The Best Hamstring Rehab Exercise Guide

If you have read our previous article on how to assess for hamstring injuries, you will now be looking at a period of rehabilitation to ensure your hamstring injury resolves, and importantly is less likely to return in the future. The following exercises are excellent strengthening for strengthening the hamstrings, but it is important to know some other components of your rehab that should not be missed. For example, if you play a running and kicking sport, the timing of when to reintroduce these into your training is a conversation that you should have with your physiotherapist. 

The other important question we as physiotherapist often get asked is: should I stretch my hamstring? In short answer, no – not in the immediate 48-72 hours after injury. This may only increase the severity of the injury and negatively impact on your return to play timeline. Foam rolling may be appropriate earlier, but depending on the extent and exact location of your injury, may also be contraindicated. 

So once you have cleared all of your tests from your physio, what are the top 5 hamstring exercises to complete to ensure you get your hamstring as strong as it possible can be? See our Instinct solutions below: 

Please note: these have been laid out in a specific order of increasing difficulty so should be completed in this order to maximise the safety of your recovery.

  1. Single leg prone hamstring curl – This is concentric/eccentric exercise where the hamstring are under tension when both bending and straightening. This exercise can be completed in a several different variations, but our preferred method is as follows:
    1. Lie on your stomach with both knees straight
    2. Attach a theraband or powerband around the back of the ankle 
    3. Pull the heel in towards the bottom in a slow and controlled manor until you reach 90°
    4. Slowly release the leg back towards the floor and repeat 
    5. Complete 4 sets of 10 repetitions with 45 seconds between sets 
  2. Fitball hamstring curls – this is a great exercise for using our bodyweight to eccentrically (lengthening) load the hamstrings on an unstable surface
    1. Lie on your back, with both feet on a fitball or gymball 
    2. Start by thinking about peeling your spine off the floor, and gradually lift your bottom up off the floor until your shoulders/hips and knees are in a straight line
    3. Roll the ball away from yourself as far as you can by straightening the knees
    4. Pause with the knees extended, then roll the ball back in towards your heels
    5. Slowly lower back to the floor, and repeat 
    6. Complete 5 sets of 8 repetitions with 45 seconds between sets
  3. Romanian Deadlift (Kettlebell) – this exercise begins to add load greater than just our body weight to load the hamstring
    1. Start with your feet just inside hip width apart standing in front of a kettlebell of 12-20kg (depending on your strength) 
    2. Think about folding from the hips with the arms straight and only a slight bend in the knees and place your hands on the handle of the kettlebell 
    3. Tuck your chin in, keep your core muscles activated and your spine in neutral 
    4. Squeeze your glutes (bottom muscles) and lift the kettlebell up towards your hips as you stand up straight 
    5. Keep the kettlebell close in towards your shins as you stand up
    6. Slowly lower back towards the floor until you feel a stretch of the hamstrings 
    7. Repeat 3 sets of 10 reps, with 60 seconds between sets
  4. Hamstring tantrums – the fast pace of the exercise helps to return power and speed to our hamstrings
    1. Sit on a bench or chair with a small fitball tucked under the bench or chair 
    2. Start with the knees bent to 90° and thighs resting comfortably on the chair 
    3. As rapidly as you can, kick the fitball with your heels and alternate legs with your kicks 
    4. Complete 6 sets of 20 seconds with as many repetitions as you can in that time. Rest for 30 seconds between sets.
  5. Nordic hamstring curls – this exercise is an extremely difficult exercise and should only be completed towards the end of a rehabilitation period. You will also need a partner for this exercise.  
    1. Begin on your knees with a foam pad underneath the knees and your partner holding onto your heels for support 
    2. Keeping your shoulders/hips/knees in a straight line, begin to lower yourself down towards the floor as if you would land on your face 
    3. Keep the movement as slow as you can until you feel you will fall 
    4. Catch yourself with your hands on the floor, then push up through your hands to return back to the start 
    5. Complete 6 sets of 5 repetitions with 60 seconds between repetitions 

This series of exercises should be completed one after another and 3 exercises should be completed in any one session. If you feel an increase in pain during any exercises you should stop immediately and discuss this with your physiotherapist. These strength sessions will be most effective when completed in conjunction with massage, dry needling and other release techniques. 

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