Overcoming Proximal Hamstring Tendinopathy

Hamstring Strength, Running Form & Injury Risk: The Science Every Runner Should Know


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Research Deep-Dive: Hamstring Strength & Running Biomechanics

This episode reviews the study: ā€œHamstring Strength and Architectural Properties Are Associated with Running Biomechanicsā€, including findings from ultrasound imaging, EMG analysis, and 3D running mechanics.Ā 

Key Study Questions

  • Do stronger hamstrings create better running mechanics?
  • Do better mechanics help build stronger, longer hamstrings?
  • How do strength, fascicle length, pelvic position, and muscle activation interact?

šŸ”Ž Main Findings From the Study

1. Stronger Hamstrings = Better Running Mechanics

Athletes with higher eccentric hamstring strength had:

  • Higher stride frequency (cadence)
  • Better control of decelerating the swinging leg
  • Lower ground contact time (improved efficiency)
  • Lower hamstring activation at sub-max speeds → reduced overloadĀ 

2. Longer Hamstring Fascicles = Safer, More Efficient Loading

Runners with longer fascicle lengths showed:

  • Less anterior pelvic tilt
  • Lower hamstring activation
  • Better ability to tolerate late-swing loading (a high-irritation phase for PHT)Ā 

3. A Two-Way Relationship Exists

Strength ↔ mechanics influence each other.

  • Stronger hamstrings → better running technique
  • Better running technique → better hamstring loading → stronger, longer muscle structure over time
    Ā This creates a positive adaptation loop.Ā 

4. Over-Reliance on the Biceps Femoris = Red Flag

Runners with weak or short hamstrings tended to over-activate the biceps femoris long head — the most common site of PHT.
Stronger runners shared load better with the medial hamstrings, reducing tendon stress.Ā 

šŸƒ Practical Rehab Takeaways

1. Build Eccentric Strength

Eccentric strength is one of the strongest predictors of hamstring injury risk.
Ā Examples Brodie recommends:

  • Hamstring sliders
  • Weighted eccentric sliders
  • Single-leg sliders
  • Assisted → full Nordic drops
  • Deadlifts (when tolerated)Ā 

2. Improve Fascicle Length

Eccentric exercises at long muscle lengths help lengthen fascicles naturally — more so than stretching alone.

3. Strengthen the Medial Hamstrings

To prevent overload of the biceps femoris:

  • Use toes-in hamstring curls
  • Toes-in sliders
  • Toes-in deadlift variations
    Ā These help redistribute load more evenly across the tendon.Ā 

4. Slightly Increase Cadence (~5%)

A small increase in stride frequency may reduce late-swing strain and improve running economy.

5. Integrate Running Into Rehab

Before adding speed:

  • Build to 30 minutes continuous, easy running → symptom-free
    Then introduce:
  • Strides (15–20 sec at ~75% speed, 4 reps)
  • Gradual progression based on symptoms the next dayĀ 

Final Thoughts

Hamstring strength, muscle architecture, and running technique are deeply interconnected. Improving one helps improve the others — creating a pathway toward better performance and long-term PHT resilience.

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Overcoming Proximal Hamstring TendinopathyBy Brodie Sharpe

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