It may seem during this last stage that the hamstrings simply will not loosen up. Modalities such as NMT, structural integration, orthopedic massage, active isolated stretching, myoskeletal alignment and functional movement training are often used to help restore length-strength balance in the musculo-fascial kinetic chain. Once all the neurological components of the hamstring injury have been addressed, the therapist may need to pump some juice into the cross-linked scar tissue allowing the collagen to heal faster and function better.

Functional training goals during this period may include improving running coordination of the trunk and pelvis (neuromuscular control), sport-specific activities such as quick starts and stops, and improving strength. Exercises will continue to be used from the previous phases, but their intensity and focus on quality of movement is increased. Some movements that have been shown to help strengthen and reduce re-injury include high-knee marching, quick running drills, forward-falling running drills, explosive start drills, and eccentric muscle actions (muscle is lengthened while it is activated).

More research is needed to better assess the causes of hamstring injuries, i.e., muscle imbalances, neurological weakness, SI joint inhibition and myo-kinetic kinks. More and better strategies are needed to prevent occurrence and reduce prevalence. No matter the sport or the method of delivery, this injury is one that causes a multitude of problems and time away from competition. More knowledge on prevention and rehabilitation of hamstring injuries is a focus of many pain management, orthopedic massage and sports medicine practitioners.