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5 Ways to Avoid Hamstring Injuries

Keep often-ignored leg muscles healthy with careful warm-ups, stretching and strength work

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AndreyPopov / Getty Images

Your hamstrings, located in the back of your thighs, are a part of your body that’s easy to ignore — until you make the wrong move and feel that sudden, sharp pain from an injury that could keep you hobbled for months.

“You can’t really move well without your hamstrings,” says Elizabeth Matzkin, M.D., chief of women’s sports medicine at Brigham and Women’s Hospital in Boston, and a spokesperson for the American Academy of Orthopaedic Surgeons (AAOS).

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That’s because the hamstring, a group of three muscles that stretch from the bottom of your pelvis to your lower leg, does the simple but important job of enabling you to bend your knee and extend your leg behind your body. These muscles are essential for running, riding a bicycle or maneuvering around a tennis court. They’re also needed for everyday tasks such as walking, climbing stairs or getting out of a chair.

Hamstring strains a common injury

It’s not just professional athletes who strain their hamstrings on the football field or basketball court. Matzkin says it is a relatively common injury among athletic adults over 50 years old who enjoy running, golf and tennis. She’s even seen some serious hamstring injuries suffered by recreational water skiers who’ve taken a spill. She notes that about 30 percent of the patients she sees come in with a hamstring injury.

Older adults are particularly vulnerable to hamstring injuries because there’s a natural tendency for the muscles to become stiffer and less flexible with age. Additionally, “sometimes our core stability isn’t as good,” Matzkin says. Those factors make it easier for a quick movement to overload the muscle, or to force it beyond its normal range of motion, causing a tear in one of the three muscles that make up the hamstring..

Hamstring injuries vary in severity, from small (grade 1) tears that require rest and rehabilitation, to severe (grade 3) tears that can require surgery to repair. Either way, Matzkin says you might be looking at several months before you can get back to your usual activities, and a few more months to reach the point where you no longer notice the injury when you move. “It takes a long time for it to completely resolve,” she says.

Once you hurt a hamstring, you may be in for more trouble down the road. “One of the most significant risk factors for a hamstring injury is a previous hamstring injury,” Matzkin says.

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Even if you don’t suffer a traumatic injury, hamstrings can factor into back pain. Because they attach high on the back of the leg, tight hamstrings tend to pull the pelvis out of line. “That can put a lot of strain on the low back,” says Jill Henderzahs-Mason, a wellness physical therapist at the Mayo Clinic in Rochester, Minnesota. Conversely low-back problems also can put stress on the hamstrings, causing them to get tighter. “It’s a sort of chicken-or-the-egg sort of situation,” she says.

While you can’t eliminate all risk of hamstring injuries, there’s a lot you can do to protect yourself. Following the right fitness routine and practicing a little moderation, it’s possible to keep your hamstrings healthy, functioning and pain-free.

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1. Always do a warmup

When you’re young, you might get away with walking out onto the tennis court a few minutes before a match and just going at it. But for an older athlete with stiffer muscles, going from zero to 60 is an easy way to get a hamstring injury. That’s why you should devote at least a few minutes to a warmup routine, in which you do a less intense version of some of the athletic movements you’ll be performing. “It’s really important to take our joints through their full range of motion, and really kind of gently, in a controlled fashion,” Henderzahs-Mason says. “You want to lengthen the muscles, so they’re prepared for the activity and don’t receive a shock.” She also suggests a hamstring-specific movement that she calls the tin soldier, in which you march and gently swing your lead leg and the opposite arm at the same time.

2. Make stretching a part of your routine

Getting tighter with age isn’t necessarily inevitable, according to the experts. “Somebody who practices yoga, for example, might have the same flexibility at age 70 as they did at in their 20s,” sports medicine expert Dr. Jamil Neme, M.D., an assistant professor at the Saint Louis University School of Medicine explains. After your muscles are warm from playing a sport or doing a fitness workout, the Mayo Clinic’s website suggests spending a little time on stretching your range of motion. For the hamstrings, Mayo suggests this stretch, which you lie on the floor and lift one slightly-bent leg toward the ceiling, until you feel a stretch, and then hold it for 30 seconds before switching legs and repeating the move. Denise Austin also suggests a hamstring stretch to improve knee mobility. You also want to stretch other muscles such as the hip flexors and quadriceps in the front of your thighs, since tightness in those places can affect your hamstrings, according to Henderzahs-Mason. For additional stretching ideas, AARP has videos available that can help including “the world’s best stretch,"and 10-minute stretch and toning tutorials led by Austin and another led by Kathy Smith.

3. Get stronger

Henderzahs-Mason says it’s also important to spend a few minutes two or three times a week on strengthening both the hamstrings and other supporting muscles. “The core is really important, because if we don’t have a good stable core for those muscles in the lower body, that’s when they start tending to have dysfunction as well,” she says. “They start getting tight to help compensate.” She recommends bodyweight exercises such as squats and lunges, as well as single-leg bridges for core, glute and hamstring strength. Be sure to master the movements and develop good form before increasing the intensity or adding resistance, she says.

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4. Increase your activity carefully and gradually

If you take up jogging and a few weeks later impulsively decide to enter a 5K race, you could be asking for trouble. Getting out on the basketball court after a long layoff and trying to pull off one of your old moves also might leave you limping. “Anytime you do something beyond your normal functional level or try to jump back in, you’re at risk,” says Neme. “The injury most often happens with a quick stride — it just pulls that hamstring longer than it’s used to going.” With an unfamiliar activity or one you haven’t done for a while, it’s smarter to ease in. “Hold back to make sure you have good form at a slower place,” he says. “Then gradually increase the intensity and duration of your activity.”

5. Know when to stop

Even if you’re the competitive type, avoid pushing yourself to play a sport to the point of exhaustion. Fatigue will cause your body mechanics to suffer, making you more vulnerable to injury. “If you’ve been playing tennis for two hours and you’re feeling tired, that might be a good time to say, ‘I’m done,’” Matzkin says.

It’s also good to watch out for warning signs, such as hamstring soreness, that indicate something might not be right, and to consider going to a physical therapist for a consultation. “Pain means something is wrong,” Henderzahs-Mason says. “Whether it’s just that you’re doing some movement incorrectly, or something else is going on with your hamstring that’s more critical, it needs to be attended to.”

Patrick J. Kiger is a contributing writer for AARP. He has written for a wide variety of publications, including the Los Angeles Times Magazine, GQ, Mother Jones, and websites of the Discovery Channel and National Geographic.

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