Tag Archives: strength training

Hamstring Pain? Try Some Eccentric Training!

This past weekend we had the opportunity to help treat runners at the finish line of the St. Augustine Half Marathon! During one of these events, one of the most common running injuries we tend to see in runners is hamstring tightness/pain due to strains or tendinopathies.

Although hamstring issues tend to be very common among runners, dancers, gymnasts and kickers, they can affect anyone especially those with limitations in hamstring flexibility. Unfortunately, these injuries often become recurrent and chronic in nature. A history of a previous hamstring strain is the number one predictor of sustaining a subsequent injury, so chances are if you have experienced one, you will experience another especially if preventative measures aren’t taken!

The hamstrings are a large muscle group(semitendinosus, semimembranosus located medially, biceps femoris located laterally)  spanning from the ischial tuberosity (buttock region) to the tibia and fibula (picture shown below)1. Their muscle actions include bending the knee (knee flexion) and extending the hip.  Eccentric muscle contraction occurs when the muscle is controlling the weight & motion of a limb while moving into a lengthened state.   The hamstrings are required to work eccentrically during walking and running.

Additionally, the speed of the contraction matters in that fast eccentric contractions produce more force than slow eccentrics.1  Dysfunction of the hamstrings limits the ability to work eccentrically and is thought to contribute to overuse injuries to this area.Due to eccentric demands on the hamstrings, eccentric training is a crucial part of rehabilitation in a hamstring injury, especially for athletes. Training eccentrically has been shown to enhance muscle hypertrophy, strength, normalize tendon structure & improve ability to return to sport after injury.3,4

Last week, Steve demonstrated a series of eccentric hamstring exercises as part of University of St. Augustine’s Continuing Education Facebook live event.  These are just a component of hamstring rehabilitation and it is important to note that other impairments should also be addressed. We have included a video from this series below. All videos of exercises are available on our facebook & instagram pages!


Click here to view the video of a deadlift: deadlift2019VASPT 2

Follow us on Instagram @vighettipt and Facebook (www.facebook.com/VASPhysicalTherapy) for more videos and tips on injury prevention & rehabilitation!


  1. Gray M, Gray H. Gray’s Anatomy for Students.Philadelphia, PA. Elsevier/Churchill Livingstone; 2005.
  2. Kisner C, Colby LA, Borstad J. Therapeutic Exercise: Foundations and Techniques. Vancouver, B.C.: Langara College; 2019.
  3. Jayaseelan DJ, Moats N, Ricardo CR. Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization and trigger point dry needling: 2 case reports. 2014;44(3):198-205.
  4. Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med. 2011;39:146-153. http://dx.doi. org/10.1177/0363546510379324
  5. Öhberg L, Lorentzon R, Alfredson H. Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up. Br J Sports Med. 2004;38:8-11. http://dx.doi.org/10.1136/

Is Your Tibialis Posterior Causing Heel Pain?

Heel pain is one of the most common complaints we hear about in the clinic. Whether it is a runner, gymnast or someone who’s always on their feet, heel pain is notorious for interfering with every day activities that once seemed simple. More often than, not people self-diagnose or determine after googling that they have plantar fasciitis. While plantar fascia irritation is definitely a possibility, there are a ton of other structures in the foot that can mimic plantar fascia pain. One of those is the posterior tibialis muscle & tendon. Check out the picture below to get an idea of where this muscle is located…1

The posterior tibialis is a dynamic stabilizer of the arch and has many attachments at the foot which make it susceptible to irritation. The actions of this muscle are to plantarflex (point your toes down) and invert (turn your foot in) your ankle & foot. A dysfunction of this tendon can lead to a collapse of the arch which research has found to be linked to knee dysfunction as well as running injuries.2

Last week, University of St. Augustine DPT students invited a few Orthopedic Manual Fellowship trained PTs to present various manual therapy and exercise techniques and Steve was one of them. Check out his original posterior tibialis exercise that targets both concentric and eccentric strength throughout the full range of motion. Note that before doing this exercise it is best to address foot/ankle mobility & muscle length deficits as these are required for optimal muscle function & strengthening.3

If you are interested in learning more about running related injuries or refining your running mechanics, contact us today at info@vighettipt.com. Be sure to let us know if you try this exercise out!



  1. Kendall, F. P., McCreary, E. K., Provance, P. G., Crosby, R. W., Andrews, P. J., & Krause, C. (1993).Muscles, testing and function: With Posture and pain.
  2. Hughes C. The foot and ankle: physical therapy patient management using current evidence. Current Concepts of Orthopaedic Physical Therapy. LaCrosse, Wis: Orthopaedic Section, APTA, 2011. Print.
  3. Patla, C, Chaconas E, et al. Cuboid manipulation and exercise in the management of posterior tibialis tendinopathy: a case report. Int J Sports Phys Ther, 2015; 10(3):363-370