Common Injuries: Hamstring Strains

Who here is a DeAndre Hopkins fan? Or how about Darrell Daniels? What about AJ Brown, Sterling Shepard, Darius Slayton, or Jonas Griffith? What do all these players have in common? They have all experienced some sort of a hamstring strain during the 2021 NFL season and have probably resulted in multiple fantasy football upsets.


Let's talk about what hamstring strains are, how they occur, and what typical recovery can look like.


What Are Hamstring Strains?

Hamstring strains are one of the most common injuries plaguing the NFL. In looking at the NFL injury report almost every team has at least one player out with a hamstring strain. Why? Why are hamstring strains so prevalent in the NFL, what does this mean for your fantasy team, and what is an expected rehab process for a hamstring strain? I’m glad you asked. Let’s investigate!


Hamstring strains are so common that this year the NFL’s Scientific Advisory Board has awarded the University of Wiscon with $4 million to research the prevention and treatment of hamstring strains. Let’s break down what a hamstring strain is and then we will talk about why it’s so common in the NFL. The hamstrings are comprised of 3 muscles located on the back of your thigh. Their main function is to bend the knee and their secondary function is to extend the hip. Hamstring strains are graded based on their severity and range from mild to complete tearing.


Grade I

This grade signifies that only a few muscle fibers are mildly affected with nothing being torn.


Grade II

Grade 2 strains represent a partial tear, this happens when around half the muscle fibers are affected with some of them being torn.


Grade III

Lastly, a grade 3 strain is a full tear of the muscle, all the fibers are affected at this point.


Muscle strain grades, hamstring strain
There are 3 grades of muscle strains, ranging from mild to complete. Muscle strains are all a type of muscle tear.

What Causes Hamstring Strains?

Two common causes of hamstring injury are poor eccentric hamstring strength and muscle imbalances between the front of the thigh (quadriceps) and the back of the thigh (hamstrings). What’s eccentric hamstring strength? ❗️Stay tuned for more information on that later.


I would go out on a limb to say most people in the USA have deficient hamstring strength. We are a quad dominant nation. This issue gets non athletes into trouble all the time. Just look at 75% of the people squatting at your local gym, knees forward, weight in the toes, traveling forward as they come up out of their squat…. quad dominance.


Many of the lifts that are commonly used to strengthen your legs can be performed so that most of the work is being done by your quadriceps. Huge quads might look great, but trying to control those bad boys out on the field seems to be another story. One of the main jobs of the hamstrings during acceleration or deceleration while sprinting is to slow or control the leg as the quadriceps straighten the knee. If there is an imbalance here it definitely places your hamstrings at risk of a strain. Poor hamstring training and quad dominance seem to be a key culprit in why this injury is so common among NFL players.


So what’s the damage in regards to your fantasy team? One study found that on average a grade I strain resulted in 1 game missed, while a grade II strain averaged 2 games missed and a grade III strain is likely to result in missing the rest of the season. DeAndre Hopkins has been diagnosed with a grade 2 hamstring strain as of October 28th. So unfortunately I’d expect him to be out for the next couple games.


Let’s talk recovery process.

Obviously there will be some variability in the rehabilitation process depending on the grade of strain, but in general for the average adult coming to physical therapy after a hamstring strain they need graded exposure to loading that leads into specific training that replicates their sports demands. A typical rehab process consists of 3 phases.


Phase 1

Phase 1 focuses on pain management and improving tolerance to motion. This doesn’t mean max stretching. This means gentle activation and gentle mobility that aims to restore the legs normal ROM so that you can tolerate walking without pain.


Phase 2

Phase 2 happens when you can handle some strengthening without a large increase in pain. The goal during this phase is to strengthen the hamstring muscles and increase their tolerance to loading. With NFL players in particular they need a high volume of strength training that includes eccentric specific training so that they can improve their hamstrings performance during acceleration and deceleration while sprinting.


Phase 3

Phase 3 focuses on return to sport activities and ensuring the whole leg is ready to go for game day. This often includes more dynamic activities that incorporate the balance, power and agility required for their particular sport while ensuring that the hamstrings are actually doing their job adequately. Some sources approximate that with proper treatment a grade I strain will recover in 3 weeks, grade II in 4-8 weeks and grade III up to 3 months.


We want to hear from you!

Now that we have a better understanding of hamstring strains and can estimate when our favorite NFL player should be back in the game, let’s talk about you. If you’ve experienced a hamstring strain and are still dealing with the aftermath we’d love to hear from you! Without specific treatment these injuries can tend to linger on for a LONG TIME! Send us your questions, we would love to help you out!