T Nation

Chronic Hamstring Running Injury Help

Hey guys, I’ve recently been plagued by a bout hamstring injuries and I don’t know what to do. So first off I’m a newbie triathlete. I started gettin fb interested in the sport at the beginning of this year and began training for some races in the fall. In the early spring of 2016, I had a pretty decent hamstring strain in my right leg during a 100m sprint workout. It was bad enough to prompt me going to a pt, who said it was just a strain not a super big deal, things like that happen. She gave me some stretches to do and also noted that my hips were fairly weak and gave me stability exercises to do. I went home and rested for a couple weeks and it seemed to heal up pretty well. I stretched for a couple weeks after the injury but pretty soon after I stopped just out of neglect.

A couple months after that injury in the very early summer I had a minor tweak in my left outer hamstring, bicep femoris short head?, just during everyday activities. This is the first time I can remember that I felt the chronic injury that has plagued me since. This first instance the injury wasn’t too bad but it was somewhat noticeable while walking. I rested a couple days and went back to training. Throughout the summer this injury would flare up every now and again and i would rest it and then resume training. About mid summer, a month to two months ago, I ran a fairly hard and long run of 10 miles at 7:00/mile pace, longer then I usually run. Halfway through this workout that chronic injury flared up and I just ran through it. When I finished I went home and kinda assumed I would just rest it and it would go away again.

However, the next day it was more noticeable than it previously had been. This prompted me to take 2 weeks off from training and I began reserching running injury prevention. I picked up Kelly Starrett’s ready to run and began doing lacrosse ball rolling, flossing, and dynamic warm ups before all the sessions. I then resumed my training and was running moderate pace 5k runs only and the injury never really came up so I assumed that the Starrett style mobility work was working. Because I had taken off those two weeks from training I wasn’t in the kind of shape I wanted to be for one of my races, so I took the week leading up to that race, last week, off and didn’t train. I then re did my training program to include more intensity so I could be ready for my next race in about a month. Today was my first day back into the swing of things and it was supposed to be a fartlek run. I probably shouldn’t have started off with so much intensity but oh well, during the week of rest and my warm up before my run, I noticed my hamstrings didn’t feel really great. It’s not that they hurt but there was a little discomfort. I wrote it off and assumed it would go away once I started my workout.

The first interval of my fartlek run, my hamstring injury, left outside hamstring almost right behind the knee, flares up again. I stopped running and walked home gutted and dismayed. These strings of injuries have been killing me as I love being outside running, biking, and swimming. I have a long history of athletics, weight training, boxing, soccer in hs, but I have never had so much fun as I am having with my triathlon training, this makes it all the more difficult when I get injured. Some notes about my injury: it is the lower part of my hamstrings, short head of the bicep femoris?, on the outside of my knee.

The injury is predominantly my left leg but I notice some discomfort in the same area of my right leg. I recently switched to minimalist shoes, Altra one 2.5’s, and have been working on a forefoot strike, after having read ready to run. Since I have made this switch I have noticed my calves are EXTREMELY sore after my runs and I have been attributing this to my new style of running. I’ve also noticed that my left calf is noticeably tighter than my right. I’m not sure if calf tightness or weakness might somehow connect to my injury but I thought I would mention it.

Also, I think my hamstrings are noticeably weaker than my quads but I haven’t tested this yet. I’m not sure if this imbalance is the cause of my injury, again I just want to make sure I address all factors. And finally my hips are a mess. my left hip is noticeably weaker than my right and my hips are VERY VERY tight. I hope I have given you guys enough info to maybe pinpoint my problem or problems. Any help or input is greatly appreciated, thanks in advance.

Those are some good videos.

My suspicion is that if you already suspect you have a pretty big imbalance between quads and hamstrings, that you probably do (although that imbalance might be based on weaknesses elsewhere…). Take some time off of running and do some strength training (make sure there is enough volume to induce some hypertrophy). Hit the quads, hit the hamstrings, make sure you are getting your glutes, hips, and calves involved. So in other words, compound movements like squats, RDLs, and deadlifts (you probably don’t need to do isolation movements, especially if you aren’t already strong). Pick a program. Start the weight lighter than what you want to do, and then gradually ramp up for 4-6 weeks. Then gradually add runs.

I’m not a PT, and I don’t run triathalons. But if running is injuring you, then you should do something else for a month or more, and strengthen your lower body. I used to be a major Starrett fan (I still like his stuff), but one thing he fails to discuss is that tightness and weakness are often related. I struggled with squat depth for a very long time. Once I got some lifting shoes and started going to town on my squats, I found that my depth was cured even without lifting shoes. The problem wasn’t stiff tissues and undistracted joints, it was weakness (particularly in my calves) through the squat pattern. Squats fixed it, not Mwod.

Since some good insight has already been posted I’ll add something else. In general hamstring strains are caused by the glutes crapping out thus making the hamstring do double duty. This can happen in guys with underdeveloped glutes or even guys with great development but they simply trained to hard and caused the hamstrings to take over. Glute bridges work great for me as far as an exercise that directly helps my butt do what it’s supposed.

Over striding (my problem) can really jack a hamstring because the hammy is forced to contract near it’s end range. I try to deal with that by always never quite going into an all out sprint.

Really appreciate all the help guys. So, my suspicion was right, the problem is that my hamstrings are WAY weaker in proportion to my quads and glutes. My guess is because cycling is the sport I am coming into triathlon from, and I am a very very strong cyclist, cat 2.

I did gym workouts when I was riding, but now looking back my programming was terrible. All I ever did for my lower body was squats. I would do like 10 sets of 20 a workout and never gave any attention to my hamstrings, they really aren’t used in cycling, and I ran osymetric cranks sometimes even further reducing hamstring involvement.

So I went to the gym today and tested out my imbalances and the things I listed turned out to not really be a problem, with the exception of tight hips, they are as tight as I thought. I tested the strength difference between my hamstrings and quads. The verdict is that my hamstrings can lift 50% of the weight my quads can, and my mind muscle connection with my hamstrings is complete garbage, so I’m almost positive that’s my problem.

I’m guessing that the weakness of hamstrings compared to my quads, along with the fact that my glutes are very strong, is what has been causing my problem. I know that inactive glutes is the usual problem, but in my case I think it might be the opposite. I weight only about 135 or so, but can squat 315, like I said I squatted a lot when I was cycling competitively. However, I can count on one hand the number of times I’ve deadlifted. I’m guessing my quads and glutes are just way out of proportion to my hamstrings.

So, that hamstring imbalance coupled with my lack of weight training for like the past 3 months, is the culprit of my hamstring troubles I’m guessing. So I’m trying to write up a strength program to run. I’ve come up with this, again I’m an endurance guy not a weightlifter, so any input from you guys would be awesome.

Prehab(to work on my imbalances before lifting)
Rotator cuff band work 2x10(to prevent swimming imbalances)
Hip hike 2x10
Pistol squats 2x10
Resistance band hamstring curl eccentrics 2x10
Main workout
Bulgarian split squat 3x5
Single leg Romanian deadlift 3x5
Overhead press 3x5
Weighted pull-ups 3x5
Core work
Planks 3x5:00
Side planks 3x2:00

This could be complete garbage, I don’t know, this is definitely foreign territory for me. Any additional input is greatly appreciated.