Hamstring Tantrums (Flutter) Exercise: Why use it?
This is a series of posts on exercises that have become prevalent on social media and simply programming. There are no bad exercises. But in 2023 there is a huge number of exercises and derivatives. The task now is why use an exercise and when. What is rationale? Will it enhance athlete performance? Or is it clogging up a program with fluff? For athletes the strength and conditioning program is often a small percentage of total training time. One would presume less is better. But faced with a huge array of exercises now, it is tempting to add exercises to a program. Also new exercises can look funky. I will start with Hamstring tantrums or hamstring flutters. I might be slightly biased in my selection of exercises, given they are often the ones I question putting in a program.
This exercise has many names. And also many variations. It certainly figures on social media a lot. And creeps into some evidence based articles on hamstring injury prevention and rehabilitation.
Below is an example of some hamstring tantrum exercises one can find on you tube and social media.
I used a video from Mick Hughes site. So it is appropriate to read what he said in a Linkedin article a few years ago, which is a balanced summary.
“Swissball kicks (Tantrums), particularly the prone version, has been shown to have one of the highest levels of hamstring recruitment when compared against other common hamstring rehab exercises! Even more than Nordics (Tsaklis et al, 2015). The only thing to consider is that the Tantrum has the highest level of activity when the muscle is SHORTENING, which is not particularly useful as most hamstring strains occur when the hamstring unit is LENGTHENING. So as a stand-alone exercise, the Tantrum can’t be sold as the panacea for injury prevention. However when added to a comprehensive program, it can be a very powerful exercise to help improve hamstring muscle recruitment and performance.”
So as he says the exercise is rapid shortening of the hamstrings. Not unlike “butt flicks”.
In fact the study mentioned in Mick Hughes article so far is the only one that analyses this exercise that I can find searching.
Below is an example of the huge variation of exercises that can come under name of hamstring tantrums exercise in a google search. In reality. It is finding an object to rapidly contract against. This could be with legs straight and prone or sitting using a Swiss ball as in video. In some ways one could find a justification for calling them different names given the actions vary a lot.
So the question is how, why and when would one use a variation?
First stop is to find more evidence on this “exercise”. As I said I did not find much. And I certainly invite people to prove me wrong. I may not have varied the name of the exercise enough on Scholar. Below are some graphs and tables from the tsaklis 2015 paper. Whilst EMG activity is high, they also state in the table that lengthening or eccentric actions do not take place.
Taking liberty in a blog article, the general consensus is that high load eccentric exercises are needed in hamstring programs. Obviously the debate still rages.
I would be interested to see what the EMG activity of the butt flick running drill is at fast pace? Anecdotally athletes have used this exercise as a primer in warmups. If one cannot quickly activate the hamstrings in this exercise some athletes say subjectively they are not ready for high intensity. This is an excellent you tube below. It differentiates between the butt flick as a stretch versus a sprint drill. Nevertheless the hamstrings are contracting in both variations.
Obviously the specificity is low again with “butt flicks” compared to the forces obtained at late swing phase of fast running. But as many indicate the “hamstring tantrum” is a useful exercise to activate the muscle group or for muscle recruitment. But is it more useful than fast butt flicks or derivatives of these drills where “hip up, knee up, toe up’ is emphasised also as in video?
The “grey” continues in my blog article. It is tempting for me to suggest that these exercises are useful for a dynamic warmup rather than specific conditioning. And certainly the words “muscle recruitment” seem valid for all forms of flutter or tantrums. But what useful adaptive response is occurring? If we look at load. It seems negligible with tantrums. Therefore one would assume adaptive stress is low.
What I did find interesting was some recent articles on hamstring catches and the 1989 research on hamstring catches by Purdam and Stanton.
The reason to mention these first is to emphasise the eccentric nature of these exercises. This is versus the concentric nature of hamstring tantrums and/or flutters. For experienced practitioners obviously the difference between catches and flutters is obvious when referring to concentric and eccentric activation. But on social media, maybe not! And the word catches gets used for many exercises that involve tantrums or flutters. But these are actually catches using glutes. I am not going to go into detail about this recent study on catches, but information on the forces, speed and EMG activity are included, which I could not find on hamstring tantrums.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329323/pdf/ijspt_2021_16_4_25364.pdf
Cross-sectional Study of EMG and EMG Rise During Fast and Slow Hamstring Exercises
In a 1989 article, Craig Purdam and Peter Stanton introduced the hamstring catch but slightly different to the 2021 study. This study looks a lot more like tantrums but is still eccentric given the catch. In the study there was information on the forces and speed of the exercise. The exercise could be done prone and also lying over a table. And involved high speed “catches” starting with bodyweight but often ending with 5 kilogram ankle weights. I actually used this exercise a lot in rehabilitation with successful outcomes at return to play. (Caveat is many factors make up a successful RTP).
Hamstring injuries in sprinting – The role of eccentric exercise
Journal of Orthopaedic and Sports Physical Therapy · February 1989 Craig Purdam. Peter Stanton.
So getting back to hamstring tantrums or flutters. Most of the versions of these exercises are rapid and elicit high EMG readings. But are concentric. Whilst there is some debate still, the general consensus is that high eccentric forces are needed in late swing phase to decelerate the leg before touchdown. Summary of a 2019 review noted this in abstract. “While direct evidence is still lacking, the majority of the literature suggests that the most likely timing of injury is the late swing phase’
https://pubmed.ncbi.nlm.nih.gov/31033024/Scand J Med Sci Sports. 2019 Aug;29(8):1083-1091. Late swing or early stance? A narrative review of hamstring injury mechanisms during high-speed running
So where does this leave us with the hamstring tantrum exercise? If your PT clients love it. Keep doing it, it is funky. Safe. Good general exercise. Probably does not promote much hypertrophy though. If you get likes on instagram keep posting endless tantrums. But maybe be careful what you say? Is it really an end range Return to Play hamstring exercise? Well in my opinion it is a good warmup exercise maybe. A good activation exercise. There is little load, so major strength gains seem improbable. Given the lack of eccentric forces, there does not seem a lot evidence for all the variations of tantrums to be classed as return to play hamstring exercises or effective injury prevention exercises.
loris bertolacci 