One of the most common phrases I hear on a daily basis is “my hamstrings are so tight.” But are they really? Clients with continued/chronic back pain, who have been through rounds of physical therapy in the past, come in and say, “I don’t know why I keep getting back pain. I do my hamstring stretches every day.” Believe it or not, excessive hamstring stretching can cause more harm than good!
Let me give you a very basic rundown on lumbopelvic anatomy and muscle attachments:
1. Iliopsoas (hip flexor): attaches from the front of the spine, through the pelvis, and to the thigh bone.
2. Rectus Femoris (hip flexor): attaches from the front of the pelvis to below the knee in the front.
3. Hamstrings (hip extensor): attaches from the “sits bones” to below the knee in the back.
4. Gluteals (hip extensor): attaches from the back of the pelvis to the back of the thigh bone.
Now what does that all mean? When the aforementioned muscles (in addition to many others) are working in balance and harmony, the pelvis is held in a neutral position and all of them are the appropriate “length.” But, when those muscles are out of balance, the pelvis will be out of balance and things just don’t run as smoothly as they should. As a general statement, hip flexors tend to be excessively tight from our society’s love of sitting – because of this love of sitting and excessive anterior tightness, the pelvis tilts anteriorly. When the pelvis tilts anteriorly, that means that the poor hamstrings are being stretched constantly! See the image to the right for reference:
Since the hamstrings are on constant stretch, they feel extremely “tight.” The normal response to this is to then stretch them, but they’re already on stretch. More stretching of the already stretched muscles leads to a further imbalance of the pelvis, since there is nothing holding the pelvis down in the back. Surprise! Nothing holding the pelvis down in the back leads to the pelvis being more anteriorly tilted, which leads to more back pain.
Long story short: STRETCH YOUR HIP FLEXORS instead of stretching your hamstrings. By stretching your hip flexors (iliopsoas and rectus femoris), your pelvis has a better chance of being in a neutral position, giving your hamstrings a chance to feel not so tight and also gives them a chance to do their job. You learn something new every day, right?
Alix Terpos PT, DPT
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