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What is the best exercise for tight hamstrings?

Tackling Tight Hamstrings-

Are you suffering from tight hamstrings? Are you feeling pulling or tension in the back of your thigh during exercise or activities? Have you been wanting to address this feeling of tightness and improve the flexibility in your hamstrings but are unsure where to start? If so, this article is a great place to begin as we will be discussing hamstring tightness and how to treat it.

LET’S TAKE A CLOSER LOOK AT THE HAMSTRING MUSCLES

The hamstrings, as we refer to them, are actually a group of three separate muscles: biceps femoris, semimembranosus, and semitendinosus. Their tendons attach at either the inferior aspect of the pelvis or posterior aspect of the femur (the long bone of the thigh) and travel along the posterior thigh inserting below the knee on either side of the lower leg. Collectively these muscles bend the knee and extend the hip and are used in activities such as walking, running, bending over to pick things up off the floor, and much more.

WHAT DO YOU MEAN BY “TIGHT”?

When a client arrives for a physical therapy assessment complaining of tight hamstrings, it is important to distinguish between a sensation that the hamstring muscle has increased tension and an observation that the muscle feels shortened. Both can exist simultaneously but may be addressed differently. A muscle can have a physiologically normal length but have increased neuromuscular tension causing a sensation of tightness. Similarly, a muscle can be relaxed but may be too short to allow full mobility for the tasks you are trying to do.

What might be adequate hamstring length for a runner may be inadequate for a dancer or gymnast who may perceive their shortened hamstring muscle as feeling tight when they try to kick their leg high over their head or bend down to touch the floor. Conversely, a runner or soccer player may have adequate hamstring length but still feel a sensation of tightness and stiffness at the end of a run or game. 

HOW CAN WE TREAT TIGHT HAMSTRINGS?

When a muscle is short, different methods for improving tissue mobility and lengthening the muscle may be prescribed. Some of these strategies will promote a relaxing of the tension created in the muscle by the nervous system causing an immediate but often temporary lengthening, while others will focus on long term changes in the muscle structure itself.

Here are some ways to improve muscle length:

Static Stretching: Most people are familiar with this type of stretching in which a muscle is lengthened until a stretch is felt and then held in that position for a period of time. This can be performed in several positions. Note, it is a good idea to warm up before stretching your muscles and the stretch sensation should be only a 2-4/10 discomfort. 

Seated hamstring stretch: Sit on the floor with your leg extended out in front of you or in a chair with your foot on the floor or elevated on a small stool. Start by sitting up straight then slowly bend forward at the waist, reaching toward your toe until a moderate stretch is felt along the back of the leg. Maintain a small arch in your lower back throughout this stretch.

Lying Down hamstring stretch: Lie down on your back and hook a strap or belt around the foot of the leg you wish to stretch. Extend the leg until it is as straight as possible and slowly pull on the strap to help pull your leg toward your head. Stop when you feel a moderate stretch. If you straighten the opposite leg along the floor it will intensify the stretch, if you bend it, it will lessen the stretch.

Hold either of these stretches for increments of 15-60 seconds and repeat until you have completed a total of 60 seconds of stretch. Repeat 2-3x per day for best results.

PNF stretching: Proprioceptive Neuromuscular Facilitation (PNF) is a stretching technique used to improve muscle elasticity and has been shown to improve both passive and active mobility of muscles, even more so than static stretching. Unlike the static stretches described above, PNF stretching techniques involve actively contracting either the target muscle or its opposing muscle. It has been proposed that these active muscle contractions cause a reflexive relaxing or inhibition of the target muscle, allowing it to lengthen further.  Two of the most common techniques for hamstring mobility are as follows. Note, it is a good idea to warm up before stretching your muscles and the stretch sensation should be only a 2-4/10 discomfort. 

Contract Relax:  This technique requires either a partner or a sturdy surface that you can prop your leg against. Lying on your back with your legs extended, lift your leg up off the ground (or have a partner lift it) as far as you can until you feel a moderate stretch or resistance to further stretch. If you have a partner, they will hold you in this position for the next step. If you are by yourself, you will prop your leg against a wall or other sturdy surface to hold you at your end range. Next, you will contract your hamstring muscles and push your leg down against your partner’s resistance or the sturdy surface as though you are trying to push your leg back to the ground.  Keep pressing down for 6 seconds then relax. You do not need to push down as hard as you can, you should utilize 50-60% of your maximum strength only. You (or your partner) will then move your leg further into the stretch as the muscles have relaxed, holding for about 30s. Repeat this cycle several times or until no further increase in flexibility is noted.

Antagonist Contraction: In this technique the “antagonist” or opposing muscle (quadriceps) is contracted actively and held for several seconds. To perform this stretching technique it's best to lie on your back. If you have a partner or a strap around your foot you will pull your leg up until you feel a moderate hamstring stretch and hold for 30s. Next, you will actively contract your quadriceps muscle, trying to straighten the knee, and hold this contraction for 6 seconds. Remember, you only need to contract the quads at 50-60% of their maximum effort. After relaxing, try to stretch the hamstring a bit further and hold for 30s before repeating the cycle again for a few rounds or until no more improvements in flexibility occur. 

Instrument Assisted Soft Tissue Mobilization (IASTM): these techniques involve using tools such as cups or handheld instruments to target the fascial layer that envelops our muscles, the skin, muscles and tendons. IASTM can improve tissue mobility and alter nervous system input that may be increasing tension in the muscle. These techniques have been shown to be more effective than static stretching but should only be performed by your physical therapist as they can be injurious if done incorrectly. 

If the actual length of the hamstring is not limited, then the sensation of tight hamstrings is more likely related to weakness, lack of stability and motor control of the tight muscle and surrounding muscles. When a muscle is unable to adequately stabilize and control the movement at the joints around it, the body may create more tension in the muscle to compensate. This can be perceived as a feeling of tightness. Physical therapy treatments for this cause of hamstring tightness can include the following:

  • Hamstring strengthening exercises

  • Strengthening exercises for the muscles that work in conjunction with or oppose the hamstring muscles

  • Exercises to improve the motor control around the pelvis, hip, and knee, to improve the stability in that area. 

PHYSICAL THERAPY CAN BE YOUR GUIDE

If you want to learn which specific techniques to address hamstring tightness are best for you, call Evolve PT. The physical therapists here will assess the length and strength of the hamstrings and surrounding muscles and give you a program to improve your hamstring flexibility and mobility for good!

Click here for more information about physical therapy for hamstrings and legs


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