Mastering Hamstring injuries: Evidence-Based Techniques for Injury-prevention, rehabilitation and performance

Hamstring Injuries: Evidence-Based Training Methods for Injury Prevention, Rehabilitation, and Performance

In this course, scientist and elite athlete Bas Van Hooren discusses the latest insights into the development of hamstring injuries, the risk factors, and how to train these factors to prevent injuries and improve rehabilitation. There is also a practical component where the theoretical concepts are applied, and participants can experience the exercises themselves.

Hamstring injuries remain one of the most common and persistent problems in both elite and recreational sport. Despite decades of research, debate continues on the exact mechanisms that cause hamstring strains and how best to prevent them. This advanced continuing education course, led by Bas van Hooren (Maastricht University), explores the complex interplay between muscle-tendon dynamics, running technique, and neuromuscular control to help physiotherapists design effective prevention and rehabilitation programs.

Participants will dive deep into the biomechanics of the hamstring muscle–tendon unit during running, distinguishing between fascicle lengthening and musculotendinous behaviour. Through critical analysis of modelling studies and animal research, the course clarifies the ongoing discussion around eccentric versus isometric function of the hamstrings and highlights the methodological challenges behind both perspectives.

The practical implications are substantial: physiotherapists will learn how to translate these biomechanical insights into targeted exercise selection and programming. The course compares the mechanical load profiles of popular exercises such as the Nordic Hamstring Curl, Single-Leg Deadlift, and Roman Chair variations, identifying which movements best promote fascicle length adaptation, strength endurance, and high-force capacity.

Further emphasis is placed on lumbo-pelvic control and running coordination, essential for reducing hamstring strain during high-speed running. Drawing on recent prospective studies, participants will discover how pelvic positioning, fatigue resistance, and sprint technique all influence injury risk and performance economy.

By integrating evidence from cutting-edge research with clinical reasoning, this course equips physiotherapists with the analytical tools to critically evaluate existing prevention programs, adjust exercise selection based on individual demands, and justify their interventions using sound biomechanical rationale.

Learning Goals

1. Critically analyze the biomechanical functioning of the hamstring muscle–tendon unit during running, distinguishing between fascicle and musculotendinous length changes, and evaluate implications for injury prevention and performance.
2. Synthesize and appraise evidence from modelling and experimental studies (e.g., Thelen, Van Hooren & Bosch) to identify methodological limitations and their impact on interpreting eccentric versus isometric hamstring function.
3. Design evidence-informed training interventions targeting hamstring strength, endurance, and fascicle length adaptation by comparing mechanical loading characteristics of exercises such as the Nordic Curl, Romanian Chair, and Single-leg Deadlift.
4. Integrate neuromuscular control and lumbo-pelvic coordination principles to develop individualized strategies that reduce hamstring strain during sprinting and improve running economy.
5. Evaluate and justify periodized training programs that combine fatigue resistance and high-force loading to mitigate late-phase injury risk, grounding recommendations in empirical data and biomechanical models.

Topics covered include:

• Acute vs. overuse hamstring injuries.
• Eccentric vs. isometric actions of the hamstrings during sprinting.
• Eccentric, concentric, and isometric strength training.
• Sprint training and sprint technique.
• Muscle fiber length.
• Predictive value of various tests.
• Hip vs. knee-dominant exercises.
• Neural inhibition.
• Intramuscular coordination.
• Fatigue resistance.
• Strength and more.

Accreditation for Physiotherapists:

The course is accredited by the Kwaliteitshuis Fysiotherapie of KNGF and Keurmerk.