All too often we see people sticking their leg up as high as they can on something, bend forward, and say they’re stretching their hamstrings. In reality, this person is hanging on passive structures, stretching their nerves, and probably pissing off their low back.

There are better ways to stretch your hamstrings! One of the easiest ways to stretch a muscle is to add a load to it. Another way to term this is to perform eccentric muscle actions. The hamstrings extend the hip and flex the knee – thus you want to perform movements that load the hip into flexion with the knee in extension.

Here are two exercises that are great to perform before leg day, running, or any type of sport. Most sport-related hamstring strains are due to an extreme uncontrolled stretch. Priming the hamstrings before activity and learning to actively control motion at end ranges is a way to prehab those hammys. Be sure to limit pelvis and low back motion, keep the ribs pulled down, and breathe through the exercises

One of my favorite exercises to incorporate early in the ACL rehab process are standing heel raises. Not only do you of course get work on the calf, but more importantly you work on:

✅ Terminal knee extension

✅ Glute and quad activation

✅ Progression into full weight bearing on that affected leg

✅ Working on active knee extension ROM

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If you’re in the first few weeks of an isolated ACL repair and cleared for full weight bearing, start utilizing heel raises in your program. As ALWAYS, adhere to your surgeons and physical therapists recommendations for your rehab exercises!!

HOW: Get set-up standing with a band around and above the knee with the band anchored in front of you. To perform the exercise, put tension on the band so that it wants to pull your knee forward, let your knee bend and your foot go onto the toes followed by squeezing your quad, pushing your heel into the ground, and pushing your knee back until it is fully straight.

 

FEEL: You will feel your quads working with this exercise and maybe even your glutes. You may also feel a stretch behind your knee in the calf and hamstring region when your knee is straight.

 

COMPENSATION: Keep your hip extended (pushed forward) and stand tall as you perform this exercise, don’t let your butt go back and your hip bend when you straighten your knee.

HOW:  Start on your back with one knee bent on the floor, with the opposite leg perform a straight leg raise. Next, drive your heel into the ground and lift your hip up towards the ceiling with the bent knee. At the end position your knee, hip, and shoulder should be in one straight line. Hold the end position and squeeze the glutes, then slowly return to starting position and lower the straight leg back down.

 

FEEL:  You should feel your glutes work to control this motion. At no point should you feel your low back muscles doing the lifting motion. If you feel it only in your hamstrings, try bending your knees a bit more and repeat. The straight leg will be working the front of the hip and thigh muscles.

 

COMPENSATION:  Avoid arching at the low back as you perform this. Don’t let the knee bend with the leg that is elevated.

HOW: Begin with your mid-back against a bench with you feet about hip width apart. While keeping your chin tucked, thrust your hips towards the ceiling. Focus on driving into the floor with your heels and tuck your tailbone (AKA posteriorly tilt your pelvis) at the top of the thrust.  Slowly return back to starting position and repeat.

 

FEEL: You will feel the gluteal and hamstring muscles working with this exercise particularly of the leg the is bent in closer to you.

 

COMPENSATION: Avoid arching with the lower back, allow a majority of this movement to come from the hips and pelvis.

HOW: Get set-up in front of a wall or an object to use for balance if necessary. While keeping your glutes and quads tight to keep your knees straight, lift your heels off the ground in a slow and controlled manner, then slowly lower your heels back down to the ground. Repeat

 

FEEL: You should feel your calves getting a workout, but also your glutes and quads working as well to help keep your legs straight.

 

COMPENSATION: Do not let your knees bend as that is a different exercise. Do not shift your weight side to side. Make sure you go through your full range of motion at your ankle.

This mobilization is designed to improve your kneecap mobility. It is important to perform this to help regain knee flexion and extension range of motion.

– Position yourself long-sitting with your legs and bottom supported on a surface. Also keep your back supported if possible

– Using the webspace of your hand or your fingers, gently mobilize your patella (kneecap) in all four directions (up, down, side-to-side) and hold each position for ten seconds. You should not be putting pressure down into your knee cap as this may be uncomfortable, instead focus on gliding your kneecap in all four directions. Repeat as prescribed.

– Use your other knee cap as a reference for how your kneecap on your affected knee should ideally move.

This exercise (quad set) is paramount to getting re-gaining active control your quadriceps muscles, which is the muscle on the front of your thigh. After an injury (which includes surgery), there is lots of swelling in the knee that accumulates. This swelling leads to a phenomena called arthrogenic inhibition, in which there is an inability to completely contract a muscle despite no injury to the muscle or innervating nerve. To combat this, lots of practice and developing a new “brain-body connection” is required.

HOW: Follow this foolproof guide to wake your quad back up! Laying on the ground or on a table, place a rolled-up towel/shirt under your knee. This will act as a lever which will make it easier to activate your quadriceps muscle. Attempt to lift your heel off the ground by squeezing your quadriceps muscle until your knee is fully straight. return to starting position and repeat

FEEL: Really focus on squeezing your quad. Sometimes touching the muscle, massaging it, or hitting it can help. Think about moving your kneecap up and into your hip socket. Push your knee down into the towel roll. Move your shin bone in the shape of a “J” by moving your knee down and your heel up at the same time. Squeeze both quadriceps at the same time to improve the quality of the quad contraction.

COMPENSATION: Do not lift your entire leg off the towel/shirt, focus on getting your knee fully straight similar to the other side.

HOW:  Begin this exercise by balancing one leg on a foam pad. Next focus on hinging primarily at the hips. This is achieved by bringing your torso forward and pushing your butt back. Kicking out the back leg may make it easier for you to counterbalance your trunk forward. Lower yourself as far as comfortable, then pull yourself upright by using the muscles in the back of the leg. Squeeze your butt once you are upright to ensure that you stand fully erect. This exercise required a lot of stability, make sure you are staying engaged with the foot muscles. Make sure your hip, knee, and ankle are in alignment, this may be easier if you are looking in the mirror.

 

FEEL:  You will the muscles in the back of the leg work with this exercise. As you hinge over you will feel a pull in the hamstrings.

 

COMPENSATION:  Avoiding rounding the back as you lean your torso forward. Movement should primarily be at the hips. Don’t allow the knee to go forward past your toes with this exercise. Also, avoid your knee caving inward, make sure to keep your ankle, knee, and hip in alignment. One other common compensation is rotating your body open towards the leg that is kicking back, keep your chest facing the floor with this exercise.

HOW: Anchor a band roughly knee height, and place the band around the back of your lower leg. You will then perform a squat while leaning into the band and keeping your trunk straight.

 

FEEL: You will feel the muscles on the front of your thigh working with this exercise.

 

COMPENSATION: Avoid leaning your trunk forward. The more you lean into the band the easier it will be to keep your trunk upright.

HOW: Place a wedge underneath your heel. Reach forward with the elevated leg as far as you can, tap the floor and return back to starting position.

 

FEEL: You will feel the muscles in your legs working, particularly the muscles on the front of your thigh.

 

COMPENSATION: Make sure the leg on the wedge is straight. The hip, knee, and ankle should be aligned.

HOW: Get set-up in a quadruped position on your hands and knees. Start strong in your shoulder blades by pushing your body away from the floor. From here you will lift one leg off the floor and drive your knee out to the side and back while keeping your knee bent at 90 degrees. This motion is driven by the hip.

 

FEEL: You should feel this exercise in your hip muscles, particularly your butt (glute) muscles of the leg that is moving.

 

COMPENSATION: Avoid rotating your entire trunk with this exercise, avoid arching your back, do not bend or straighten your knee, maintain knee position.