Hamstring Injuries: What Should You Work on Before Pre-Season?
Hamstring injuries can be frustrating for football and soccer players. You might get back onto the field, start rebuilding some consistency, and then find yourself dealing with another hamstring problem later in the season.
If a hamstring injury disrupted your season — or kept you out of important games or finals — the off-season provides an opportunity to work on your preparation before team pre-season begins.
But that preparation needs to involve more than simply going for a few easy runs.
For athletes returning to sports involving sprinting, acceleration and repeated high-speed efforts, preparation should consider hamstring strength, overall conditioning and progressive exposure to higher-speed running.
The aim isn't to guarantee that another hamstring injury won't occur. No training or rehabilitation program can do that.
The aim is to prepare you appropriately for the demands you're going to face.
Why do hamstring injuries keep coming back?
A previous hamstring injury is an established risk factor for another hamstring injury.
Research examining risk factors across sport has found that injury history is associated with subsequent hamstring strain injury risk. British Journal of Sports Medicine
That doesn't mean another injury is inevitable.
It does mean that if you've injured your hamstring previously, simply waiting until the pain disappears and then returning to your normal sport may leave important aspects of your preparation unaddressed.
Depending on the individual athlete, rehabilitation and subsequent training may need to consider factors such as:
hamstring strength and capacity
exposure to faster running
overall running and conditioning loads
the demands of your position and sport
previous injury history
the progression from rehabilitation into unrestricted training.
There isn't one single cause of hamstring injuries, and identifying one supposed "weakness" doesn't mean we've discovered why an athlete was injured.
That's why a good program should prepare the athlete for the overall demands of their sport, rather than relying on one exercise or test.
Why slow running isn't enough for football and soccer players
Going for easy runs can certainly have a place in an off-season conditioning program.
The problem is that football and soccer aren't played entirely at jogging speed.
Depending on your sport and position, competition can expose you to sprinting, acceleration, deceleration and repeated higher-intensity running efforts.
Your training therefore eventually needs to prepare you for those demands.
Research examining hamstring injury risk suggests that the relationship with high-speed running is nuanced. Greater and particularly sudden increases in high-speed running exposure have been associated with hamstring injury risk, while graduated exposure may help athletes develop the capacity required for sprinting. British Journal of Sports Medicine
The practical message isn't:
"Avoid high-speed running because it causes hamstring injuries."
Nor is it:
"Sprint more and you won't injure your hamstring."
Instead, high-speed running is a demand of many field sports. It therefore needs to be appropriately and progressively incorporated into preparation, rather than avoided throughout the off-season and suddenly encountered when club training starts.
Strength training matters too
Running isn't the only component.
There is good evidence supporting hamstring strengthening as part of injury-prevention programs.
One of the most extensively studied exercises is the Nordic hamstring exercise.
A systematic review and meta-analysis involving 8,459 athletes found programs incorporating Nordic hamstring exercises were associated with substantially lower hamstring injury rates than comparison programs. British Journal of Sports Medicine
A broader evidence review similarly found some of the strongest evidence for hamstring injury prevention involved programs incorporating Nordic hamstring exercises. British Journal of Sports Medicine
That doesn't mean everyone who has previously injured their hamstring should simply start doing Nordics.
Nor does it mean Nordics are the only hamstring exercise that matters.
A strength program can incorporate exercises targeting the hamstrings through different joint positions, contraction types and movement patterns, while also considering the athlete's broader lower-limb and sporting demands.
The appropriate exercises and progression depend on the individual.
Strength alone isn't enough
This is an important point.
You could become significantly stronger in the gym but still be poorly prepared for the running demands of your sport.
Likewise, you could accumulate plenty of running kilometres without adequately developing hamstring strength.
For a football or soccer player with a history of hamstring problems, we generally want to think about both sides of the equation:
Can you produce and tolerate force?
And:
Are you progressively exposed to the running speeds and workloads your sport requires?
That's why rehabilitation shouldn't necessarily finish when you can perform some hamstring exercises without pain.
The later stages of rehabilitation and return to sport need to bridge the gap between rehabilitation and actual sporting demands.
Why the off-season is such a valuable opportunity
During the season, rehabilitation can become a race against the calendar.
Players understandably want to get back for the next game, an important match or finals.
Training also needs to fit around games, recovery and team sessions.
The off-season changes that.
Without the pressure of playing every weekend, you may have an opportunity to progressively work on qualities that were difficult to address during the season.
That could include:
Hamstring strength: progressively developing the hamstrings rather than stopping rehabilitation once symptoms settle.
Running capacity: maintaining an appropriate aerobic and running base.
High-speed running: progressively reintroducing faster running rather than waiting until club pre-season.
General strength and conditioning: improving your overall physical capacity for the demands of your sport.
Other injuries: addressing the ankle, groin, knee or other problems you managed throughout the season.
The exact priorities should depend on the athlete rather than following a generic "hamstring prevention program".
Don't make pre-season your first exposure to sprinting
Imagine finishing your season, significantly reducing your running for several months and then turning up to the first week of football pre-season.
Suddenly you're completing repeated running efforts, accelerations, skills drills and eventually faster running.
Your club may only have a relatively short pre-season in which to prepare the entire squad.
That's not necessarily the ideal time to start rebuilding every component of your physical
capacity from scratch.
You also don't need to complete your own full pre-season before club training starts.
The objective is to arrive with an appropriate base level of strength and conditioning, including exposure to the types of running you'll need to tolerate.
You should be ready to build — not already at your peak.
What could a hamstring-focused off-season include?
There isn't a single program that suits everyone, but preparation might progressively incorporate:
Strength training: Exercises targeting hamstring strength alongside appropriate lower-limb and whole-body strength work.
Running: Maintaining or rebuilding an appropriate running base.
Faster running: Gradually progressing towards the higher-speed running demands relevant to your sport.
Conditioning: Developing the capacity to tolerate repeated efforts rather than focusing only on isolated sprint performance.
Sport-specific preparation: Progressively bridging the gap between general conditioning and the demands you'll encounter when training resumes.
The amount and timing of each component depends on your previous injury, current capacity, sport, position, training history and how long you have until pre-season.
What if you've just had a hamstring injury?
A recent injury is different from simply preparing for another season.
The appropriate progression depends on factors including the nature and severity of the injury, your symptoms, strength, running capacity and sporting requirements.
Trying to rush directly from an acute injury into high-speed running isn't what we're suggesting.
Running and higher-speed exposure should be introduced at an appropriate stage and progressed according to the individual athlete.
If you're unsure whether your hamstring is ready, an assessment can help establish where you currently sit and what needs to be developed before returning to unrestricted training.
Frequently Asked Questions
Are Nordic hamstring exercises good for preventing hamstring injuries?
Programs incorporating Nordic hamstring exercises have good evidence for reducing hamstring injury rates across sporting populations. A major systematic review found an approximately 50% reduction in injury rates in programs incorporating the exercise. British Journal of Sports Medicine However, an individual athlete's program should not necessarily consist of Nordics alone.
Should I sprint if I've previously injured my hamstring?
If sprinting is a requirement of your sport, exposure to higher-speed running will usually need to form part of your preparation at an appropriate stage. The important considerations are timing and progression. A recent hamstring injury may require a structured rehabilitation and running progression before maximal or near-maximal running is appropriate.
Is jogging enough preparation for football pre-season?
Jogging can help develop general conditioning, but football and soccer also involve higher-speed running and other demanding movements. Your preparation should therefore progressively reflect the demands you'll encounter when team training resumes.
Can strengthening stop me from injuring my hamstring again?
Strengthening can be an important part of reducing hamstring injury risk, and programs incorporating Nordic hamstring exercises have good supporting evidence. British Journal of Sports Medicine However, no exercise program can guarantee that an athlete won't experience another hamstring injury.
When should I start preparing for pre-season?
That depends on how long you've had away from training, your current conditioning and whether you're rehabilitating an injury. The important point is not to leave all of your preparation until the first week of club pre-season.
Prepare for the demands of your sport
If hamstring injuries have repeatedly disrupted your football or soccer season, the off-season is an opportunity to do more than simply wait for next year.
Recover from the season, but then use the time available to work on your physical preparation.
That can include progressive hamstring strengthening, conditioning and appropriate exposure to higher-speed running.
You don't need to arrive at pre-season flying.
You want to arrive ready to train.
At Body Fit Physiotherapy in North Adelaide, we work with footballers, soccer players and other athletes on hamstring rehabilitation, strength and conditioning, running progression and return-to-sport preparation.
If a hamstring injury has limited your season, an individual assessment can help identify where you currently sit and what you need to work on before returning to full training.
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