Welcome to the second blog of our Hamstring series, where we look at hamstring muscle strength.
A huge question in sports medicine is what are the causes of hamstring injuries. This has been a topic of interest for decades.
High quality research back in 1997 found that in Australian Rules Footballers, weakness in the hamstrings pre-season both when compared to the quadriceps, and when compared to the opposite leg, was related to hamstring injuries in that season. The same study found that flexibility was not related to injury risk.1 A study in 2015 found that eccentric strength differences between sides (left compared to right) was also a risk factor to injury in Rugby Players. 2 . Both studies found that having had a previous injury within the last 12 months, and increasing age, were also risk factors.
So the question that then is critical for us is, are my hamstrings weak? Am I at risk of hamstring injury when I run and sprint and play sport?
In these studies I have mentioned, expensive equipment is used to control and measure the motion of the leg and gain an accurate measurement of muscle strength. This equipment is not available to the average physiotherapy clinic, let alone the sportsperson. However, in the clinic, hamstring testing can be done clinically, needing little or no equipment. It can be done at home to give an idea of whether there is weakness and imbalance in the hamstrings.
Easy tests for hamstring strength and endurance. 2 tests that you can do for hamstring strength.
1. Single leg bridge test.
Lie on your back, with knees bent. Straighten one leg out. Gently tighten your lower tummy muscles. Push into the floor with your foot, and lift your hips off the floor until your knee, hips and shoulders are all in line. Hold for 3 seconds, then lower smoothly.
Repeat up to 15 times. Maintain good control and alignment for each lift. If you are not able to keep your hips aligned, or if your back arches or gives pain, you should stop.
Compare your performance between the left and right legs. If you find it much more difficult on one side, then you have an imbalance in strength.
If you are not able to perform 3 sets of 15 good quality exercises, then your strength levels may be lower than is needed for your sports.
If you struggle with this exercise, consider starting work on a hamstring strength program.
2. Resistance band hamstring curl test.
For this test you need a loop of resistance band. Lie face down and position the band around the heel of the test leg, and around the toes of the resting leg to secure the band. Gently tighten your tummy to ensure you back does not arch.
Smoothly bend the knee without arching your back or lifting your hips. You will feel the hamstring working. Hold for 3 seconds, and then lower. Perform 15 times, or until you feel the muscle is too tired or fatigued. Then compare with the opposite leg. Make a note how many repetitions you achieve, or of the level of difficulty in each leg - give it a rating out of 10 so you can re-measure once you have done some work on a strength program.
These 2 tests are easy to perform, and will give you an idea of your hamstring strength. However, do keep in mind that they are not scientifically accurate, and will not tell you the whole story about your hamstring strength and health. However, if you find you really struggle with either, or there is a noticeable difference between sides, then perhaps a strength program is what you need to build strength and prevent injury.
We will look into options for strength and injury prevention later in this blog series.
Do get in touch with us at Onebody Clinic with any questions you have. And if you need more help in assessing your hamstring health, and help with rehabilitation and strengthening, then come and see us for an appointment.
1. Am J Sports Med. 1997 Jan-Feb;25(1):81-5.)
2. Am J Sports Med. 2015 Nov;43(11):2663-70.