Return to running after hamstrings injury

A controlled return to running after hamstrings injury is one of the most vital, and commonly missed, elements of hammy injury rehab.

It sounds crazy – you can do all that carefully planned hard work to recover from the injury, but then you just resume your normal training like you flipped a switch!

The one hidden risk with running after hamstrings injuries is that they can continue to move and work differently, even after the damage has healed.

The brain alters the way it controls the muscle during running and, under higher running loads, it makes you more susceptible to a 2nd injury.

Types of hamstrings injury

There are plenty of different ways to injure a hamstrings muscle, and even more ways to classify them…

Some classification systems divide injuries up based on whether you’ve damaged connective tissue, muscle fibres or a combination of both.

Other systems grade it based on the amount of damage sustained (grade 1, grade 2 or grade 3, with grade 3 being the most damage).

But the easiest way to think of your hammy injury is how it responds to stretch and strength.

If it hurts to stretch or is limited in how far it can stretch (compared to the other side), you have a stretch deficit.

If it hurts to directly load (such as sliding off your shoe by pushing on the heel with the other foot) or feels weak, you have a strength deficit.

Armed with the knowledge of whether your injury is susceptible to stretch or strength, or both, you can map out a running program that can avoid overloading that aspect of your hammy performance.

runners in park

Effect of hamstrings injury on running technique

The hamstrings is more active in the front half of the running stride, when the leg is in front of you.

As the leg swings forward, the hammy works to slow the swing down so the speed of the foot matches the speed of the ground and you can land without skidding.

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Once you’ve hit the ground, it works to initiate leg drive and start pulling the leg backwards (and your body forwards).

It doesn’t work much once the leg is under you and moving behind. It doesn’t bend the knee as you leave the ground (that’s done by the calf muscle). And it DEFINITELY doesn’t lift the heel towards your bottom – that’s not actually part of a normal running stride (no matter how much some techniques try to sell it as a crucial element…)

An impaired hamstrings is going to have trouble judging speed as it works to slow the leg in the swing phase. You’ll notice your foot skids as you land, worsening as you run faster. Sometimes you can hear it, other times you’ll notice that the back corner of your outsole has sheared away.

Post-injury, you can also notice a change in stride length and a loss of power from that leg. The loss of power causes the brain to lengthen your stride, giving you more time on the ground to drive through the leg.

How to modify your running technique to reduce hamstrings loading

This is where it gets tricky – hamstrings injuries and the resulting loss of power cause you to lengthen your stride.

A longer stride overstretches the hamstrings and will aggravate any length deficits.

But if you actively try to shorten your stride, you’ll overwork the muscle that shorten stride length – the hamstrings!

So here are some tips on prompts or focus points for technique that help with returning to running after hamstrings injury:

  1. Never just shorten your stride – it’ll happen but only if you focus on other elements
  2. Focus on forward knee drive as the leg swings – the bent knee will take the pressure off hamstrings
  3. Look ahead around 10-15m – watching the ground right in front of you causes a forward lean and adds more load to hamstrings
  4. Wear older shoes – shoes with less traction place less loading on hamstrings as you pull the leg backwards after landing
  5. Focus on rhythm – thinking about your overall “flow” improves efficiency, whereas focusing on hamstrings activity tends to disrupt that activity
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Program changes for running after hamstrings injury

Here are the aspects of a typical running program and how they relate to running after hamstrings injury:

Speed sessions

The faster the legs move, the more load is placed on the hamstrings. Seems logical, right?

But with faster speeds comes greater forces AND reduced efficiency (less response time to fine-tune movement). That combination means that the hamstrings loading skyrockets with even a small increase in pace.

You can avoid the highest risk by gradually accelerating off the mark, building up to speed over 3-5 seconds or switching intervals for fartlek sessions.

You can further reduce your risk by wearing less grippy shoes (and definitely no track spikes).

Long runs

Long runs are slower, reducing the speed risk above, but they have considerable fatigue involved.

As different muscle groups fatigue, other muscle groups (such as hamstrings) are selectively loaded. At the same time, there’s a drop in running efficiency to cause further overload.

The simplest way around this is to add in walk breaks into your long run – you still get your distance or time covered, but with less fatigue.

And while this may not sound like the sexiest option (runners having to walk, WTF!!!), it’s better than only covering half the distance or flaring the injury up again. It’s also a viable option to complete longer races before you’re back to 100% (popularised by Olympian Jeff Galloway).

Vertical/hill sessions

Running uphills can be problematic as the forward lean adds more stretch to the hamstrings, and the incline needs more power to generate speed.

That combination can make uphill running one of the worst sessions for a recovering hamstrings.

A safer option would be stairs – you still get your vertical but the stairs limit the issue of overstride, taking away the stretch risk.

Sample running program (with explanations)

This program would be an early (building) phase program that I’d use for one of my mid-pack 10k runners. It would vary each week but this gives an overview of the rationale behind the design.

DaySessionReason
MondaySwim recovery
+ rehab exercises
Swimming has been shown to be the most effective non-running recovery session. While an easy run is often used as a recovery run, running on fatigued legs (from the Sunday long run) increases the risk of irritating the injury
TuesdayStair session
40 minutes
Adding in stairs for power and heart rate recovery, but avoiding hills due to the excessive stretch on hamstrings with uphill overstride + forward lean
WednesdayRehab exercisesIncluding time for rehab is crucial at continuing to challenge the hamstrings and ensuring a complete recovery
ThursdayFartlek session
60 minutes
Fartlek (2min fast : 2min easy) allows for more gradual acceleration while still reaching decent speeds (however still slower than max efforts)
FridayRehab exercisesAs above
SaturdayEasy 5kAs easy run is a chance to practice effortless technique and refine technique efficiency
SundayLong run:walk
90 minutes
The run:walk design (8 minute run : 2 minute walk) allows for fatigue to build endurance but reduces its negative effect on running technique. It also allows for time on feet, and the 2min walk breaks improve heart rate recovery