Nordic Hamstring Exercise
The Nordic Hamstring Exercise
The Nordic Hamstring Exercise (NHE) is one of the more popular exercises prescribed for patients that are coming of a hamstring related injury. Aimed at increasing muscle fascicle length and eccentric hamstring strength. It is often used in conjunction with training as an exercise to specifically target injury prevention for elite level athletes. But what are the actual benefits and what does the evidence state when it comes to inclusion of the NHE.
One systematic review/meta-analysis by Van Dyk et al 2019, attempted to answer this very question. Achieved by analysing 15 studies that reported incidence across varying sports and age groups in both men and women. To summarise they found a reduction in overall injury risk ratio of 0.49 (95% CI) in favour of programmes including the NHE, and an overall reduction of hamstring related injuries up to 51%.
It is important to note that the population included in the studies “athletes” was anyone participating in a sporting activity. These studies were not based around general population but let’s be real, nearly all hamstring related injuries occur in the sporting realm. The framework of eccentric related training and the NHE is prevalent at the elite level but the adoption of this exercises into regular programming of non-elite level athletes is poor.
Do I think that the NHE should be implemented for all populations in both rehabilitation and injury prevention of hamstring injuries? Well, this depends on what the patients’ goals are and if they are aiming to get back to pre-injuries level to play sport or not.
Nonetheless, there is a lot of evidence to support the implementation of the NHE, and although the research doesn’t lend itself to the non-sporting population, I think it is a great exercise that we as clinicians can incorporate into both rehabilitation and injury prevention.
Van Dyk, N., Behan, F. P., & Whiteley, R. (2019). Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. British journal of sports medicine, 53(21), 1362–1370. https://doi.org/10.1136/bjsports-2018-100045

Jamie Cheok – BeFit Training Physio Coogee
Jamie Cheok is a physiotherapist based in Coogee in the Eastern Suburbs of Sydney. Jamie has successfully treated musculoskeletal problems on the basis of a thorough assessment and diagnosis coupled with evidence-based rehabilitation programs tailored to the needs and goals of each individual. To book a consultation, click the link below.