Hamstrings
Acceleration Runs
The hamstrings are often injured in the first part of a sprint, when the athlete is
accelerating. Before returning to sport, the athlete should practice these runs, gradually
increasing the intensity, up to 100% effort.
Over a distance of 40-100 meters (start with shorter distances and increase), every
10 meters should be marked
The athlete accelerates from 0-10 meters and then decelerates almost to a stop by 20
meters, before accelerating again between 20 and 30.
This is only for those who have had at least 6 weeks of rest and treatment following a
hamstring injury
Eccentric strengthening
It is important to strengthen the hamstring muscles eccentrically (as they lengthen)
as this is when they are most commonly injured.
This is a very advanced exercise and should only be performed when the injury has
healed and earlier strength training has been progressed.
Starting in a kneeling position with the feet and ankles firmly fixed, lean forwards and
aim to resist the downwards movement.
Ensure you keep the back straight and do not pivot at the hips.
Slowly allow your body to move forwards towards the floor, under complete control.
Once you reach the 'point of no return' where you feel you cannot control the
movement much further, hold for a couple of seconds, rest and then repeat.
As your hamstrings become stronger you will be able to lower yourself with more
control.
Functional exercises >>
Image 6 - Advanced eccentric hamstring exercise
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Hamstring Curls on Swiss Ball
Begin this hamstring strengthening exercise lying on your back with a Swiss ball under your
legs as demonstrated (figure 6). Keeping your back straight, slowly bend your knees
tightening the back of your thighs (hamstrings). Then return to the starting position. Perform
3 sets of 10 repetitions provided the exercise is pain free. Once this is too easy, the exercise
can be performed on each leg individually (figure 7).
Figure 6 – Hamstring Curls on Swiss Ball
Figure 7 – Hamstring Curls on Swiss Ball Single Leg (right)
Begin this hamstring strengthening exercise lying on your back in the position
demonstrated (figure 8). Slowly lift your bottom pushing through your foot, until your
knee, hip and shoulder are in a straight line. Tighten the back of your thigh (hamstrings)
as you do this and hold for 2 seconds. Then slowly lower back down. Perform 3 sets of 10
repetitions provided it is pain free.
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Concentrics (for hamstrings and Buttocks)
Bridging
Begin this hamstring strengthening exercise lying on your back in the position demonstrated
(figure 3). Slowly lift your bottom pushing through your feet, until your knees, hips and
shoulders are in a straight line. Tighten the back of your thigh (hamstrings) as you do this.
Hold for 2 seconds then slowly lower your bottom back down. Repeat 10 times provided it is
pain free.
Single Leg Bridging
Begin this hamstring strengthening exercise lying on your back in the position demonstrated
(figure 8). Slowly lift your bottom pushing through your foot, until your knee, hip and
shoulder are in a straight line. Tighten the back of your thigh (hamstrings) as you do this and
hold for 2 seconds. Then slowly lower back down. Repeat 10 times
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Calf exercises (for Achilles pain, shin splints)
The following intermediate calf strengthening exercises should generally be performed 1 - 3
times per week provided they do not cause or increase pain. Ideally they should not be
performed on consecutive days, to allow muscle recovery. As your calf strength improves,
the calf exercises can be progressed by gradually increasing the repetitions and resistance
provided they do not cause or increase pain.
Generally you should perform only 1 or 2 of the following calf exercises, provided they are
pain free, beginning with Calf Raises (figure 3). Once this calf strengthening exercise is too
easy, progress to the next exercise Calf Raises over Step (figure 4) and so on.
Calf Raises
Begin this calf strengthening exercise standing at a bench or chair for balance. Keep your feet
shoulder width apart and facing forwards (figure 3). Slowly move up onto your toes, raising
your heels as far as possible and comfortable without pain, tightening your calf muscles.
Then slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.
Figure 3 – Calf Raises
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Single Leg Calf Raise
Begin this calf strengthening exercise standing on one leg at a bench or chair for balance
(figure 5) . Keeping your foot facing forwards, slowly move up onto your toes, raising your
heel as far as possible and comfortable without pain, tightening your calf muscle. Then
slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.
Figure 5 – Single Leg Calf Raise (right leg)
Calf Raises Over Step Eccentrics (good for Achilles)
Begin this calf strengthening exercise standing with your heels dropped below the level of a
step as demonstrated (figure 4). Ensure you have something to hold onto for balance. Slowly
move up onto your toes, raising your heels as far as possible and comfortable without pain,
tightening your calf muscles. Then slowly lower back down. Perform 3 sets of 10 repetitions
provided it is pain free.
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Figure 4 –Calf Raises over Step
Single Leg Calf Raise over Step
Begin this calf strengthening exercise standing on one leg with your heels dropped below the
level of a step (figure 6). Ensure you have something to hold onto for balance. Slowly move
up onto your toes, raising your heel as far as possible and comfortable without pain,
tightening your calf. Then slowly lower back down. Perform 3 sets of 10 repetitions provided
it is pain free.
Figure 6 – Single Leg
Add in arm weight to progress loading
Calf Raise Over Step (left leg)
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Gluteals – Groin rehab and knee pain
Clams
Begin this gluteal strengthening exercise lying on your side with your shoulders, hips and
ankles in alignment. Your knees should be bent at right angles and resting together (figure 5).
Slowly lift your upper knee away from your other leg, keeping your ankles together, your
pelvis still, and tightening your buttock muscles (gluteals). Hold for 2 seconds then slowly
lower the knee back down. Repeat 10 times as far as possible pain-free.
Squats with Swiss Ball
Begin this gluteal strengthening exercise in standing with your feet shoulder width apart and
your feet facing forwards. A Swiss ball can be placed between a wall and your lower back to
improve your technique. Slowly perform a squat, keeping your back straight. Your knees
should be in line with your middle toes and should not move forward past your toes (figure
8). Perform 3 sets of 10 repetitions provided the exercise is pain free.
Figure 8 – Squats with Swiss Ball
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Lunges
Begin this gluteal strengthening exercise standing with your back straight in the position
demonstrated (figure 9). Slowly lower your body until your front knee is at a right angle.
Keep your knee in line with your middle toe and your feet facing forwards. Perform 3 sets of
10 repetitions provided it is pain free.
Figure 9 – Lunges
Gluteal Strengthening – Advanced Exercises
The following advanced gluteal strengthening exercises should generally be performed 1 - 3
times per week provided they do not cause or increase pain. Ideally they should not be
performed on consecutive days, to allow muscle recovery. As your gluteal strength improves,
the exercises can be progressed by gradually increasing the repetitions, number of sets or
resistance of the exercises provided they do not cause or increase pain.
Single Leg Squat with Swiss Ball
Begin this gluteal strengthening exercise in standing on one leg with your foot facing
forwards. A Swiss ball can be placed between a wall and your lower back to improve your
technique. Slowly perform a squat, keeping your back straight (figure 10). Your knee should
not bend beyond right angles and should be in line with your middle toe. Your knee should
also not move forward past your toes. Perform 3 sets of 10 repetitions provided the exercise
is pain free.
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Figure 10 – Single Leg Squat with Swiss Ball (left leg)
Lunges with Weights
Begin this gluteal strengthening exercise standing holding light weights, with your back
straight in the position demonstrated (figure 11). Slowly lower your body until your front
knee is at a right angle. Keep your knee in line with your middle toe and your feet facing
forwards. Perform 3 sets of 10 repetitions provided the exercise is pain free.
Figure 11 – Lunges with Weights
Progress to walking lunges ensuring you keep the same form as shown above
Patella tendinosis (knee pain below the knee cap)
Stand on a step (or an incline if you can) on the affected leg and keep the other leg straight
just in front of you. Perform a small knee dip so that the other leg drops below the level of
the step and the hips stay level.
Perform 40-60 reps of these. PLEASE NOTE: There may be an increase in pain initially but
persevere. It will take 6 weeks of daily exercise
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Rotator Cuff Strengthening (shoulders)
External Rotation vs. Resistance Band
Begin this rotator cuff strengthening exercise standing with your back straight, shoulder
blades back slightly and holding a resistance band as demonstrated (figure 4). Keeping your
elbow at your side and bent to 90 degrees, slowly move your hand away from your body
keeping your shoulder blade still. Perform 3 sets of 10 repetitions as far as possible provided
it is pain free.
Figure 4 – External Rotation vs. Resistance Band (left side)
Internal Rotation vs. Resistance Band
Begin this rotator cuff strengthening exercise standing with your back straight, shoulder
blades back slightly and holding a resistance band as demonstrated (figure 5). Keeping your
elbow at your side and bent to 90 degrees, slowly move your hand towards your body
keeping your shoulder blade still. Perform 3 sets of 10 repetitions as far as possible provided
it is pain free on each side.
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Rotator Cuff Strengthening – Advanced Rotator Cuff Exercises
External Rotation at 90 Degrees vs. Resistance Band
Begin this rotator cuff strengthening exercise standing with your back straight, shoulder
blades back slightly, arm side elevated to 90 degrees and holding a resistance band as
demonstrated (figure 6). Keeping your elbow bent to 90 degrees, slowly move your hand
backwards against the resistance band keeping your shoulder blade and elbow still. Perform 3
sets of 10 repetitions as far as possible provided it is pain free.
Figure 6 – External Rotation at 90 degrees vs. Resistance Band (left arm)
Internal Rotation at 90 Degrees vs. Resistance Band
Begin this rotator cuff strengthening exercise standing with your back straight, shoulder
blades back slightly, arm side elevated to 90 degrees and holding a resistance band as
demonstrated (figure 7) . Keeping your elbow bent to 90 degrees, slowly move your hand
down and forwards against the resistance band keeping your shoulder blade and elbow still.
Perform 3 sets of 10 repetitions as far as possible provided it is pain free.
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Seated Row
Begin this rhomboid strengthening exercise sitting on a seated row machine with your back
and neck straight as demonstrated (figure 7). Slowly pull the handle towards your chest,
bringing your elbows backwards and tightening your rhomboids by squeezing your shoulder
blades together. Perform 3 sets of 10 repetitions provided it is pain free.
Figure 7 – Seated Row
Rhomboid Pull Backs on Swiss Ball
Begin this rhomboid strengthening exercise standing with your knees bent, back straight,
hand on a Swiss ball or bench and holding a light weight as demonstrated (figure 8). Slowly
pull the weight towards your chest, bringing your elbow back and tightening your rhomboids
by squeezing your shoulder blades together. Perform 3 sets of 10 repetitions provided it is
pain free.
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Ankle injuries
Proprioceptive ability is often lost or diminished following an injury. Proprioception
needs to be worked on in order for a joint to return to or near its pre-injury level.
Joints that do not have normal Proprioception are more likely to be re-injured
because they will more easily be placed in an extreme position before the brain
reacts
Any patient that has suffered a significant ankle or hindfoot injury (ex. Ankle sprain,
ankle fracture, etc.) or has undergone ankle, or foot surgery should perform some
proprioceptive exercises in order to optimize their recovery.
How is proprioceptive training done? Perform a graduated program that works to
improve proprioception until both the right and left sides have equal proprioceptive
ability (assuming one side is uninjured). Compare to your uninjured side (do
exercises on both sides until each side is equal). Consider the following guidelines:
1. Do exercises daily
2. Do exercises for 30 seconds and repeat for 5-10 repetitions
3. Gradually progress the complexity of the exercises:
Basic Exercise

Stand on one foot on a flat surface with your eyes open (30seconds)
Harder

Stand on one foot on a flat surface with your eyes closed (30seconds). Have
something available to grab if you lose your balance.
Even Harder
Stand on one foot on a flat surface with your eyes closed and move your head from
side to side (30seconds). Have something available to grab if you lose your balance
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Hardest Stand on one foot on a soft surface (ex. a pillow or bed) with your eyes
closed and move your head from side to side (30 seconds). Have something
available to grab if you lose your balance
Basic Balance Exercises
Single Leg Balance Standing on one leg, maintain your balance. Try to hold for 1 minute.
Once this exercise is too easy progress to eyes closed. A further progression can involve
performing the exercise standing on one or more pillows with eyes open and then eyes
closed.
Figure 1 – Single leg balance (right side)
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Intermediate Balance Exercise
Ball Around Back
Standing on one leg, take a ball around your back whilst maintaining your balance (figure 2).
Once this exercise is too easy, progress to eyes closed.
Figure 2 – Ball around back balance exercise
Ball Under Leg
Standing on one leg, take a ball under your leg whilst maintaining your balance (figure 3).
Once this exercise is too easy, progress to eyes closed.
Figure 3 – Ball under leg balance exercise
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Ball Circles Around Leg
Standing on one leg, move a ball around your leg whilst maintaining your balance (figure 4).
Perform clockwise and then anti-clockwise. Once this exercise is too easy, progress to eyes
closed.
Figure 4 – Ball circles around leg balance exercise
Ball Throws Against Wall
Standing on one leg, throw a ball against a wall or to a partner whilst maintaining your
balance (figure 5).
Figure 5 – Ball throws against wall balance exercise
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Side Throw Against Wall
Standing on one leg, throw a ball across your body against a wall or to a partner whilst
maintaining your balance (figure 6). Repeat the exercise, throwing the ball to the opposite
side of your body.
Figure 6 – Side throw against wall balance exercise
Advanced Balance Exercises
Wobbleboard Balance Exercises
Standing on a wobbleboard with both feet, maintain your balance and try not to let the rim
touch the ground (figure 7). Progress the exercise by doing circles with the rim touching the
ground clockwise and then anticlockwise. Once this is too easy you can try these balance
exercises with your eyes closed and, eventually, with only one leg eyes open and eyes closed.
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Duradisc Balance Exercises
Begin standing on a Duradisc with both feet and maintain your balance. Progress the exercise
by closing your eyes. Once this is too easy you can progress the exercise by balancing on one
leg with eyes open and eventually with eyes closed.
Figure 8 – Duradisc balance exercise
Single Leg Jump and Hold (Multidirectional)
Using the general shape of a square, hop in different directions from one point of the square
to the next (figure 9). Pause for 3 seconds once you have landed and maintain your balance.
Progress this exercise by increasing the distance of the hop, or by closing your eyes.
Figure 9 – Single leg jump and hold (multidirectional)
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Core Stability
Plank
Plus leg lift
Same position as above, then keeping the back level, lift one leg at a time without rocking
the pelvis
Side plank
Kettle bells
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