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Many athletes and clients struggle with hamstring muscle activation. A normal quad to hamstring ratio would be 3:2, but studies often find that subjects tend to be closer to 2:1 (especially females). This diminished ratio can increase knee injury risk with jumping and cutting sports. Some people struggle with proximal hamstring tendinopathy related to overuse. Incorporating eccentric hamstring exercises in your training can markedly improve hamstring strength and activation patterns.
 
Execution:
Begin in supine with 90 degrees of knee flexion and the feet flat on the floor. Next, bridge up into a table top position. Then, slowly begin to walk the feet out keeping the weight on the heels in an alternating pattern. Move the feet as far away from the body as possible while maintaining a good static bridge position.

Once form starts to falter or fatigue sets in, walk the feet back in using the same cadence and incremental steps until the start position is achieved. Perform 5 repetitions and repeat 2-3 times. Focus on control while avoiding pelvic rotation, and be cautious working into too much knee extension to avoid poor form or cramping..

Application:
This is an excellent way to improve hamstring strength while emphasizing pelvic stability. This exercise should be preceded by static bridging to ensure the client understands how to maintain a neutral pelvic position (consider using a half roll or towel as a visual aid to cue him/her out of rotational movement initially). The walk out exercise can be implemented as part of ACL prevention/rehab programs and also works well for runners and athletes struggling with hip/pelvic stability, proximal tendinopathy and general posterior chain weakness.

 

Regression:
Bridge up and march in place for repetitions or time to develop sufficient strength and stability.

 

Progression:
Increase repetitions or slow the cadence down pausing longer at each step to increase time under tension. Additionally, move the hands from palm down to palm up to reduce stability. For advanced clientele, the arms could be crossed with the hands resting on the opposite shoulder.


Brian Schiff, PT, OCS, CSCS, is a licensed physical therapist, respected author and fitness professional. Currently, he serves as the supervisor for Athletes' Performance at Raleigh Orthopaedic in Raleigh, NC. Brian conducts live continuing education webinars and presents nationally at professional conferences and seminars on injury prevention, rehab and sport-specific training. For more information on his products and services, visit www.BrianSchiff.com.