Hamstring injuries and the need for speed.

Hamstring injuries continue to present a major injury burden for all sports that involve high speed running. From the pitch to the track, hamstring strain injuries present a problem with many contributing factors driving the injury bus. So it is no surprise that there continues to be a significant amount of research aimed at improving the prevention and rehabilitation of hamstring injuries. 

A recent investigation from a French University group of researchers wanted to see what exercises could be used to best mimic the stresses experienced during high speed running accelerations and sprints up to 50m Their thought was that if they could find exercises that replicate the stresses experienced during high speed sprints then it provides some insight into how we can train and develop some of the factors required for preparing athletes to withstand these forces. The ultimate aim of which is to stop the injuries from happening in the first place. 

So what did they find?

Well to give further context they wanted to determine whether the horizontally orientated hamstring tasks (those would push you forward, similar to how we propel ourselves in sprinting) could replicate both the force output and muscle activation experienced in all out sprints. What they found was that there was a considerable correlation between the forces and activation levels experienced in tasks such as standing hip extension exercises and Nordic Hamstring exercises when compared with the hamstring muscle actions during high speed sprinting. What was abundantly clear is that the forces and activation, whilst correlated are still significantly lower than hat is experienced during sprinting. 

So what does this mean for using hamstring strength exercises to prepare for fast running activities?

It suggests that these tasks are a part of the conversation, they are an entry to the types of loads, contraction types and activation patterns that may be utilised by the hamstring muscles during sprinting. However they will never fully prepare athletes for the types of loads experienced. It seems like an obsolete statement, but the best way to prepare an athlete to sprint fast in their sport is to gradually and progressively expose them to greater volumes and intensities of fast running. The loads that they experience are specific to that task and it requires gradual acclimatisation to fast running to build the tolerance within the hamstrings to do so. Hamstring strength exercises (and particularly horizontally orientated exercises) provide some foundation, but at the end of the day to prepare and improve your hamstrings’ tolerance for fast running there is, and always be, a need for speed training in your preparation program. 

To access the paper head to https://www.frontiersin.org/articles/10.3389/fspor.2020.609636/full?utm_source=S-TWT&utm_medium=SNET&utm_campaign=ECO_FSPOR_XXXXXXXX_auto-dlvrit

References

George, E., Sheerin, K., & Reid, D. (2024). Criteria and guidelines for returning to running following a tibial bone stress injury: a scoping review. Sports Medicine, 54, 2247–2265. https://doi.org/10.1007/s40279-024-02051-y

Hollander, K., Rahlf, A., Wilke, J., Edler, C., Steib, S., Junge, A., & Zech, A. (2021). Sex-specific differences in running injuries: a systematic review with meta-analysis and meta-regression. Sports Medicine, 51, 1011–1039. https://doi.org/10.1007/s40279-020-01412-7

Joachim, M. R., Kliethermes, S. A., & Heiderscheit, B. C. (2023). Pre-season vertical center of mass displacement during running and bone mineral density z-score are risk factors for bone stress injury risk in collegiate cross country runners. Journal of Orthopaedic & Sports Physical Therapy. https://doi.org/10.2519/jospt.2023.11860

Kliethermes, S., Stiffler-Joachim, M., Wille, C. M., Sanfilippo, J. L., Zavala, P., & Heiderscheit, B. (2021). Lower step rate is associated with a higher risk of bone stress injury: a prospective study of collegiate cross country runners. British Journal of Sports Medicine, 55, 851–856. https://doi.org/10.1136/bjsports-2020-103833

Kraus, E. A., Tenforde, A., Nattiv, A., Sainani, K. L., Kussman, A., Deakins-Roche, M., Singh, S., Kim, B., Barrack, M., & Fredericson, M. (2018). Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury. British Journal of Sports Medicine, 53, 237–242. https://doi.org/10.1136/bjsports-2018-099861

Sirls, E. R., Roux, E. L., Gaudette, L., Bruneau, M. M., Willy, R. W., & Tenforde, A. (2025). Biomechanical associations with bone stress injuries in running: a scoping review. PM&R, 18, S60–S82. https://doi.org/10.1002/pmrj.70059

Stennett, R., Scheer, V., & Kaulback, K. (2025). Bone stress injury epidemiology and risk factors in female off-road runners: a systematic review. Journal of Sport Rehabilitation. https://doi.org/10.1123/jsr.2024-0288

Tenforde, A., Ackerman, K. E., Bouxsein, M., Gaudette, L., McCall, L. M., Rudolph, S. E., Gehman, S., Garrahan, M., Hughes, J. M., Outerleys, J. B., Davis, I. S., & Popp, K. (2024). Factors associated with high-risk and low-risk bone stress injury in female runners: implications for risk factor stratification and management. Orthopaedic Journal of Sports Medicine, 12. https://doi.org/10.1177/23259671241246227

Wilzman, A. R., Tenforde, A., Troy, K., Hunt, K., Fogel, N., Roche, M., Kraus, E. A., Trikha, R., Delp, S., & Fredericson, M. (2022). Medical and biomechanical risk factors for incident bone stress injury in collegiate runners: can plantar pressure predict injury? Orthopaedic Journal of Sports Medicine, 10. https://doi.org/10.1177/23259671221104793

Our Physios

Mia Bailey

MPhysio, BExSpSc

Australian Rules

FIELD SPORTS

Running

Mia is a physiotherapist with a particular interest in team sport injuries, having worked in local AFL and regularly managing soft tissue conditions such as hamstring, calf and Achilles complaints.

Key Areas:

Achilles

Hamstring

Calf

Soft tissue

ACL

Knee

Running Assessments

Jasmine Genis

M.Physio and M. Heath Science (osteopathy).

AUSTRALIAN RULES

FIELD SPORTS

TRACK AND FIELD

Jas is an experienced physiotherapist with a special interest in field-based sports, having worked across AFLW and VFL competitions over approximately 5 years.

Key Areas:

KNEE INJURIES

HIP PAIN

ANKLE INJURIES

HAMSTRING INJURIES

GROIN / ADDUCTOR STRAINS

LOWER LIMB INJURIES

SOFT TISSUE INJURIES

RETURN TO SPORT REHAB

James Elwin

Physiotherapist (B.Physiotherapy)

Olympic Lifting

Crossfit/Functional Fitness

Football/Cricket

James is a keen footballer in winter and cricket physio in Summer and is also a competitive Olympic lifter and Crossfit gym owner.

Key Areas:

Hamstring injuries

Calf injuries

Quad strains

Shoulder injuries

Back pain/injuries

achilles

Side strains