Science-Based Hamstring Solutions with Dr. Tobias Alt

“Bridging the gap” is a popular expression in strength coaching that describes applying evidence-based research to athletic training. Dr. Tobias Alt is a German sports scientist who is doing just that.

Alt’s athletic journey began at age 7. He excelled in track and field, and among his best performances was a 7.17m long jump. While attending the German Sport University (GSB), Alt earned a Master’s in Exercise Science with undergrad studies in Performance Analysis in Sports. His PhD dealt with hamstring/quadriceps muscle imbalances, and he has been a lecturer at GSB for eight years.

Alt works at the Olympic Training and Testing Centre in Dortmund, Germany. Since 2017, he has supported national teams with performance analysis and strength coaching in bobsleigh, skeleton, and track and field (sprint, relays, hurdles). His responsibilities expanded to working with athletes at the 2022 Olympic Winter Games in Beijing, the 2022 European Championships in Munich, and the 2024 World Relay Championships in Nassau.

Alt began researching hamstring strain injuries (HSI) in 2012 to find solutions to these frustrating and often career-ending injuries. Here are some insights into what he’s learned.

Freelap USA: You’ve said the Nordic hamstring exercise (NHE) is overrated and that the hamstring push-up is superior for hamstring training. Why?

Dr. Tobias Alt: Yes, the NHE is overrated, especially considering how it is usually performed. I tried traditional Nordics for the first time in 2015. I always felt discomfort, so I started looking for better solutions. Nine years later, I am confident and happy that I found some solutions and a system that works well for me and the athletes I work with.

The biceps femoris is a commonly injured hamstring muscle, so we need to activate it specifically. One of our studies demonstrated that the guided Nordic hamstring push-up exercise elicited the highest biceps femoris activity. Here are three additional advantages of the NH push-up:

1. Intensity and fatigue can be dosed by the assistance of the arms.
2. It is easy and safe. Everyone can execute it, from beginners to the elite.
3. It has multiple purposes: warm-up, pre-activation or potentiation, and resistance training.

The biceps femoris is a commonly injured hamstring muscle, so we need to activate it specifically. One of our studies demonstrated that the guided Nordic hamstring push-up exercise elicited the highest biceps femoris activity. Share on X

The knee diver is another golden piece in the hamstring toolbox, especially for pelvis control: APT/erect lower back despite the long muscle-tendon length. Most athletes display excessive kyphosis, losing control and being unable to maintain pelvis stability due to insufficient force-length capacities at extended knee and flexed hip angles and descending limbs.

Freelap USA: In one paper, you said some Nordic hamstring curl studies must be viewed skeptically. What issues do you have with these studies?

Dr. Tobias Alt: Bad execution, inappropriate heel fixation and knee position, poor reporting of implemented methods, and using methods that cannot be replicated.

Nordic hamstring exercise (NHE) studies mainly use two standard protocols: Mjølsnes et al. (2002) and FIFA 11+. These protocols do not address the crucial characteristics of effective performance enhancement, injury prevention, and rehabilitation. These characteristics include extended knee angles, flexed hip angles, low accumulated muscular fatigue, and optimal exercise setup. Consider the example of resistance training protocols.

Suppose you use a protocol of 3 x 12 with elite athletes. The intensity and time under tension in the injury-relevant knee angles—being lower than 30° knee flexion—is way too low, and the athletes become sore because of the excessive eccentric stimuli, necessitating a prolonged recovery period.

The biceps femoris is preferentially activated at extended knee angles, which most athletes do not reach during the traditional NHE. There is also no superimposition of the glutes, which is a real game-changer. Athletes must squeeze their glutes when reaching extended knee angles to mirror the coordinative sprinting pattern.

What coaches and therapists must consider is that HSI is multifactorial. From my personal and professional experience, the cause of many hamstring injuries that can be modified most effectively is the force-length capacities of the muscle-tendon units of the posterior chain muscles. Let me expand on this topic.

From my personal and professional experience, the cause of many hamstring injuries that can be modified *most effectively* is the force-length capacities of the muscle-tendon units of the posterior chain muscles. Share on X

Muscle-tendon interaction is essential in sprinting. The muscles must be stiff enough to stretch the tendons involved in energy absorption and to protect the muscle from injury, particularly at the longest muscle-tendon lengths. Coaches must prepare their athletes systematically for extended knee joint angles (60° hip flexion), excessive anterior pelvic tilt, and stretching of the posterior chain fascia. We should only increase speed or resistance training exercises if these three points are addressed.

Freelap USA: What are your general rules for preventing hamstring injuries?

Dr. Tobias Alt: Preparation should focus on tendon adaptation, which takes a minimum of three months to see first results. The optimal time under tension is 3 to 8 reps, with a high-contraction intensity of more than 80 percent.

Coaches must ensure that the exercises are safe, for example, with hand guidance or external assistance, so that athletes can sustain a high level of muscle activity throughout the entire range of motion. This precaution is especially true when they usually lose control, when muscles switch off/relax because of the sensation of excessive tension.

Next, coaches should minimize accumulating muscular fatigue with low volumes, isometric, or eccentric-only exercises so the muscles are strong and stiff enough to stretch their tendons. For elite athletes, hamstring training should be executed as follows:

1. Training Frequency (3-4x/week)
2. Low Repetition Volume (3-4 reps per set)
3. High Intention in Intensity and Posture
4. Muscle-Specific Activation (semitendinosus, semimembranosus, and biceps femoris)

This approach significantly reduced hamstring and ACL injuries in different cohort studies. Unfortunately, injury data from elite sports are hard to publish, but this approach significantly improved the rehabilitation of related injuries.

Freelap USA: You have done studies involving the Ham’s Hell bench, which allows for lower leg and ankle adjustments. What is the advantage of this design?

Dr. Tobias Alt: I invented the Ham’s Hell device to solve problems of existing devices. During the pandemic from 2020 to 2021, I worked with two colleagues to provide my bobsleigh and skeleton athletes with a device for preparations and competitions before and during the Beijing Winter Olympics 2022.

The Ham’s Hell can adjust the shin length and inclination and free the knees for improved comfort and muscle activation. Although plenty of criticism exists, there is no evidence that it is detrimental to the posterior collateral ligament. Exercises with hip flexion are crucial to learning to maintain pelvis control and getting strong at long muscle-tendon length, thus enlarging the safety zone.

Exercises with hip flexion are crucial to learning to maintain pelvis control and getting strong at long muscle-tendon length, thus enlarging the safety zone. Share on X

Having the knees extend over the edge of the bench position provides higher comfort, greater muscle activation, and intensity via the lower lever arm. Our clients give the feedback that the Ham’s Hell isolates the hamstrings to an extent that no other device does. Proceeding through the six progression levels appears to be the biggest challenge.

Freelap USA: What research projects are you currently involved in or planning?

Dr. Tobias Alt: My outside assignments include the 2024 Olympic Games in Paris (sprint, hurdles, relays) and the 2026 Olympic Games in Italy (bobsleigh, skeleton). I am also involved with coaches’ education and the mentorship of young researchers.

I am currently researching thigh angular velocity and acceleration, the effect of wearable shank resistance on sprint mechanics, shin roll in elite sprinters, and the efficiency of hamstring-emphasized rehabilitation following ACL.

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