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What you need to know about hamstring strains and tears

Updated: Jan 10, 2020

Having been a sprinter in a Division 1 Track and Field program, I’ve had my fair share of hamstring strains and pulling up “lame” at the finish line. I can sympathize with that feeling of depression and let down recreational and elite runners alike can get when just one muscle completely shuts down a run.

My strength and conditioning coach believed he had it all figured out: strengthening the hamstrings and increasing its flexibility was the key to protecting me and my teammates from any further hamstring injuries. He preached that there should be a balance between the strength of the quadriceps and hamstrings.  The quadriceps should not overpower the hamstrings because that would cause an increased “knee extension moment” (aka knee straightening) causing the hamstring to fail. We followed his plan meticulously, but, for most of us, it didn’t work.

Understand that health and fitness professionals have been pushing this same theory, and elite athletes have been following it uninterrupted for years. While some athletes do escape hamstring injuries, most are plagued by recurring problems. But why is this?

Anatomy and Physiology

First, it is important to understand that EVERY BODY is created differently -- some bodies have a natural disposition to injure one part over another.

Functionally, the hamstring is more or less a postural control muscle for the knees and the hips. It originates from the ischial tuberosity located in your buttocks and, as a group, is actually comprised of THREE different muscles. I say it’s just a “postural” muscle because if you look at the biomechanics of running and walking, there is very little firing except when the knees and hips are propelling someone forward. The muscle’s main job is to CONTROL or slow down these joints, preventing hyperextension.

The hip flexor, or the iliopsoas, and the quadriceps have come under fire in the past few years as a cause for back injuries because of where they attach to the pelvis.  The main job of these muscles, however, is to provide stability when the foot hits the ground. In other words, they keep your body from collapsing at the knees or hips and falling; shattering your precious face.

The perfect balance of strength and length of our hamstrings/glutes and the psoas/hip flexor/quadriceps group is the KEY to healthy hamstrings!


My Theory

My practical theory is that the focus should shift from the quads to the hamstrings and hip flexors. Imagine a side profile of your body. We’re going to make a looping pulley system of your lower half: the hamstrings are on one side and the hip flexors and the quadriceps are on the other. Both sides make a ring around two pulleys, one at your hip and one at your knee. Both sides need to keep an even “tug of war” tension. If you stretch out the hamstrings, the iliopsoas and the quads have an advantage and will turn your pelvis forward and down. This is commonly referred to as an anterior pelvic tilt. As I mentioned above, the hamstrings need their regular length to produce a stable force on the knees and hips. When it needs to stretch to control the knees from overextending, the hamstring fails and tears because IT’S ALREADY OVERSTRETCHED. Like an elastic rubber band at its absolute limit, it won’t be able to stretch any further without tearing.

As a side note, this is also the very same reason you may have the perception your hamstrings are tight all the time.  An overstretched muscle will make you feel tight as well, and if you continue to stretch it your front muscles will continue to get tighter and perpetuate the vicious cycle.

Here’s the reality: This is already a problem for most of us because we sit for hours at work, and in a car, and then go home and sit for the remainder of the day in front of a TV. Then, on the weekends we try to be a superhero athlete and hurt ourselves. 

Your hamstrings are already overstretched, and your front muscles -- like the iliopsoas and the quads -- are overly tight.  

Here are your take-home lessons:

Don’t stretch your hamstrings. Stretch your quads and the iliopsoas. Check out our youtube!

Don’t sit all day. Get up and practice good posture. Try the above exercise 3-4 times (or more) per day for 30 seconds as it takes that long for real change to occur in your muscles.

See your licensed Doctor of Physical Therapy if your problems persist. We often can help mobilize your hips and pelvic alignment and plan the right exercises to rebalance you!

Dr. Justin C. Lin

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