Sports injuries: preventing and treating thigh pain

Treating and preventing hamstring and quadraceps injuries

 Phase 1: Muscle Balance

The aim of phase 1 is to restore normal muscle length, range of motion and introduce postural awareness. The stretches outlined below are an indication of muscle stretches that are advised but do not have to be followed to the letter. Therefore if you have a preferred quad or hip flexor stretch for example, go ahead and use it. The stretches below are aimed to give a new perspective and new ideas on the sometimes stale stretches that we have been performing over the years.

Hip flexor stretch – floor

Lying supine, with knees bent, both feet flat on the floor, the lower back is flat. Bring one leg up towards chest and holds it, while keeping lower back to the floor. The other leg is extended straight out and the gluteals on that side are contracted, while the back of the leg is pushed into the floor. This position is held for 8-10 seconds and repeated 6 times before swapping legs.

Abductor stretch

Standing with leg to be stretched crossed in behind. Laterally flex away from the stretching leg until a stretch is felt. This position is held for 20-30 seconds, repeating 2-3 times and swapping legs if necessary.

Standing Adductor Stretch

Standing with one leg straight and the opposite leg bent with legs apart and feet facing forward. Move sideways towards the bent leg until a stretch is felt in the inner thigh of the straight leg. The stretch is held for 20-30seconds and repeated 2-3 times before swapping legs.

ITB stretch

Lying on your side with lower hip and knee bent, and the pelvis slightly rotated forwards. The top leg is straight and positioned forwards, with the knee turned up slightly.
The top leg is then abducted and then extended, so it is positioned slightly behind the body. The leg is then dropped towards the floor and allowed to hang for 15-20 seconds. The pelvis should not move and the lower back should not be allowed to arch during the movement.

Standing quadraceps stretch

This well-known stretch can be refined for optimal benefit. Standing in good alignment, holding one ankle. A wall may be used to lean on for balance. Perform a posterior pelvic tilt, while squeezing the gluteals of the stretching leg. This position is held for 20-30 seconds and repeated 2-3 times before swapping.

Standing hamstrings stretch

Stand in optimal alignment with one leg resting on the couch or a chair straight ahead of you (it is essential that this is at the right height so the spine is held in neutral alignment). The foot should be facing forwards and the hips should be square to the stretching leg. You then perform an anterior tilt of the pelvis (this is a subtle movement that tilts the pelvis beckwards, the couch or chair can be raised if a stretch is not felt). The stretching leg is then slowly rotated from the hip, alternating left to right. The movement is repeated 8 times in each direction before swapping legs.

Assisted supine calf stretch

Lying supine, with a straight leg over the assisting person’s knee. The assisting person places one hand on the anterior thigh, just above the knee, and the other hand on the sole of the foot.
The assisting person applies resistance in the direction of dorsiflexion, until a comfortable stretch is felt. The knee should be kept straight throughout. This position is held for 20-30 seconds and repeated 2-3 times before changing legs. You may assist the stretch by actively dorsiflexing (bring toes towards body/bending ankle) the ankle.

Phase 2:

1. Lunge stretch (backwards)

Keep feet together and step backwards with right leg into lunge. Reach right hand to the sky, bend your torso to the left. Straighten torso and step forward into the starting position. Alternate sides and repeat for 10-15 repetitions.

1b. Lunge stretch backwards and moving

This exercise is the same as the lunge stretch backwards but instead of returning to the start position, walk forwards into the next position.

2. Inverted Hamstring

Stand on one leg in good postural position, holding onto a wall, chair or table with one hand for stability and reaching out to the side with the other hand. Shoulder blades should be kept down. Maintaining a straight line from ear to ankle, bend over at the waist, raising opposite heel to the sky. You should feel the stretch then return to standing position and contract hamstrings, gluteals. Make sure back is kept flat and your shoulders are parallel to the ground.

2b. Inverted hamstring progress (no chair)

Phase 3:

3. Dead lifts

Feet shoulder width apart. Lightly brace abdominals and keep neutral spine. Similar to a squat bend down to a position where the thighs are almost parallel with the floor, as if to place dumbbells by the side of body. Brace abdominals further and contract gluteals. Return to start position and perform 10-12 repetitions.


Good Mornings

4. Single leg dead lifts


Single leg good mornings

5. Single leg Natural Glute-Ham Raise

Ankles are secured to the machine as demonstrated. Hold arms across chest and raise body up bending at the knee. Brace abdominals and gluteal muscles. Bring arms away from body and move hands into a push up stance when coming down to land on the floor to push back up again.

This can also be performed on the floor with a partner holding securely just above the ankles. Start with 2x6reps and work up to 4×8 reps

Phase 4:

6. Lateral lunge stretch progress

Stand with feet wider than shoulder width apart, shift your hips to the left and down by bending your left knee and keeping your right leg straight. Push through left hip returning to starting position. Do alternate sides and then repeat.

7. High arms – deer running drills

In this running drill you need to use your arms to propel yourself in a bounding high knees motion. Think tall and keep head up

8. High legs through running ladder

This drill needs concentration. Quick feet and high knees are essential you need to use arms to drive through each step.

9. Squat Jump

You must use a mat or spring floor for this exercise. You must use explosive power that comes from the quads and knees. You must not squat too low and must also not pause between jumps to keep the plyometric effect going. Focus on a fixed position otherwise you will migrate across the gym floor.

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