Exercises for Hamstring Strains and Tendinitis

High insertional hamstring tendinitis—pain near the sit bone where the hamstring tendons attach—is a frustrating injury that affects athletes and active individuals. Hamstring strains are a tear in the muscle.  Rehabilitation focuses on progressive hamstring strengthening, particularly in lengthened positions, to restore tendon capacity, improve load tolerance, and reduce pain.

Below are six effective exercises commonly used in rehab programs for insertional hamstring tendinopathy.

1. Floor Bridge (video)

How to do it:

1. Lie on your back with knees straight, feet on a bench or couch, hip-width apart.

2. Engage your core and press through your heels to lift your hips off the ground.

3. Squeeze your glutes and hamstrings at the top.

4. Lower slowly with control.

Tips:

• Avoid overarching your lower back.

• Progress by changing position (feet together or rolled out, or single-leg variation).

2. Hamstring Bridge

How to do it:

1. Lie on your back with your knees bent.

2. Keep knees bent over 90° (~135).

3. Press through your heels to lift your hips, contracting hamstrings.

4. Hold briefly at the top, then lower with control.

Tips:

• Increase challenge by performing single-leg bridges.

• Avoid letting hips drop unevenly.

3. Seated Hamstring Curl (Machine)

How to do it:

1. Sit on a hamstring curl machine with legs straight and pad just above your ankles.

2. Grip handles and keep hips firmly against the seat.

3. Curl your heels down toward the floor by contracting your hamstrings.

4. Slowly return to the starting position.

Tips:

• Use a slow, controlled tempo.

• Focus on full range of motion.

• Progressions include feet narrow, neutral and wide as well as single leg

4. Prone Hamstring Curl (Machine or Band)

How to do it:

1. Lie face down on a leg curl machine or attach a band around your ankles.

2. Start with legs extended.

3. Curl your heels toward your glutes by contracting the hamstrings.

4. Lower back slowly.

Tips:

• Keep hips pressed into the pad.

• Don’t swing or use momentum.

• Keep abs tight and minimize low back arch

5. Hip Thrust

How to do it:

1. Sit on the ground with your upper back against a bench.

2. Roll a barbell over your hips (or use bodyweight).

3. With feet flat and knees bent, drive hips upward until your torso is parallel to the floor.

4. Squeeze glutes and hamstrings at the top.

5. Lower with control.

Tips:

• Keep chin tucked and ribs down.

• Focus on controlled hip extension, not arching your back.

6. Romanian Deadlift (RDL)

How to do it:

1. Stand tall holding a barbell or dumbbells in front of thighs.

2. Keep knees slightly bent and spine neutral.

3. Hinge at the hips, pushing them backward as you lower the weight along your thighs.

4. Stop just below knee or until you feel a strong hamstring stretch.

5. Push feet into the earth and drive hips up and forward to return to standing.

Tips:

• Don’t round your back.

• Think “hips back” rather than “bend forward.”

Key Takeaways

• Start with bridges and machine curls to build baseline hamstring strength with less tendon strain.

• Progress to hip thrusts and Romanian deadlifts to strengthen hamstrings in lengthened positions—crucial for tendon adaptation.

• Perform exercises 2–3x per week, starting with low load and gradually increasing as tolerated with load and frequency.

• Always listen to your body and consult a physical therapist for tailored rehab guidance.

Need help with a nagging hamstring injury? Our team at Manual Therapy Specialists specializes in sports injury rehab and performance optimization. Contact us today for a comprehensive evaluation and personalized recovery plan.

Reach out and let’s set up a session. We’ll take the guesswork out of your recovery.

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About the author: David Potucek, PT, MSPT, CFMT

David is an orthopedic physical therapist with over 20 years of experience. He has successfully helped countless individuals with hamstring issues. From Olympians to weekend warriors, he has been able to find a solution for everyone. He is a former D1 athlete, and currently keeps active with lifting and running.