Hamstring Strain🏃🏻‍♀️

The hamstrings are the muscle group located in the posterior aspect of your thighs and are made up of the semimembranosus, semitendinosus and biceps femoris. They work to control knee flexion and hip extension. 


💥Hamstring strains are common injuries that can occur in runners and athletes. Rehabilitation for a hamstring strain focuses on loading & lengthening, eccentric control and trunk & pelvic stability.

➡️ Extenders: Hold your affected leg in 90 degrees of hip flexion. Bend and unbend your knee and stop when moderate stretch is felt and just BEFORE discomfort occurs. 


➡️ Bridges: Lie on your back with your knees bent and your feet flat on the surface, then lift your hips up towards the ceiling. 

▫️Loading and Trunk & Pelvic Stability 

➡️ Planks: Place your elbows under your shoulders, curl your back toes under and keep your hips in line with your shoulders.

▫️Trunk & Pelvic Stability 

➡️ Supine Hamstring Curls with Ball: Place the physioball under your heels, lift your hips into a bridge position and bend your knees, bringing the ball towards your glutes and back out.

▫️Loading and Eccentric Control

➡️ Nordics: Kneel on the floor and bend your knees into 90 degrees with your lower legs behind you. Anchor your shins and feet down with weights or have someone hold your feet throughout the exercise. Move your body towards the ground slowly. 

▫️Eccentric Control

➡️ Divers: Keep the affected leg on the floor with a 10-20 degree bend in the knee. Lift the opposite leg up while reaching the arms out forward.

▫️Loading, Lengthening & Eccentric Control

➡️ Gliders: Place the unaffected leg on a slider (or a towel underneath your foot with a wood surface.) Keep your body weight over your affected leg, with your knee kept at 10-20 degrees of flexion, with your foot dorsiflexed. Hold onto a support surface while sliding your unaffected leg back behind you. Stop when you feel a moderate stretch or BEFORE discomfort is felt then use the bar and your upper body to pull your leg back up to the starting position. 

▫️Loading, Lengthening & Eccentric Control

Questions or concerns?⁣⁣⁣


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Run Happy, Run Healthy!✨⁣⁣


Natalie Niemczyk, PT, DPT

Running Technique Specialist

Runner, Triathlete

@StonyBrookU Alum

Crossfit, Boxing, and Movement.

Anyone who knows me understands that I speak in a string of movie quotes or silly made up words for anatomical terms; that covers my whole day. But if I was going line for line with the actor from my favorite movie, I probably wouldn't be able to recall his name. And I will never be able to quote How I Met Your Mother no matter how much peer pressure goes on guys.

I’ve never fan-girled over a celebrity, but last week there was a moment. There may have been a squeal in the excitement. Someone who inspires me professionally, who I count on to spark interesting meaningful discussion; she quoted me. It was a moment of, ‘hey, we’re listening’. And it reminded me that if I want my message to be heard, our message as physical therapists, I need to start talking. Thanks @themovementmaestro, you’re awesome. Check it out. 


The discussion was one that I have with patients and colleagues everyday in the clinic, in the gym, even at home. Is [Insert choice of exercise modality, fad workout, online training app] bad for you?

Unfortunately, crossfit has gotten a bad rep. That’s not because the crossfit workout is bad. There are numerous arguments agreeing with that assertion; We'll save that for another time. My defense, the quote that inspired my voice, is that “poorly executed movement and sloppy form in any workout can lead to injury. But sitting on your couch afraid of movement is exponentially worse.

As a doctor of physical therapy working primarily with the fitness population, this statement is a summary of my mission. Almost every patient that sits down to tell me about their pain, mentions something along the lines of ‘I know I should have rested more’ or ‘I know I’ll never go back to [insert sport, workout, class]. It’s not crossfit. It’s not running. It’s not barre. I want to scream this so everyone hears. The limiting factor is not the workout. It is you. 

That was harsh. But hear me out. Let’s go to a fun example. In the spring, a young guy in average shape came in with patella-femoral pain after boxing for 2 months. He told me his story, went through the physical exam, determined there was no urgent pathological cause. Told him to stand up and throw a few punches. He stared at me puzzled laying flat on his back on the exam table. “Get up and hit me,” I repeated holding my hands up. 


Nontraditional I know. Yet after a couple jab-cross combos I could see the problem. I’m no boxer, but I know you pivot on your back foot when you throw a punch across your body. He was pivoting with his back heel flat on the ground. DEMO: Stand up-keep your right heel on the ground-twist your knee in. Now imagine doing that for 45 minutes of an hour training session 3 days a week. Yeah, my knee hurts just thinking about it. 

Again, I am not a boxer. I am a movement expert. That is the definition of a physical therapist. We study movement. For 7 years. I may not be able to teach him correct boxing techniques. But I sure as hell taught him how to pivot on his toe and strengthen his hips to maintain that form. PS I’m not blaming his instructor for this flaw because even with verbal cueing he wasn’t strong enough to maintain proper form. So no pointing fingers!

This boxing client of mine, he came in saying things like “I know I should have rested sooner” and “I have to find a safer way to get in shape.” HE LEFT…with a clear plan of x amount of weeks to strengthen before returning to his sport. He left with the understanding that rest wouldn’t have solved his problem of poor form and poor execution. And most important, he left WITHOUT fear of movement. 

That’s the goal. The ultimate goal is to spread awareness that movement is the medicine. Everyone needs a few tweaks here and there. Be smart about your exercise. Listen to your body. Learn to ask for feedback. Seek out a movement expert.


Comment with your thoughts. Start a discussion. 

Help spread the message by sharing this post. Keep in touch by following @houseofphysicaltherapy on social media. Exciting things to come!

The Beginner's Guide to Foam Rolling

The Beginner's Guide to Foam Rolling

“When you foam roll an injured or overused muscle before a workout, you tell the muscle to calm down, don’t overwork,” says Shane. You’ll use overworked muscles less and work the weaker muscles more, balancing out your workout and cutting your injury risk.  

So you want to do a handstand...

So you want to do a handstand. There are two factors that will prevent the handstand from happening. The first factor is fear; in order to do the handstand you have to be okay with being upside down. Hopefully you have access to some mats, but if not try a carpet or soft surface. 

Practice doing a forward roll: Place your hands on the ground in front of you bend your knees and roll on forward. Once you’ve mastered going in a straight line…well then you have defeated your fear of being upside down. 

 Now we run into our second limiting factor…strength. Let’s say you ain’t afraid of no upside downs. You attempt the handstand and realize, I should’ve counted my macros today. Here are some options for building in the strength progression for the handstand. I will list them all and you can decide where you’re at strength-wise. 

Push Up: Maintaining a perfect plank, lower your body to the floor in one solid piece, elbows pinched by the sides and pelvis posteriorly tucked. Bring your chest to deck and press back up with elbows pinched in close to the body and the body from head to tailbone maintaining a straight line. If you can doTEN straight through, move on.

Box Walks: Using a step or box, begin in a push up position and walk your hands as close to the step as you can. The feet stay in one place! Tightness in the hips or legs may prevent how close your hands get to the box, but that’s a whole other article… Either way give it a try. 

Wall Walks:  Last step! Begin in a push up position and walk your hands as close to the wall as you can. Your feet should move up the wall as your hands come in. Only as far up as you feel comfortable.

Once you have made your way face to wall at least 5 times…well my friend, your strength is there!

Now that we have overcome the fear, and gained some strength, let’s talk about the actual handstand. The next part of the progression is the kick and follow through. Many times getting the feet to the wall is the most challenging part of the handstand. It is important to choose a side you will be using from here on out. The kicking leg is important. I myself, kick up with my right leg for two reasons: it is stronger than the left, and I have more flexibility in the left leg to achieve the extension necessary to kick up. That being said, choose your kicking leg and stick with it. Keep in mind I’ve worked with children and adults and this progression may seem silly and simple, but it is effective.

The kick and follow through progression:

Donkey kicks: Hands flat on the floor (NEVER BEND YOUR ELBOWS) and kick the legs up with bent knees…this helps with the fear thing if you’re still a little nervous.

¾ kicks: As above, kick a little harder with straight legs and only come up about three quarters of the way and try to tap the feet at the top.

Full on kick: Stand facing the wall (the bigger the initial lunge is for that kick, the easier it will be – being closer to the floor and all). Place your hands about an inch away from the wall and kick. You can kick as hard as you need the wall ain’t going anywhere. Eventually your body will figure out how much force is needed to get the legs up and you will master getting your feet to the wall seamlessly and effortlessly.

The end goal, we want to be able to do these sexy handstands away from the wall, am I right? So let’s stick with the wall for a bit and attempt letting the feet off the wall for 3 whole seconds.

Let the feet off the wall: For this you need to recruit every single muscle in your body, but most important will be the traps, core, and glutes. It’s like holding in the biggest poop you’ll ever take while someone is punching you in the gut – if that imagery is helpful. Progress from 3 seconds to 5 seconds. Then to 8 or 10 seconds. Try this for a few rounds before moving from the wall.  If you’re holding that handstand by the wall for ten seconds consistently, you can start moving away from the wall and do them free standing.

Free standing handstands require that graceful kick and follow through, as well as the strength to squeeze like you’ve never squeezed before. There are ways to bail out of this if you need to.

The first way is my favorite and it’s that forward roll we talked about earlier. While in the handstand, if you feel you kicked to hard and are falling over, tuck your chin to your chest and roll on out of that handstand.

Option two is simply going back to the starting position (the original lunge you did before kicking to the handstand). I suggest doing the free standing ones with a bestie before you do it alone. Get comfortable not having a wall and then tell you bestie…it’s been real and thank him. Time to try it on your own!

My last piece of advice is how you should go about programming. I am a proponent of the Crossfit EMOM. No it’s not an electric mom…it is a lovely acronym for...

Every Minute on the Minute, and is exactly what it sounds like. For every minute you will try to complete whichever part of the progression you are up to. For example, attempt to get at least 3-5 wall walks per minute for 5-10 rounds which comes out to 5-10 minutes.

The reason I like the EMOM is because it helps you transition from the cognitive stage of motor learning (figuring out what muscles to use and making tons of mistakes) quickly into the associative stage (when the technique starts to become automatic and your body learns the feeling of the correct position). Some people call this muscle memory, but the neuro nerd in me prefers using the terms of motor learning for skill acquisition. By round 5/6 something 'clicks' in your body and you just start doing the exercise without all the thinking, and you feel more comfortable with the movements. Being that the handstand is a pretty advanced movement, using an EMOM will help you get it faster.

Patient Handstand SL.JPG


After 4 weeks of strengthening with planks and box walk outs, Sisi has progressed to the next phase! 

Pictured left: Kicks and follow through. 

How often should you practice? 3-4 times a week. Everyone will have a different timeline dependent on how strong and how experienced you are.

Beginners, meaning those who are doing it for the first time, give it about three months to master a perfect handstand. There are a lot of moving parts, and you want to make sure you are maintaining proper technique and also NOT overtraining. So 5-10 minutes 3-4 times a week work on your progressions. 

Now get to work! Tag us in your videos so we can cheer you on! @DelfinaPilates @HouseofPhysicalTherapy