Series: Latest on Hamstring Strain Injuries

Strong is not always fast.

We see it constantly in return to play discussions. An athlete comes back from a hamstring strain, ticks every box on paper — full range, symmetrical strength on the dynamometer, no pain on stretch or contraction — and yet something still feels “off” to them, or to us, when they get back onto the track or the field.

For a long time the answer to this was to keep testing peak strength. If the numbers matched left to right, the tissue was considered ready. But peak strength is a measurement of how much force a muscle can eventually produce, given enough time to reach it. And time is exactly what the hamstring doesn’t have during a sprint.

In the late swing phase of a sprint stride, as the leg whips forward and the hamstring has to slam the brakes on the shin before foot strike, that entire deceleration happens in around a tenth of a second. There simply isn’t time for the muscle to reach its ceiling. What matters in that moment isn’t how strong the hamstring eventually becomes, but how quickly it can get there — its rate of force development.

This is where a lot of previously strained hamstrings quietly fall short. Athletes with a history of strain can produce completely normal peak force, and still show a markedly slower rise to that force — in some cases over 30 percent slower on the injured side, and interestingly, often slower on the uninjured side too. That second finding tends to surprise people, but it points to something beyond the local tissue: a more systemic drop in how quickly the nervous system can recruit that muscle group after injury, not just a scar tissue problem.

It’s why we’ve shifted a lot of our later stage rehab testing towards early phase force output rather than eventual peak output. Practically, that means looking at how much force is produced in the first 50 to 100 milliseconds of a contraction, not just the highest number an athlete can eventually reach on the dial. It also means testing at longer muscle lengths, closer to where the hamstring is actually working hardest during sprinting, rather than the mid-range positions that are easiest to test in.

None of this is as simple as it sounds. Early rate of force development is a genuinely noisy measure to collect. Split it into different time windows or muscle lengths and you can get quite different numbers between sessions from the same athlete, even when nothing has actually changed in the tissue. We get far more reliable, trackable numbers when we standardise the time window we’re measuring within and express early force as a percentage of that individual’s own peak, rather than chasing an absolute number in isolation.

The upshot for anyone returning from a hamstring strain is this: passing a strength test tells you the muscle can produce force. It doesn’t tell you whether it can produce that force fast enough to do the job it’s actually needed for. Chasing the second question is a large part of what separates athletes who return and stay fit, from those who return and quietly break down again a few weeks later.

References

Barber, R., Fahey, J., & Comfort, P. (2024). Normalization of rapid force to peak force in an isometric hamstring assessment using force plates. Apunts Sports Medicine. https://doi.org/10.1016/j.apunsm.2024.100450

Buhmann, R., Trajano, G., Kerr, G., & Shield, A. (2021). Lower knee flexion and hip extension rate of torque development in athletes with previous hamstring strain injury. Journal of Sports Sciences, 40, 534–541. https://doi.org/10.1080/02640414.2021.2003981

Fahey, J., Cuthbert, M., McMahon, J., & Comfort, P. (2023). Rapid force generation during unilateral isometric hamstring assessment: reliability and relationship to maximal force. Sports Biomechanics, 24, 3218–3229. https://doi.org/10.1080/14763141.2023.2276316

Opar, D., Williams, M., Timmins, R., Dear, N., & Shield, A. (2012). Rate of torque and electromyographic development during anticipated eccentric contraction is lower in previously strained hamstrings. The American Journal of Sports Medicine, 41, 116–125. https://doi.org/10.1177/0363546512462809

Woodbridge, R., Ryan, C., Burkitt, J., Ye-Lee, D., & Cronin, J. B. (2024). Reliability of a portable fixed dynamometer during different isometric hamstring assessments. Applied Sciences. https://doi.org/10.3390/app142210202

Our Physios

Mia Bailey

MPhysio, BExSpSc

Australian Rules

FIELD SPORTS

Running

Mia is a physiotherapist with a particular interest in team sport injuries, having worked in local AFL and regularly managing soft tissue conditions such as hamstring, calf and Achilles complaints.

Key Areas:

Achilles

Hamstring

Calf

Soft tissue

ACL

Knee

Running Assessments

Jasmine Genis

M.Physio and M. Heath Science (osteopathy).

AUSTRALIAN RULES

FIELD SPORTS

TRACK AND FIELD

Jas is an experienced physiotherapist with a special interest in field-based sports, having worked across AFLW and VFL competitions over approximately 5 years.

Key Areas:

KNEE INJURIES

HIP PAIN

ANKLE INJURIES

HAMSTRING INJURIES

GROIN / ADDUCTOR STRAINS

LOWER LIMB INJURIES

SOFT TISSUE INJURIES

RETURN TO SPORT REHAB

James Elwin

Physiotherapist (B.Physiotherapy)

Olympic Lifting

Crossfit/Functional Fitness

Football/Cricket

James is a keen footballer in winter and cricket physio in Summer and is also a competitive Olympic lifter and Crossfit gym owner.

Key Areas:

Hamstring injuries

Calf injuries

Quad strains

Shoulder injuries

Back pain/injuries

achilles

Side strains