Nordic Hamstring Exercise: A Game-Changer in Physiotherapy and Sports Rehab

Discover how the Nordic Hamstring Exercise strengthens and protects against hamstring injuries. Learn why eccentric training is key in physiotherapy and athletic performance.

Introduction

Hamstring strains are among the most common injuries in sports and physical activity — and one of the most likely to recur. For physiotherapists, addressing eccentric strength and muscle architecture is essential in both rehabilitation and prevention.

One exercise that continues to stand out in research and real-world results is the Nordic Hamstring Exercise (NHE) — also known as the Nordic Curl or Nordic Drop.

What Is the Nordic Hamstring Exercise?

The Nordic Hamstring Exercise is a controlled eccentric movement, where the hamstrings are loaded while lengthening.

Starting from a kneeling position with the ankles secured (by a partner or sturdy support), the individual slowly leans forward while engaging the hamstrings to resist the descent. Hands can be used to catch or assist if needed.

With consistent training, the ability to lower further without hand support improves, strengthening the hamstrings through their full eccentric range.

Why Eccentric Hamstring Training Matters

Eccentric loading plays a critical role in both rehabilitation and performance. Here's why it's so valuable:

1. Builds Strength Where It's Needed Most

Most hamstring strains occur during eccentric actions — such as deceleration while sprinting. Eccentric training directly strengthens the muscles in that vulnerable phase.

2. Improves Muscle Architecture

Research shows eccentric exercise increases fascicle length, helping reduce strain and enhancing muscle resilience.

3. Enhances Flexibility, Balance, and Control

Regular eccentric training improves flexibility, coordination, and neuromuscular control — all vital for efficient movement and injury prevention.

Nordic Hamstring Exercise in Injury Prevention

Evidence strongly supports the Nordic Hamstring Exercise as one of the most effective tools for injury prevention.

Research Highlights: Rehabilitation and Performance

• 8-Week RCT (BioMed Central): Soccer players who performed NHE showed improved balance, flexibility, agility, and strength compared to those doing only dynamic stretching.
• 4-Week Eccentric Training Study (PLOS): Recreationally active participants performing NHE three times per week gained better postural control and hamstring strength than the control group.
• Acute Strain Trial (Semantic Scholar): NHE proved more effective than traditional stretching and strengthening for reducing tissue damage and improving recovery outcomes.

How to Incorporate Nordic Hamstring Exercises in Rehab

A structured, progressive approach ensures safety and maximum benefit. Below are key principles physiotherapists follow:

1. Start Gradually

Begin with hand support and a partial range of motion. As control and tolerance improve, increase the range and reduce hand assistance.

2. Consistency and Duration

Training 2–3 times per week for 4–8 weeks has been shown to significantly improve hamstring strength and architecture.

3. Form and Control

Maintain a neutral hip position throughout the exercise. Avoid jerky or uncontrolled movements during descent.

4. Combine With Complementary Training

Integrate NHE alongside general lower-limb strengthening, flexibility work, neuromuscular control drills, and sport-specific conditioning.

5. Individualisation Is Key

Tailor load, frequency, and volume based on injury severity, pain tolerance, and performance goals. Always monitor post-session response.

6. Before Return to Play

Ensure strength symmetry, neuromuscular control, and sport-specific testing before full return.

Conclusion

The Nordic Hamstring Exercise is one of the most evidence-backed tools for both hamstring injury prevention and rehabilitation. When integrated into a well-designed physiotherapy or sports performance program, it enhances strength, improves flexibility, and helps athletes return stronger and more resilient than before.