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Hamstring Injuries: Dr. Jen's Guide to Prevention

Updated: Apr 21, 2023

Injuries to the hamstrings are a common issue among athletes and runners. From sprains, strains, tears and pulls - understanding how to prevent and treat hamstring strain is key for a healthy running career. Hamstring injuries can be complex due to their anatomy as well as the various causes of injury that range from overuse or lack of stretching before exercise. It's important for runners and athletes to understand the causes and symptoms associated with a hamstring strain in order to properly diagnose it early on so treatment can begin quickly and effectively. With prevention strategies such as prehab exercises that focus on eccentric strengthening exercises and proper stretching techniques you can perform at home, and home treatment of the injury: we'll explore all you need know about hamstring strains and how to prevent them.

Anatomy of the Hamstring

The hamstring is a trio of muscles situated in the posterior portion of the thigh, stretching from hip to knee. The hamstring muscles flex and extend the knee joint while also providing stability to the hip joint during movement.

The hamstrings are made up of the semitendinosus, semimembranosus and biceps femoris muscles and collectively they provide dynamic stability when running or walking while also allowing us to bend our knees when sitting down or standing up. They have 2 key roles during a running stride: they flex the knee and extend our hips. They can be thought of like an engine that helps power our legs forward with each stride we take as well as breaking system slowing our leg down during the swing phase of our stride.

Muscles Involved:

All three muscles have similar functions but differ slightly in their attachments and actions on different parts of our lower leg bones.


The semitendinosus originates at one side near our buttocks before traveling down along our inner thigh where it attaches just below our knee joints; this muscle assists with internal rotation movements such as bending your leg inward towards you body’s midline when squatting or lunging.


The semimembranosus starts from a similar point but travels along an outer path towards its attachment point; this muscle works opposite from semitendinosus providing external rotation assistance for activities such as turning outwards away from you body’s midline when performing squats or lunges.

Biceps femoris

The biceps femoris begins at two separate points – one near both sides near your buttocks – before connecting further down just above both sides of your kneecap; this muscle helps extend/straighten out both legs simultaneously when jumping or sprinting forward quickly.

The hamstrings are intricate muscles, and comprehending their composition can help to avert or cure any trauma due to strain. Having a lack of suppleness and strength disparities can be significant contributors to hamstring injuries, so having knowledge about these components is essential for managing this sort of injury properly.

Causes of Hamstring Strains

Hamstring strains can be caused by a variety of factors, including overuse injuries, poor flexibility and strength imbalances around the hip and knee joints, or traumatic injury due to sudden force or impact.

Repetitive motion can lead to hamstring injuries for athletes who engage in activities such as running, leaping, kicking or any other movements that necessitate fast motions.

This type of strain is usually caused by not allowing enough time for muscles to rest between activities. It can also occur when an athlete increases their intensity too quickly without proper warm-up exercises and stretching. Over-striding and sprinting are both very common cause of hamstring strain in runners.

Runners also have a tendency to become quad dominate due to the repetitive nature of the their sport and in return this often results in tight hamstrings. Poor flexibility and strength imbalances around the hip and knee joints can also lead to hamstring strains because they put extra stress on the muscles involved in those areas which can lead to tears or pulls if they aren’t properly conditioned for strenuous activity. To prevent this type of strain it’s important for athletes to stretch regularly as well as incorporate exercises into their workouts that target these specific areas such as Romanian deadlifts variations and hamstrings bridges.

Muscle fatigue is also a cause of hamstring injuries in runners. Many runners push their endurance goals too quickly and this will often lead to muscle fatigue which is a major risk factor for injury. A sudden or drastic increase in mileage or speed can also cause hamstring strains in runners. It is important to implement a well structured running plan to help reach your goals to help prevent muscle fatigue. If you are in need of a safe and effective running plan, Kim Miller Fitness builds custom running plans tailored to your specific goals and needs.

Hamstring strains may stem from a variety of causes, including overuse injuries, muscle imbalances, muscle fatigue, increases in your running activity or even direct trauma. Recognizing the signs linked to hamstring strains is essential for grasping how to avert and treat them.

Key Takeaway: Hamstring strains are often caused by overuse, inadequate preparation for physical activity or imbalances around the hip and knee joints. To avoid such issues, athletes should ensure they have adequate rest between activities and regularly stretch and perform exercises that target these areas to build strength.

Symptoms of Hamstring Strains

Aching and soreness in the back of the legs or gluteal region is a frequent sign linked to hamstring tears. This pain can range from a dull ache to an intense burning sensation, depending on the severity of the strain. Swelling and bruising are also common signs that a person has suffered a hamstring strain. The affected area will often appear red and swollen due to inflammation caused by muscle fibers being torn during injury. Bruising may also occur as blood vessels burst under pressure when muscles contract too quickly during activity.

Difficulty walking or bending the knee joints fully is another symptom commonly experienced after suffering a hamstring strain. Muscles which have been strained can become severely tightened, making it difficult to move them through their full range of motion without risking more injury or discomfort. As such, those who have sustained a hamstring strain should take extra care not to overextend their leg muscles while walking or engaging in any other activities involving movement of these areas until they have healed completely.

Awareness of signs of hamstring injury is key to ensuring proper medical care if needed. To mitigate the chances of suffering from a hamstring strain, it is prudent to incorporate preventative measures such as prehab exercises and stretching into your workout regimen.

Key Takeaway: Aching and soreness in the backside or hindquarters, along with puffiness, discoloration, and difficulty walking, flexing can be caused by a hamstring strain. A genuine annoyance, potentially leading to more severe harm if not treated properly, can be felt in the neck or legs due to a hamstring strain.

Home Treatment for Mild Hamstring Strains

Most mild hamstring strains can be managed and treated at home. If you are in severe pain or do not notice and improvement in symptoms I always recommend seeing a healthcare provider to assess your injury.

Rest, Ice, Compression, Elevation (RICE) Protocol to Reduce Inflammation and Pain Symptoms

RICE is a widely used protocol for the treatment of hamstring strains. It involves resting from activities that cause pain or discomfort; applying ice packs to the affected area; compressing the area with an elastic bandage or wrap; and elevating the leg above heart level when possible. This helps reduce inflammation and decrease pain symptoms in order to allow healing. It is suggested to start this protocol right away after an injury occurs for optimal results. If your pain has shown signs of improvement and pain has decreased, starting gentle stretching exercises of your quads and hamstrings followed by a slow progression of strengthening exercises and return to activity. Stretching should not be painful and should be performed in a pain free range.

Physical therapy may be necessary depending on the severity of the injury. If symptoms persist, seek professional medical advice from a qualified healthcare provider to ensure an effective treatment plan is in place.

Prevention Strategies for Hamstring Strains

Prevent a hamstring injury before you have to treat one. Even a minor hamstring injury can sideline your running career for weeks or months. Prehab exercises are a crucial part of injury prevention when it comes to hamstring strains. Improving the flexibility, strength, and balance around the hip and knee joints can help reduce risk for injury.

Eccentric strengthening exercises such as Romanian deadlift variations, hamstring bridges, hamstring walk outs and hamstring curls (focusing on the eccentric contraction) can also be beneficial in reducing risk for injury by increasing muscular control throughout the entire range of motion of a particular exercise or activity. These exercises should be done slowly with focus on form rather than speed or weight lifted; this helps ensure that all muscle fibers are being activated properly while maintaining good posture throughout each repetition.

Below are some of my favorite exercises for strengthening hamstrings to prevent injury. The key: Slow and Controlled with proper form.

Romanian Dead Lifts

Staggered RDL's

Hamstring Bridges

Hamstring Walk Outs

Hamstring Curls

Increasing the flexibility of your quads and hamstrings before and after exercise sessions is imperative for preventing a muscle strain. This helps improve normal length-tension relationships within the muscle groups so they don't become too tight from repetitive movements over time and will help increase range of motion, which is necessary for proper movement patterns during running or other activities. Taking 10 minutes at the end of your workout to perform dynamic stretches like leg swings or walking lunges will go a long way towards keeping those "hammies" healthy.

By implementing a combination of prehab exercises of eccentric strengthening movements and regular stretching sessions into your training routine, you can reduce the risk for developing hamstring strains. In the event of an injury, it is essential to be familiar with appropriate treatment protocols in order to facilitate a speedy recovery.


Don't let a hamstring injury be the reason you don't meet your next running goal. It can be prevented with proper prehab exercises. KMF Stronger Together workouts are programmed specifically to help prevent injuries in runners and incorporate these exercises regularly. They are designed to help you meet your goals injury free. Proper prevention strategies are essential for reducing risk of this type of injury so runners can continue their training without interruption or discomfort.

Train smart, be consistent and unlock your fitness potential,

Jennifer PT, DPT

**The content in this physical therapy blog post is provided for informational purposes only and is not intended to serve as medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. The author and publisher of this blog post are not liable for any errors or omissions in the content, nor for any losses, injuries, or damages arising from its use. Reliance on any information provided by this blog post is solely at your own risk.**

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