Hamstring injury rehab is a buzz topic in physiotherapy right now and rightfully so! Subsequently, I’ve been reading and listening to everything I can to provide to you a condensed version of what we know, so you can get better, faster!
Firstly, if you haven’t checked out the previous hamstring articles by Roar Physiotherapy, check them out, here and here. If reading isn’t your thing, I summarised it in a short video which can be found, here. These resources go through why we get hamstring injuries and the factors that can predict them.
To begin the conversation, let’s get into what we know about how the hamstrings are built, or their architecture. There are three hamstrings which can be divided roughly into medial and lateral groups. The medial hamstrings are made up of the semitendinosus and semimembranosus muscles and originate from the medial aspect of the ischial tuberosity (your sit bone) and insert to the medial shin bone. The lateral hamstrings are split into two heads of the biceps femoris muscle, being the long and short head. The long head starts in the same spot as the semitendinosus (medial sit bone) and the short head originates from a bony groove in the back of the femur called the linea aspera. These heads run down and insert in a few locations, but mainly to the fibular head and into the lateral collateral ligament (LCL).
The semitendinosus, semimembranosus and bicep femoris long head are all supplied by the tibial branch of the sciatic nerve. Interestingly, the short head is actually supplied by the common peroneal portion of the sciatic nerve. It remains to be seen if this could be a potential reason for so many bicep femoris muscle injuries, but is certainly an area to watch!
That was intense…
The reason it is important to understand the hamstring anatomy is because of the distinct differences in each muscle. Hamstring rehab and injury prevention should include MANY different exercises, rather than just one or two curls. This will be thoroughly explained in part three, plus all the exercises you NEED to know!
Roar Principal Physiotherapist