Proximal Hamstring Tendinopathy: Mastering Hamstring Curls for Rehab

Welcome to a new episode dedicated to helping you overcome the challenges of proximal hamstring tendinopathy (PHT). I’m Brody Sharp, an online physiotherapist, recreational athlete, creator of the Run Smarter series, and someone who’s battled PHT myself. Whether you’re an athlete or not, this podcast aims to educate and empower you in managing this condition effectively. In today’s lesson, we’ll dive into modifications and progressions for hamstring curls, a crucial element in your rehab journey.

Understanding the Importance of Hamstring Curls

In previous episodes, we discussed the significance of exercises like deadlifts in your rehabilitation. However, some individuals may be hesitant to incorporate deadlifts due to past experiences with overexertion. My approach is to find suitable modifications and progressions tailored to your capabilities. Besides deadlifts, hamstring curls are another vital exercise for PHT rehabilitation. Today, we’ll explore various positions and equipment options to help you get the most out of your hamstring curl exercises.

Exploring Different Positions

1. Prone Hamstring Curl

The prone hamstring curl involves lying on your stomach and curling your ankle toward your glutes. You can use a thera-band or a resistance band attached to a sturdy anchor point for this variation.

2. Seated Hamstring Curl

In a seated hamstring curl, you sit with your leg extended and curl a weight or object underneath you. This variation is effective for targeting your hamstrings.

3. Supine Hamstring Curl

The supine hamstring curl can be done on a Swiss ball or even using a skateboard. You perform a bridge with your feet on the Swiss ball or skateboard and then curl it toward you.

4. Gym Equipment

If you have access to a gym, you can use a prone hamstring curl machine, which has weighted pads for your Achilles. This machine allows you to adjust the resistance to your preference.

5. Gym Cable

If your gym lacks a prone hamstring curl machine, you can use a gym cable. Attach a cable to your ankle, lie down, and perform the curl. This setup allows for gradual and systematic progression.

The Pitfalls of Ankle Weights

Avoid using ankle weights for hamstring curls, as they don’t provide adequate resistance throughout the range of motion. Ankle weights are least effective when the leg is fully extended, and the initial moment of lifting is the hardest due to gravity’s pull on the long lever of your leg. Hamstring curls with bands, cables, or machines offer consistent resistance, making them more suitable for effective rehabilitation.

Emphasizing Slow, Heavy Loads

For optimal tendon health, prioritize slow, heavy loads in your hamstring curl exercises. Machines, cables, and bands allow for systematic progression, ensuring you gradually increase the weight and intensity. Aim for sets of 8 to 12 repetitions, starting with three sets of eight and gradually progressing to three sets of 12. Adjust the weight as needed and maintain a slow, controlled movement during each repetition.

Variations to Consider

Eccentric Contractions

Eccentric exercises involve contracting muscles as they lengthen. While not a top priority for PHT, they can be beneficial for muscle rehab. Eccentric hamstring curls can be performed by curling both legs and then slowly releasing the weight with the affected leg.

Isometric Contractions

Isometric exercises involve holding a muscle contraction without movement. These can be helpful during flare-ups or when transitioning to more dynamic exercises. You can perform isometric hamstring curls by curling the weight slightly and holding it in place for a set duration.

Speed Work

Once you’ve built a foundation with slow, heavy loads, you can introduce speed work into your routine. For example, try faster hamstring curls using a resistance band while maintaining control. However, be cautious when introducing speed, starting with just one set to avoid overexertion.

Balancing Speed and Control

While speed work can be beneficial for specific athletic goals, it’s crucial to balance it with your foundation of slow, controlled exercises. Gradually incorporate speed work into your routine to ensure your hamstrings adapt safely.

Remember, every individual’s rehabilitation journey is unique. Listen to your body and consult a healthcare professional or physiotherapist for personalized guidance. Your progress should align with your specific goals and the demands of your chosen activities.

If you’re still navigating your PHT rehabilitation journey and need tailored assistance, consider reaching out to a physiotherapy clinic like the Run Smarter Physiotherapy Clinic. They offer both local and online physiotherapy packages designed to address PHT and a variety of other conditions.

Thank you for tuning in and taking proactive steps towards a pain-free future. Knowledge is your greatest ally in overcoming proximal hamstring tendinopathy, so keep learning and moving forward.