Quadriceps dominance arises when the quadriceps and hip flexors (Iliopsoas) overpower the gluteal and hamstring muscles. Maintaining the balance of flexibility and strength between the Hamstrings and Quadriceps is incredibly important. The ratio of hamstring to quadriceps strength should be at least 60 percent but, ideally, 75%. When these two structures are out of balance, you set yourself up for knee injuries, hamstring strains, gait imbalances, and other lower extremity injuries. Research shows that this imbalance can increase the incidence of injury by 4.66 times. (1) A hamstrings-quadriceps imbalance can also greatly diminish your athletic performance in any sport, from running to football/soccer to gymnastics and dance.
Article Index
An Imbalanced Partnership
The hamstrings primarily function in hip extension and knee flexion, while the quadriceps mainly contribute to hip flexion and knee extension. In other words, these muscle groups have opposing roles. When one muscle group acts as the agonist (primary mover), the other serves as the antagonist (mainly counteracting the force generated by the agonist).
For optimal performance, it is essential to maintain a balance in strength and flexibility between the agonist and antagonist muscles.
For instance:
In Hip Extension: As the hamstrings (agonist) contract to enable hip extension, the quadriceps (antagonist) lengthen to facilitate this movement.
In Hip Flexion: As the quadriceps (agonist) contract to enable hip flexion, the hamstrings (antagonist) lengthen to counterbalance this movement.
Weak & Overstretched Hamstrings
The interrelationship between hamstrings and quadriceps often reveals that patients have weak and overstretched hamstrings, while their quadriceps are tight, overactive, and significantly stronger. This tightness in the quadriceps can neurologically inhibit the hamstrings and gluteals, further weakening these structures.
Anterior Pelvis Syndrome is a common cause of weak and overstretched hamstrings. Ideally, the pelvis should be in a neutral position, neither tilted forward nor backward, and level from side to side. Anterior Pelvis Syndrome occurs when the quadriceps muscles (rectus femoris) tighten, pulling the front of the pelvis down, putting tension on the hamstrings at the back of the leg, and destabilizing the pelvis.
Tight hamstrings often lead to limited knee extension and increased knee flexion. This increased knee flexion results in greater ankle dorsiflexion and increased stress on the foot's Achilles tendon and plantar fascia. Consequently, tight hamstrings can significantly contribute to conditions such as ACL injuries, Achilles tendinosis, plantar fasciitis, and bunions (2).
Tight & Overactive Quadriceps
Many individuals experience tight, restricted, and overactive quadriceps due to the tendency to overuse their quadriceps and adductors for lower extremity movements like squats instead of engaging their gluteals and hamstrings. This leads to the development of muscle imbalances, characterized by strong quadriceps and weak hamstrings.
This prevalent muscle imbalance has two consequences. First, as the quadriceps become stronger, they neurologically inhibit the activation of the hamstrings. Second, this hamstring inhibition results in abnormal motion patterns throughout the entire lower extremity, affecting the hips, legs, knees, ankles, and feet.
It is worth noting that an athlete's strength imbalance between the hamstrings and quadriceps worsens with fatigue, making them more susceptible to injury (3,4).
Exercises to Restore the Imbalance
Here is the good news! It doesn’t matter how much of an imbalance there is between your quadriceps and hamstrings you can take action to correct this problem. You will have to perform a combination of myofascial release exercises and exercises to activate and strengthen you gluteal and hamstring muscles.
The following exercises are ones that we often recommend to our patients who have a hamstrings-quadriceps imbalance.
Mobility & Flexibility
Flexibility exercises should be performed on a daily bases, in many cases recommend performing these exercises several times per day.
Effective Hip Flexor Stretches
This video demonstrates some of the most effective hip flexor stretches for both primary and secondary hip flexors. The hip flexors consist of several muscles, including the psoas and iliacus muscles, which are the primary hip flexors, and the quadriceps, which are secondary hip flexors. These muscles play a crucial role in hip flexion and are essential for everyday activities such as walking, running, and jumping. Tightness or restriction in the hip flexor muscles can significantly affect hip joint biomechanics and may lead to compensatory movement patterns, resulting in overuse injuries in the lower extremities.
Relieve Quadricep Pain - Lacrosse Ball
Many people have tight, restricted, and overactive quadriceps. This is because most people tend to overuse their quadriceps and adductors to perform lower extremity motions such as squats when they should actually be using their gluteals and hamstrings. This results in the development of muscle imbalances (strongly restricted quadriceps and weak hamstrings).
Adductor Muscle Release
This lacrosse ball release exercise is extremely effective at releasing the adductor muscles. The hip adductor muscles are the antagonists to the gluteus medius. When these muscles become tight and restricted hip function is greatly reduced.
Gluteal Muscle Release
- Peanut Ball
The peanut ball is a great way to release the gluteal muscles. The gluteal muscles help to stabilize the upper body and pelvis, aid in locomotion, and extend the hip joint. The gluteal muscles help to facilitate hip abduction and extension and assist in the adduction, external rotation and internal rotation of the thigh.
Sam's Daily Five Hip and Leg Stretches
Engaging in routine stretching exercises is vital for preserving optimal musculoskeletal health, particularly for those who spend considerable time seated. Sam's Daily Five Hip and Leg Stretches provide a practical and beneficial routine to incorporate as an active break during long sitting sessions.
Strengthening
5 of the Best Hamstring Exercises
The hamstring muscles are highly functional muscles that play several critical roles in musculoskeletal health. In addition to serving as powerful hip extensors, second only to the gluteus maximus muscle, the hamstrings also function as knee flexors, medial and lateral rotators, and important stabilizers of the knee joint.
Improve Your Balance - Advanced Exercise
Balance exercises can be of great benefit to people of any age. Balance exercises improve your ability to control and stabilize your body's position. Balance exercises are great at reducing injury risk, rehabilitating current injuries, or increasing your sports performance.
Sometimes - Treatment is Required
There are instances where performing mobility and strengthening exercises alone is insufficient in rectifying a hamstring-quadricep imbalance. In such cases, myofascial treatment can be highly beneficial in achieving optimal outcomes.
As previously explained, patients with a hamstring-quadricep imbalance have weakened and overstretched hamstrings, while their quadriceps are tight, overactive, and notably stronger. Therefore, it is crucial to employ interventions that target these imbalances.
Below are two examples of procedures that we could utilize when treating patients with hamstring-quadricep imbalances. It is important to note that the specific procedures we would utilize would depend on the specific case.
Quadricep Release Procedures
In this demonstration video, Dr. Brian Abelson, the creator of Motion Specific Release, demonstrates key procedures in releasing the quadriceps.
Hamstring Muscle Release
In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures for releasing the hamstrings muscles.
MSR Gluteus Maximus Protocol
In this demonstration video, Dr. Abelson, the developer of Motion Specific Release (MSR), demonstrates specific procedures to release restrictions in the gluteus maximus.
Conclusion
In conclusion, maintaining a balance of flexibility and strength between the hamstrings and quadriceps is crucial for optimal musculoskeletal health and athletic performance. An imbalance between these muscle groups can lead to various lower extremity injuries and negatively affect athletic performance.
Fortunately, through a combination of myofascial release exercises, exercises to activate and strengthen the gluteal and hamstring muscles, and, in some cases, myofascial treatment, individuals can correct this problem and restore balance to their muscle groups. By incorporating these exercises and treatments into their routine, individuals can achieve optimal outcomes and enjoy a healthier, more active lifestyle.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson's approach in musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the developer of the Motion Specific Release (MSR) Treatment Systems, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.
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References
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Chumanov, E. S., Heiderscheit, B. C., & Thelen, D. G. (2007). Hamstring muscle kinematics during treadmill sprinting. Medicine and Science in Sports and Exercise, 39(5), 905-912.
Comfort, P., Pearson, S. J., & Kane, D. (2013). The role of muscle imbalances in the development of injury: a review of the literature. International Journal of Sports Physical Therapy, 8(2), 147-158.
Fredericson, M., Yoon, H., & Mooney, M. P. (2005). Hip muscle imbalances and running injuries in female athletes: treatment through rehabilitation. Sports Health, 7(1), 40-46.
Gribble, P. A., Hertel, J., & Plisky, P. J. (2012). The relationship between hip and ankle kinematics during running: a prospective study. Journal of Athletic Training, 47(2), 152-157.
Heiderscheit, B. C., Sherry, M. A., Silder, A., Chumanov, E. S., & Thelen, D. G. (2011). Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. Journal of Orthopaedic & Sports Physical Therapy, 41(2), 67-81.
McNair, P. J., Marshall, R. N., & Matheson, G. W. (2006). Hamstring muscle strain injuries: diagnosis, rehabilitation, and prevention. Journal of Sport Rehabilitation, 15(2), 136-163.
Powers, C. M. (2010). The influence of altered lower extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. Journal of Orthopaedic & Sports Physical Therapy, 40(2), 42-51.
Reiman, M. P., Arent, S. M., & Landin, D. (2015). The effects of hip-strengthening exercises on biomechanics during running and during a single-leg squat. Journal of Sport Rehabilitation, 24(1), 36-41.
Schache, A. G., Wrigley, T. V., Baker, R., & Pandy, M. G. (2011). Hip muscle function during the swing phase of running: implications for injury. Gait & posture, 33(3), 362-366.
Croisier, J.L., Ganteaume, S., Binet, J., Genty, M., and Ferret, J.M. (2008). Strength imbalances and prevention of hamstring injury in professional soccer players: A prospective study. American Journal of Sports Medicine, 36, 1469-1475.
Ahmad, C.S., Clark, A.M., Heilmann, N., Schoeb, J.S., Gardner, T.R., and Levine, W.N. (2006). Effect of gender and maturity on quadriceps-to-hamstring strength ratio and anterior cruciate ligament laxity. American Journal of Sports Medicine, 34, 370-374.
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