You have tight hamstrings: Or do you?

Thursday, July 11, 2019

At least on a weekly basis, and probably even more often, I will hear from a patient: “I have really tight hamstring” or “I’ve been told I have really tight hamstrings”. The main reason for this statement is that the patient cannot reach their toes. Often this hamstring tightness is what is blamed fir many injuries they have developed or may develop including low back pain, achilles tendon pain, ankle sprains and of course feeling tight and sore in the legs.

How do we define a tight hamstring? Why do they get right? Most importantly, in many of these cases, is it actually the hamstring that is tight or is there something else going on that is giving us this perceived feeling of tightness?

First of all, lets start by actually looking at the most common test(s) for hamstring length. After all, if a muscle is tight, it should show in these tests, right? The majority of people use a measure of one’s ability to bend down (touch their toes) as a basic measure. As physios, we use, or at least we should use, a number of tests to help us determine muscle length. The most common tests for hamstring length that will be seen in a physio’s treatment room are:

  • The straight leg raise
  • The 90-90 test

The question is however, are these tests isolating the hamstrings? Are they a true and reliable measure of hamstring length? Most of the time, these tests do not isolate the hamstring and there are other factors (besides hamstring length) that can affect the results of these tests.

Tightness, or even the feeling of tightness, in the hamstring can be influenced by a number of factors:

  • The muscle actually being short to the point where the muscles fibres aren’t long enough causing a restriction in movement.
  • Weakness in the muscle can cause the muscle to go into a protective spasm, tighten up and feel stiff.
  • A muscle, which has recently been exercised or worked, will hold extra muscle tone and therefore a slight restriction in movement.
  • A muscle that is being overworked, due to weakness in another muscle will become tight.

Or…

It might not be the hamstring at all!

In this case, what else could it be that is giving us this feeling or this perception of our hamstring muscles being tight? One structure that could be responsible is one of the nerves that runs down the back of the leg, the sciatic nerve. The sciatic nerve gets stretched during bending forward positions. The sciatic nerve can either, becomes less flexible because of a sedentary lifestyle, or start to get ‘stuck’ in other tissues of the leg such as muscle and fascia, normally also due to lack of movement. When either of these occur, the nerve will becomes stretched in positions such as bending forward, giving us the feeling of tightness in the back of the thigh, often attributed to tightness in the hamstring muscle.

If you feel that you have tightness in the back of the thigh but aren’t sure why, click here to make an appointment with one of our physiotherapists.

For some tips on stretching that can help with tightness in the hamstring muscles click here.

Visit Physio Inq Penrith if you're having hamstring issues.

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