Hamstring Strains in Fall Field Sports
As football and field-sport season gets going and the Bombers give Winnipeg something to cheer about, a familiar injury shows up on sidelines everywhere: the hamstring strain. It is the grab at the back of the thigh mid-sprint, the sudden stop, the cautious limp off the field. Hamstring strains are among the most common injuries in sports that involve running fast, and they have a frustrating habit of coming back. The encouraging news is that they are also one of the most studied injuries in sports medicine, and the evidence on preventing them is unusually clear.
Why hamstrings strain
The hamstrings span the back of the thigh, crossing both the hip and the knee. Their most demanding job happens during high-speed running. In the moment just before the foot hits the ground, the lower leg swings forward and the hamstrings work hard to slow it down while being stretched at the same time. This is called an eccentric contraction, the muscle producing force while lengthening, and it is where most sprint-related strains occur.
That explains the timing of these injuries. They tend to happen at top speed, during acceleration, or when an athlete is fatigued and the muscle's capacity to absorb that rapid load has dropped. Fall field sports are full of exactly these moments: repeated sprints, sudden changes of direction, and long games where fatigue accumulates. A muscle that has not been prepared for high-speed eccentric demand is a muscle at risk.
The prevention evidence: eccentric strength
If the injury happens during a lengthening contraction, it follows that training the muscle to be strong while lengthening should help. This is where the Nordic hamstring exercise comes in. It is a partner-assisted movement in which an athlete kneels and lowers their torso forward slowly, resisting the fall with the hamstrings, then returns to the start. It loads the hamstrings eccentrically, exactly the way sprinting does, but in a controlled setting.
The results are striking. A systematic review and meta-analysis by van Dyk and colleagues, pooling data from thousands of athletes, found that programs including the Nordic hamstring exercise cut the rate of hamstring injuries roughly in half.1 A randomized controlled trial by van der Horst and colleagues in amateur soccer players found the same protective effect when the exercise was built into regular training.2 Bourne and colleagues, reviewing the broader body of evidence, concluded that eccentric knee-flexor conditioning meaningfully reduces hamstring injury risk, with one important caveat: the benefit depends on athletes actually doing the exercise consistently.3 Compliance is the difference between a program that works and one that only works on paper.
Getting back to sprinting after a strain
When a strain does happen, how it is rehabbed influences how quickly and how well an athlete returns. A well-known trial by Askling and colleagues compared two rehabilitation approaches in elite footballers. One emphasized lengthening-type exercises that loaded the hamstring in a stretched position; the other used more conventional exercises. The group doing the lengthening protocol returned to play substantially faster, on average about three weeks sooner.4 The lesson is that rehab which respectfully reintroduces load in the lengthened position, rather than simply resting and hoping, tends to produce better outcomes.
A sensible return to sprinting is gradual and built on capacity. Sprinting is a skill and a load, and it needs to be rebuilt in steps: restoring pain-free strength through range, then progressive running, then controlled build-ups, then full-speed efforts once the tissue has demonstrated it can handle the demand. Rushing straight back to maximum-speed running is the most reliable way to earn a repeat injury.
The load principle underneath it all
Hamstring injuries are, at their core, a load story. The muscle gets asked to do more than it has been prepared for, often at speed and often when tired. This is the practical meaning of the idea that there are no bad exercises, only too much too soon. Sprinting is not dangerous; sprinting a muscle that has not built the capacity for it is. Gabbett's work on the relationship between training and injury makes the same point at the level of the whole athlete: appropriate, progressively built load is protective, while sharp spikes in demand are what tend to precede injury.5
It is also worth remembering that the hamstrings do not work in isolation. How the hip, pelvis, and even the opposite leg contribute to sprint mechanics all influence the load a hamstring absorbs, which is why a complete assessment looks at more than the muscle itself. For athletes heading into a fall season, the takeaways are simple: build eccentric strength before you need it, respect the ramp back to full speed, and treat a strain as something to rehabilitate deliberately rather than wait out.
References
- van Dyk N, Behan FP, Whiteley R. Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. Br J Sports Med. 2019;53(21):1362-1370.
- van der Horst N, Smits DW, Petersen J, Goedhart EA, Backx FJ. The preventive effect of the Nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med. 2015;43(6):1316-1323.
- Bourne MN, Timmins RG, Opar DA, et al. An evidence-based framework for strengthening exercises to prevent hamstring injury. Sports Med. 2018;48(2):251-267.
- Askling CM, Tengvar M, Thorstensson A. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2013;47(15):953-959.
- Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med. 2016;50(5):273-280.
Dr. Michael Minenna D.C., B.Sc., SFMA, FMS
Related care at Boreal Spine and Sport: Sports injury treatment in Winnipeg · What we do at the clinic.