Tight Hamstrings

This is one of the most predictable diagnoses in orthopedics and is attributed to a number of painful issues. I cannot speak to the origin of this proposed problem, however it is pervasive in its application to low back pain, knee pain and many others. Unfortunately having tight hamstrings is an overly reductive viewpoint on what may actually be causing the problem.

So many of us will feel a pulling sensation when we bend to touch our toes or try to bring our foot toward our head when we’re lying down. That pull you feel in the back of your thigh, sometimes the back of your knee and also your calf. We have attributed this to being due to the hamstrings being tight. Whatever tight means. The attachment sites of the hamstrings are your sits bones and the knee. Those sites have led many people to believe that if you feel the stretching sensation, then they must be pulling on those body parts and causing mechanical problems. A more robust explanation may simply be that your center of gravity is really far forward.

That does sound a little abstract, so let’s dig in a bit. The site at which your hamstrings begin is your sits bone, as mentioned earlier. However, what overlays that site is one of your larger posterior muscles, one which most of us are familiar with, the gluteus maximus. Now, if I actively squeeze that muscle it pushes me forward, and compresses the hamstring on the sits bone. That compression takes up any slack there may have been in the hamstring, and now puts tension on it. Attempt to reach forward to touch your toes and you will amplify that tension, resulting in a sense of pulling.

The hamstrings are often blamed for pain and limitations in multiple bodily regions, however that blame may be misdirected. Other musculature surrounding the hamstrings may be more of a cause, and a system wide strategy to move forward faster could be amplifying the issue. We as clinicians love black and white, easy answers, it makes for less complex problems to solve. In reality, the complexity of biology is more than we can probably comprehend, but we can certainly do better.

Austin Ulrich, Physical Therapist