I am betting that a large percentage of people reading this article would admit to having “tight hamstrings”.  I will go a little further and say a fair amount of you with tight hamstrings have also tried stretching with some regularity at some point in time with very little success in re-gaining flexibility.  Well, my goal today is to touch on one possible explanation for why this situation occurs.  I also happens to be the most common presentations we see in our office. 

 

To begin, there are multiple reasons for people to develop tight hamstrings.  A few examples include pelvic instability, neural tension, intervertebral disc injury, previous hamstring injury and chronic repetitive stress/overuse injury.  The most common reason for seeing tight hamstrings in our office is due to faulty posture and/or pelvic instability.

 

How does this happen?  Well, as we’ve discussed before, many of you reading this work jobs that require you to sit for long periods of time throughout the day.  Well, while you’re sitting 8 hours a day, 5 days per week for the rest of your life, some changes occur to your muscles and over time you may develop, what has been coined, lower crossed syndrome.  What we tend to see with lower crossed syndrome is tight/overactive lumbar spine erectors (your big back strap muscles), and short/tight hip flexors.  At the same time, your gluteus muscles (Hip extensors) become weak/inhibited along with your abdominal musculature.  When you put all these muscle changes together, your standing posture may reflect what we call an anterior pelvic tilt.  Your tight lumbar spine erectors are pulling up on the back side of your pelvis and your short/tight hip flexors are pulling down on the front side of your pelvis.  So now, if you think of your pelvis as a bowl of water, it would be spilling out of the front side of your pelvis. 

 

So why does this lower crossed syndrome thing matter?  Well, to take things a bit further, your hamstrings (posterior thigh muscles) attach to the bottom of your pelvis.  When you have an anterior pelvic tilt, this puts a small stretch on the hamstring muscles and they can become tight.  You now have a situation where your hamstrings are LONG and tight.  This can be confusing since we often think that if we have tight muscles, they must be shortened and therefore need to be stretched.  In this scenario, stretching the hamstrings will not benefit you at all.  In fact, stretching hamstrings that are already elongated could potentially leave you more open to injury.  It is important to note that your body loves stabilization.  When you have an anterior pelvic tilt, your hamstrings are not only tight because they are elongated, but probably more so because they are trying to help stabilize your pelvis since your abdominals and glutes are not getting the job done. 

 

Sidenote: It is possible to have hamstrings that feel tight because they are long and tight, and also possible to have hamstrings that are short and tight.  This is an important concept to understand because the treatment approach would differ for each situation. 

 

So now that you have a little background surrounding lower crossed syndrome and how it ties into tight hamstrings, you hopefully see how simply treating the hamstrings will probably not get you very far.  This is a perfect example of one of our favorite sayings, “he who treats the site of pain is lost, and so is his patient”.  You see, the real problem is not your tight hamstrings, that’s a downstream symptom of an upstream problem.  Therefore, in our office we would do a few different things to attack lower crossed syndrome which would allow the hamstrings to loosen up.  The following are treatment modalities that may be utilized with this sample patient.  Chiropractic adjustments and mobilizations would come in handy for restricted joints such as the hips and thoracic spine.  Rehabilitation exercises are a great way to address core stabilization, activation of the glutes and proper abdominal bracing. Lastly, soft-tissue work such as Active Release Techniques would help lengthen the chronically tight and over activated hip flexors.  All of these treatment modalities allow patients with an anterior pelvic tilt to train a more stable and neutral pelvic position, ultimately taking stress and tension off the hamstrings without ever directly stretching them. 

 

Although our lower crossed syndrome example is rather common, I think it is worth repeating that there are multiple causes of “tight hamstrings” and treatment would be different in each scenario.  For this reason I recommended that you seek out a physical medicine practitioner such as a chiropractor or physical therapist who is able to utilize various movement screens, joint palpation and active/passive range of motion screening in order to tease out what is the real cause of your muscle tightness, decreased range of motion, or faulty movement patterns.  In doing so, you can be assured that you will have a much more effective approach to not only re-gaining range of motion, but also properly controlling that range of motion in order to help prevent further breakdown and injury.

 

Have a great week and please feel free to contact our office with any additional questions. 

 

-Dr. Derek