Hamstring Anatomy, Exercise Selection
Hamstring injuries are still one of the most common injuries in sports today, especially in soccer and the exercises that have shown to reduce risk are knee dominant versus hip dominant.
Anatomy of the Hamstring
There are three hamstring muscles, bicep femoris, semitendonosis, semimembransous inserting at the pelvis and attaching along the posterior side of the femur and crossing over to the tibiafemoral joint.
Bicep Femoris is separated in two, one as a long head and the other as the short head, on the lateral side of the femur inserting into the Fibular head and the Condyle of the Tibia.
The Bicep Femoris short head assist with knee flexion, tibia lateral rotation while the long head assist with knee flexion, tibia lateral rotation and hip extension.
Semitendinosus inserts to the Medial tibia and is responsible for knee flexion and medial rotation of the Tibia.
Semimembranosus inserts to the medial tibia and assist with knee flexion, medial tibia rotation and hip extension.
Now that we covered a little anatomy, the roles each of the hamstrings assist with we possibly can look at separating which exercises are more effective at preventing injury and increasing performance.
Because the hamstring assist the knee in deceleration and acceleration with hip extension we can select exercises and loads accordingly. For example, research has been shown that knee dominant iso-eccentric exercises are more effective to reducing injury risk, including ACL injury.
The Nordic Curl is one of the best exercises for increasing muscle tension under lengthening, essentially stretching the muscles while being contracted. (2) "There is an evidence-based strategy to prevent HSIs, however, there appears to be a large disconnect between this available evidence and its adoption in elite football. For example, the Nordic hamstring exercise (NHE) programme has been shown to effectively reduce HSIs by 65%–70%."
While hip dominant exercises like the Kettlebell swing target the hamstring it tends to target the Semitendonosis more than the Bicep Femoris. Here is a recent research that shows targeting specific muscles, (3) "Kettlebell swing and Romanian deadlift targeted specifically ST over BF (Δ17-22%, p<0.05) at very high levels of normalised EMG (73-115% of MVC)."
One way that we aim in assisting in reducing hamstring injuries is by assessing with Functional Movement Screening, single leg hop testing and depth drops. When checking into AROM (active range of motion) with a exercise such as a Overhead Squat, a bodyweight exercise that will identify full kinetic chain movement, and helping to identify abnormal ROM and or limitation in muscle lengths.
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References:
Rodgers CD, Raja A. Anatomy, Bony Pelvis and Lower Limb, Hamstring Muscle. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546688/
(2) Buckthorpe M, Wright S, Bruce-Low S, et al
Recommendations for hamstring injury prevention in elite football: translating research into practice British Journal of Sports Medicine 2019;53:449-456.
(3)Zebis MK, Skotte J, Andersen CH, Mortensen P, Petersen HH, Viskaer TC, Jensen TL, Bencke J, Andersen LL. Kettlebell swing targets semitendinosus and supine leg curl targets biceps femoris: an EMG study with rehabilitation implications. Br J Sports Med. 2013 Dec;47(18):1192-8. doi: 10.1136/bjsports-2011-090281. Epub 2012 Jun 26. PMID: 22736206.
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