1. Poor pelvic control leads to anterior pelvic tilt.
2. Anterior pelvic tilt causes uncontrolled lengthening of the hamstrings.
3. This uncontrolled lengthening results in eccentric contraction beyond the optimal length.
4. Such eccentric contraction increases the risk of injury.

By improving pelvic control, the hamstrings can maintain their optimal length, allowing them to generate force safely and efficiently during running.

The Tidal Tank PRO offers a unique solution in this context. Its shifting water creates unpredictable forces that mimic the dynamic challenges athletes face during running. This environment trains the abdominals to stabilise the pelvis effectively, improving overall running mechanics and reducing the risk of hamstring injury.

 

 

How Does This Look In Training?

An effective injury prevention and rehabilitation program should address three key areas:

1. Strengthening the Abdominals: A robust core is essential for pelvic control, preventing anterior pelvic tilt, and protecting the hamstrings from excessive stretching.

2. Isometric Training for the Hamstrings: Training the hamstrings to generate force without changing length aligns with their anatomical design and prepares them to handle peak forces safely.

3. Correcting Running Mechanics: Encouraging an upright torso, hip extension before foot contact, and a vertical foot plant optimises hamstring function and prevents harmful eccentric contractions.

Practical Examples

EXERCISE 1: Tank Seated Punches 

The best way to improve the abdominals ability to control the pelvis during running, is by training the muscles to resist rapid spikes in impinging forces from the water in the Tidal Tank PRO. This will test their ability to overcome external forces that would otherwise create the eccentric lengthening we know causes injury. The goal is to remain at optimal length despite the rapid, variable forces created by the shifting water in the Tank. 
The punch of the Tank creates an impact of the water which simulates the rapid spike in impinging forces during running. The abdominals are challenged to resist these forces and remain at optimal length. 

EXERCISE 2: Tank Bridge Punches 

To train the hamstrings force-producing ability at optimal length athletes can do Tank Bridge Punches. This exercise uses the shifting water in the Tidal Tank PRO to create co-contractions of the hamstring muscles and abdominal muscles. This way both muscles are working together at the same time just as they should function during sprinting. This improves not only the isometric force of hamstrings but lumbo-pelvic-trunk control too.

 EXERCISE 3: Hydro Ball Overhead Skips

This exercise teaches all three key aspects of the hamstring injury prevention simultaneously. Abdominals strength to prevent anterior pelvic tilt, frontside running mechanics, and isometric hamstring contraction. The moving water in the Hydro Ball really challenges the abdominals to control the pelvic position.

By addressing the root causes of hamstring injuries, poor pelvic control and inadequate abdominal strength, rather than merely treating the symptoms, it is possible to break the cycle of injury and frustration. The Tidal Tank PRO is not just another training tool; it represents a comprehensive approach to helping athletes move better, train smarter, and stay injury-free.

For more practical solutions, explore the complete YouTube exercise playlist here: YouTube Playlist.