Hamstring strain injury often results in neuromuscular performance deficits that persist beyond rehabilitation and the return to full training and competitive sport. It seems appropriate to address these deficits as a part of a sport-specific training program which primarily aims to enhance performance. Prolonged deficits in horizontal ground reaction forces in sprinting, repeat sprint performance, knee flexor eccentric strength and biceps femoris long head fascicle lengths have been observed in multiple studies of hamstring strain injury. Why such deficits persist beyond the return to sport is not known, although persistent neuromuscular inhibition of the injured muscles has been proposed. There is limited and mixed evidence for sprint running kinematic (technique) differences between previously injured and uninjured limbs or athletes, although more work in this area seems warranted. While there is some uncertainty about the optimal mix of methods for addressing the aforementioned deficits, sport-specific running programs in conjunction with continued monitoring of acceleration phase sprint performance and repeated sprint ability seem appropriate. Heavy strength training with at least some eccentrically biased exercises is also recommended to address deficits in eccentric strength and muscle fascicle lengths.