The Importance Of Hamstring Strength To Protect The ACL

The anterior cruciate ligament (ACL), being the most important stabiliser of the knee, connects the femur (thigh bone) to the tibia (shin bone). It runs at an oblique angle from the back of the femur to the front of the tibia and its primary role is to prevent anterior translation of the tibia or posterior translation of the femur. Though many of us are aware of the importance of quadriceps strength for overall knee health, the hamstring muscle group tends to receive less attention. The hamstrings not only act to bend the knee, but they also pull the tibia posteriorly (backwards), hence serving as a dynamic protector of the ACL and reducing strain on the ligament.

There is evidence showing that female athletes who suffered an ACL injury subsequent to strength testing, had reduced hamstring but not quadriceps strength and conversely, those who did not go on to ACL injury had adequate hamstring strength (Myer et al., 2009).

Whether you are simply hoping to reduce your risk of ACL injury or if you are recovering from an ACL reconstruction, don’t forget to incorporate hamstring strengthening into your program. Here are two exercises to get you started:

Double heel bridge on step

  • Lie on the floor with your arms by your sides and your heels on a raised platform (approximately 30cm high). Slowly raise your buttock from the ground by pressing your heels into the platform, until your shoulders, hips and knees roughly form a straight line. Slowly return to the starting position. Repeat 2-3 sets of 10-12 repetitions.

Double heel swiss ball curl   

  • Adopt the same starting position as for the double heel bridge on step, but with your heels on a swiss ball. Raise your buttock from the ground and whilst maintaining this position, slowly roll the ball in and out by bending and straightening your knees. Repeat 2-3 sets of 10-12 repetitions.

To increase the  difficultly of these exercises, raise your hands toward the ceiling and for further progression, you may perform them with one leg only.

If you need more advice on strengthening your hamstrings book in to see one of our Bend + Mend Sports Physio’s in Sydney’s CBD.


Myer, G. D., Ford, K. R., Barber Foss, K. D., Liu, C., Nick, T. G., & Hewett, T. E. (2009). The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. Clinical Journal Of Sport Medicine: Official Journal Of The Canadian Academy Of Sport Medicine, 19(1), 3-8. doi:10.1097/JSM.0b013e318190bddb

Benjamin Wright

About Benjamin Wright

Ben has worked as a Physiotherapist in private practice since graduating from the University of South Australia in 2012. As a result of his strong sporting background, he holds a particular interest in sports-related injuries, and he likes to incorporate Neuromuscular Dry Needling with a variety of other techniques whilst empowering his clients through exercise prescription. Ben also has a keen interest in spinal injuries and headache management. He has recently moved to Sydney after spending some time travelling through Europe.

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