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Rodrigo Alcaraz · Injuries · Hamstring strain

Injuries

Hamstring strain

Most hamstrings are not rehabbed for long enough. The tissue stops hurting at about week two and is nowhere near ready at week three, which is when most people go back and most people tear it again.

How long

3 to 8 weeks

The one that keeps coming back

Reinjury

Reinjury rate is the highest of any football injury. Almost all of it is people returning early.

The phases

The phases

A moderate strain, on a plan. The dates move; the order does not.

Rehab phases
Day 0–3 Protect and offload. Not immobilise. Week 1 Isometrics, then early lengthening. Loading starts now. Week 2–3 Eccentric work, the part everybody skips. Week 4–5 Running progression, on a plan rather than by feel. Week 6+ Sprint exposure and the criteria below.

A moderate strain, on a plan. The dates move; the order does not.

Limb symmetry

Limb symmetry

Limb symmetry at week 6. Under 90% is not a pass, and the eccentric number is the one that matters most here.

Limb symmetry Injured sideOther side
Iso strength Eccentric Single-leg bridge Hop distance

Limb symmetry at week 6. Under 90% is not a pass, and the eccentric number is the one that matters most here.

Return to play

Return-to-play criteria

Decided on measured criteria, not on whether it still hurts. Published here so you can hold me to it — and so your club can.

TestThresholdMeasured by
Eccentric strength≥ 90% of the other leg Hand-held dynamometer
Single-leg bridge≥ 90% symmetry Repetitions to failure
Sprint exposure2 sessions at 95%+ max speed GPS or timing gates
Askling H-testNo apprehension Clinical

Questions

Questions

Can I play with strapping?

Strapping does not meaningfully change what the muscle can tolerate. If the criteria are not met, strapping is a way of getting injured with tape on.

Why does mine keep happening?

In most cases: returning before eccentric strength came back, and a sprint exposure that jumped rather than built. Both are visible in the numbers before they are visible on the pitch.

One email a month

One injury, explained properly. Nothing sold.

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