The Tool Desk
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Which hamstring exercises have the strongest support?
Exercise choice depends on whether you are healthy and training to prevent injury or recovering from a recent strain. The evidence does not establish a head-to-head ranking of every exercise, or a universal set-and-rep prescription. The 2022 Hamstring Strain Injury in Athletes: Clinical Practice Guidelines strongly recommend Nordic hamstring exercise as part of prevention and moderately recommend eccentric training after injury.
| Exercise or training | Main role | How to use it |
|---|---|---|
| Nordic hamstring exercise | Prevention | Include it in a wider warm-up and strength program. It requires a secure way to anchor the feet; a strap or partner can help, but no particular device is shown to prevent injury on its own. |
| Eccentric hamstring strengthening | Prevention and rehabilitation | Train controlled muscle lengthening at a level suited to current capacity. After a recent strain, progress it with clinical guidance rather than starting with maximal loading. |
| Stability, trunk, agility and sport-specific work | Comprehensive prevention and later rehabilitation | Use alongside hamstring strengthening so the program includes functional movement, not just isolated muscle work. |
| Progressive running and sprinting | Later rehabilitation and return to sport | Reintroduce according to symptoms and response to earlier loading; these are not exercises to begin regardless of pain or injury status. |
Nordic hamstring exercise for prevention
The Nordic curl is the clearest named exercise for prevention in the cited guideline. In a 2020 evidence statement, prevention programs that included Nordic exercise were associated with a 45% to 65% lower hamstring injury risk than usual care. Those results came largely from football/soccer and other athletic populations; they are not a personal guarantee or a precise estimate for every sport, age group or training setting. The statement also notes that adherence can be a practical limitation.
Use Nordic exercise as one part of a consistent program that also includes warm-up, strengthening, stability and functional or sport-specific movement. If the movement is painful, or you are still recovering from a strain, do not treat the prevention recommendation as a reason to push through it.
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Eccentric strengthening and longer muscle lengths
Eccentric training loads a muscle as it lengthens. It is an important component of both prevention and rehabilitation, but the appropriate exercise, range and load depend on symptoms and capacity. Later in rehabilitation, the aim is to rebuild strength at longer muscle lengths as well as to tolerate the demands of running and sprinting. A recent strain is not the time to jump straight to aggressive, lengthened-position loading.
After a recent strain: progress rather than rush
Rehabilitation after a strain is not a universal do-it-yourself sequence. The 2023 London International Consensus supports individualizing rehabilitation around injury characteristics, symptoms, strength and the response to previous loading. Early on, protect recovering tissue from high-strain and high-strain-rate loads; then build exercise demands progressively. A sports physical therapist can help tailor that progression and decide when running, sprinting and sport-specific work are appropriate.
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- Begin with loading that is appropriate to the injury and current symptoms.
- Progress strengthening in response to how the hamstring tolerates previous sessions.
- Build strength at longer muscle lengths in later rehabilitation.
- Reintroduce running and then sprinting progressively, before returning to the demands of the sport.
How to judge readiness to return to sport
There is no established universal strength threshold or flexibility benchmark that clears every athlete to return. The 2023 consensus panel did not agree on optimal strength-measurement methods or flexibility benchmarks. Decisions should consider injury history, rehabilitation quality, symptoms, strength and the athlete’s progression through running and sport-specific demands—not a calendar date or one test alone.
A previous hamstring strain is itself a risk factor for another injury. That makes a complete, progressive return-to-sport plan important even when symptoms have improved. The cited recommendations do not set one optimal dosage or timeline for everyone.
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Evidence and limits
The 2020 Danish Society of Sports Physical Therapy evidence statement reports the 45% to 65% reduction associated with prevention programs including Nordic exercise compared with usual care; practical adherence varied. The 2022 clinical practice guideline supports Nordic exercise for prevention and eccentric strengthening after injury. The 2023 international consensus emphasizes individualized progression and sport-specific running and sprinting, while finding no consensus on optimum strength testing or flexibility benchmarks. A SONAFE-Brazil/JOSPT guideline was published on 2026-08-28, but its accessible record does not provide specific exercise recommendations that can be verified here.
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