The Importance of Your Hamstrings Before & After an ACL Injury

The Critical Role Hamstrings Play in ACL Rehabilitation and Injury Prevention

An ACL injury can be one of the most frustrating setbacks for athletes and active individuals. Whether you are recovering from an ACL tear, preparing for ACL reconstruction surgery, or working toward returning to sports, one muscle group plays a much bigger role than most people realize: the hamstrings.

At Bowman Physical Therapy, we emphasize evidence-based ACL rehabilitation programs designed to improve knee stability, restore strength, and reduce the risk of future injuries. One of the most important components of successful ACL rehab is proper hamstring strengthening and neuromuscular training.

What Do the Hamstrings Actually Do?

The hamstrings are a group of muscles located on the back of the thigh. Their primary functions include:

• Bending the knee

• Assisting with hip extension

• Helping stabilize the knee joint during movement

After an ACL injury, the hamstrings become extremely important because they help control the forward movement of the tibia (shin bone). This forward movement is one of the exact motions the ACL is responsible for limiting.

When the hamstrings are strong and functioning properly, they help reduce stress placed on the ACL and reconstructed graft tissue.

Why Weak Hamstrings Increase ACL Injury Risk

Research has shown that weakness or imbalance between the quadriceps and hamstrings can increase the risk of both ACL injuries and ACL re-injuries.

Many athletes become “quad dominant,” meaning they rely too heavily on the quadriceps muscles while the hamstrings fail to provide adequate stabilization. This imbalance can:

• Increase strain on the ACL

• Alter landing and cutting mechanics

• Reduce dynamic knee stability

• Increase risk of graft failure after ACL reconstruction

This is one reason ACL rehabilitation should involve much more than basic strengthening exercises.

Hamstrings and ACL Re-Injury Prevention

One of the biggest concerns after ACL reconstruction surgery is the risk of a second injury. Studies show younger athletes returning to cutting and pivoting sports have a significantly increased risk of ACL re-tear or injury to the opposite knee.

Proper hamstring strengthening helps:

• Improve knee control during sports

• Reduce excessive stress on the ACL graft

• Improve deceleration and landing mechanics

• Enhance overall lower extremity stability

At Bowman Physical Therapy, we focus heavily on restoring balanced lower body strength and movement quality before clearing patients for return to activity.

What Hamstring Training Looks Like During ACL Physical Therapy

A comprehensive ACL rehabilitation program typically progresses through multiple phases depending on healing, strength, swelling, range of motion, and functional performance.

Hamstring-focused exercises may include:

• Bridges

• Romanian deadlifts (RDLs)

• Hamstring curls

• Nordic hamstring exercises

• Single-leg stability training

• Dynamic agility drills

• Plyometric progression

As rehabilitation progresses, exercises become more sport-specific and focus on safely preparing patients for running, jumping, cutting, and pivoting activities.

ACL Rehab Should Be Criteria-Based — Not Timeline-Based

One of the biggest misconceptions about ACL recovery is that time alone determines readiness to return to sport.

In reality, safe return-to-sport decisions should consider:

• Hamstring and quadriceps strength symmetry

• Neuromuscular control

• Jumping and landing mechanics

• Knee swelling and pain

• Agility and movement quality

We use individualized, criteria-based rehabilitation programs designed to help patients recover safely and confidently.

Physical Therapy for ACL Injuries in Houston 

Whether you recently suffered an ACL tear, are recovering after surgery, or want to reduce your risk of future injury, physical therapy plays a critical role in long-term success.

Bowman Physical Therapy provides personalized ACL rehabilitation programs focused on:

• One-on-one care

• Strength and movement analysis

• Return-to-sport progression

• Neuromuscular training

• Injury prevention strategies

If you are looking for ACL rehabilitation in Houston or physical therapy after ACL surgery, our team is here to help you return stronger, safer, and more confident.

Schedule an Evaluation

Give one of our three Bowman Physical Therapy clinic locations a call today to schedule an appointment, or request an appointment here on our website: 

Oakbend Physical Therapy of River Oaks: 832-409-6390

Oakbend Physical Therapy of Upper Heights: 346-571-6381

Oakbend Physical Therapy of Friendswood: 281-482-7380