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Why Hamstrings Are Mistakenly Blamed For Injury And Pain

Written by: Nick Jack
Category: 2014
on 04 May 2018
Hits: 18605

Of all the muscles to get a bad rap and always to blame for creating trouble, the hamstring muscles would be right up there alongside the upper traps as the public enemy number one. Watch anyone who plays sports do their stretching routine and you are guaranteed to see the hamstrings get a real workout, or participate in a Yoga class to see how many hamstring stretches you will have to complete and it seems like everyone must be short and tight in this muscle group. Now while this may seem like a good idea, what you will find in this article is that many people who are cranking excessive mobility into this area are in fact creating a huge potential problem at joints like the knee, and even the lower back. It is ironic for many people are doing the stretch in the belief it is going to prevent these injuries. We will also discuss the strategies that are used to strengthen the hamstrings, in particular with sports where hamstring tears are common, and show you that it is not the hamstring that is the problem. The hamstring muscles really are very misunderstood, and when you appreciate how they actually function you will become much smarter with how you approach your training.

What Is The Function Of The Hamstrings?

The hamstrings cross and act upon two joints being the hip and the knee. Semitendinosus and semimembranosus extend the hip when the trunk is fixed, they also flex the knee and medially (inwardly) rotate the lower leg when the knee is bent. The long head of the biceps femoris extends the hip, such as when you begin to walk, both short and long heads flex the knee and laterally (outwardly) rotate the lower leg when the knee is bent. The hamstrings play a crucial role in many daily activities such as walking, running, jumping, and controlling some movement in the trunk. In walking and running, they are most important as act as the brakes against the quadriceps in the deceleration of knee extension.

These muscles can be easily torn in sports like Australian Rules Football or basketball when sprinting at high speeds is required. But this does not mean that they were short and tight. Injuries occur when there is a muscular imbalance, when the hamstrings are not adequately warmed up, poor running technique such as over striding or if they are fatigued. During sprinting, the hamstrings fire eccentrically -- they contract when they are in a lengthened position -- to slow the lower leg and prepare the foot for ground contact. They must act as a stabilizer, to prevent the quads from blowing out over your knee! This is why weak hamstrings are a huge risk factor ACL tears!

And they are also playing a role in your how you move your hip and bend over. As you can see they are responsible for many key movements we use in daily life. This is where many people will tell me they have tight hamstrings for they cannot touch their toes. They instantly assume that it is a problem with their hamstrings. But what you will find is rarely is it the case. This tightness is there for a reason and you must find the answer to WHY they are tight to truly improve your ability to touch your toes. Stretching your hamstrings will only make matters much worse. More on touching toes later!

The thing to truly understand is this, THE HAMSTRINGS ACT LIKE A SLAVE MUSCLE!

This means when other muscles are not doing their job effectively the hamstrings pick up their workload. For example if your glutes are weak and not functioning correctly, which is extremely common, the hamstring has no choice but to increase the workload. You can confirm if this is the case when applying simple bridge tests. If the client experiences any hamstring cramping on a single leg hip extension hold, this is a case of hamstrings taking over due to weak glutes. No amount of hamstring stretching will ever change anything until you strengthen the glutes. And you actually would not want it to either, for then you would have no brakes for the hip and knee!

Make sure you read the article - How To Strengthen Your Glutes for more detail on this and get a copy below of our Free Checklist as you will see in this article we will be discussing the weak glutes constantly.

Not All Hamstring Tension Is TRULY Hamstrings!

What do I mean by this? There is two cases where what appears to be tight hamstrings, is not the case at all.

The first case is the most common and this is where you see someone with what is an excessively anteriorly tiled pelvis, which puts a big stretch on the hamstrings, whose job is to posteriorly tilt the pelvis. I like to use the term "TAUT not tight" to refer to what is happening here to the hamstrings. When someone is extremely anteriorly tilted, the hamstrings are constantly working to prevent the person from ending up with extension-based back pain, such as spondylolysis and lumbar erector tightness/strains. You actually need them to create this stiffness to prevent a back problem. They are not causing the pelvis to tilt like this, they are just reacting to it. This is a problem most commonly seen in females as they tend to have greater anterior pelvic tilt than males.

See the pictures below of what this looks like. The 4 pictures of the females shows the 3rd picture demonstrating a classic anterior tilted pelvis.

Vladimir Janda who pioneered corrective exercise first coined this postural imbalance as Lower Cross Syndrome. And to correct this involves tightening of the hamstrings, not loosening as you see so many people do.

A great video to watch of a case study of a young client we helped with this exact problem is below.

The second case is where you see Neural tension.

And this again has nothing to do with the hamstrings but more to do with nerves being trapped, usually around the lumbar spine. Many cases of sciatica and herniated disc injuries will present with what appears to be tight hamstrings. It is usually easy to spot the difference as the person will really struggle with a straight leg raise, possibly only able to lift the leg to 45 degrees and feel pins and needles or tingling in the calf or even pain the back. (Pins and needles or pain in your back from sitting too long is always a sign you have nerve trouble). If you bend the knee you will find the leg moves much more easily, but even still sometimes it may remain stiff and tight. The problem is the sciatic nerve is being trapped, not necessarily the muscle becoming short and tight. Nerves need to pass through or floss their way between muscles to complete their function. They are usually built with a little extra slack, similar to a rubber band, that gives them the ability to stretch a bit. But when they get trapped the nerve becomes stuck to the surrounding muscle. And when you try to move the area, it creates a ton of tension and leads to an increase in a stretch feeling because all the slack gets used up quickly.

And once your sciatic nerve is being compromised and being trapped, it will cause your hamstring to engage in what is called protective tension. When this happens, your hamstring will feel very “tight” and will not respond well to stretching mechanisms. And aggressively stretching the hamstrings WILL actually make these symptoms worse, so it's important to see a medical professional to get a correct diagnosis if you have any suspicion of nerve problems.

You can read more about back pain related articles below

If you do have sciatica we prefer to use the nerve flossing exercise featured below to assist this.

How To Assess If You Have A Mobility Or Stability Problem

For a person to have "true short and tight hamstrings", they need to be in posterior pelvic tilt when in a relaxed posture. You can see this if they lay flat on the floor, or stand against a wall and there is no gap between the floor and their lower back. But even still sometimes this can be a hip problem and not a hamstring problem. These people usually can't tell the difference between moving their hip and moving their lower back. This is known as poor hip/pelvis disassociation.This is obvious when you ask them to lift one knee when standing and instead of holding a good spinal position they will instantly tuck their butt under and round out at the lower back. Also in a squat they tend to roll into a ball and cannot maintain spinal curvature. This person is always a high risk for a bulging disc for this reason.

See pictures below for an example of this. Observe how the neutral curve of the lower back is present in standing and in the second picture but lost on the third.

This is a test in it's own right and it is important not to tell the person what you are looking for, just ask them to lift their leg and observe how they do it.

Other simple tests you can use to be sure though are below.

Mobility Test - Straight Leg Raise

An example of a mobility test is the straight leg raise test for the hamstrings. You will need to do this test out with a partner. Lie on your back with the knees bent. Your partner takes one leg and straightens it at the knee. They place their hand under your lumbar spine (lower back) and slowly raise the straightened leg. If the hamstrings are flexible enough the leg will raise to about 90 degrees until the hamstrings pull on the lumbar spine. A short hamstring will start to pull the lumbar spine much earlier.

If you passed this test easily and play sports I would stop stretching hamstrings. I might gently stretch them after heavy training or events, and include them in warm up drills beforehand, but I would never spend much time improving the flexibility and would be very wary of taking part in things like Yoga and Pilates where excessive stretching of this muscles is rampant until I have been able to establish good motor control of the hips and glute strength. Excessive hamstring flexibility is a great predictor of ACL injuries in sports and one reason why females suffer this injury at a rate 5-8 times more than males due to their hamstring laxity. When you understand that 60-80% of ACL injuries occur when the knee is forced into position of flexion and the rotation. Hamstrings work in combination with the ACL to resist the forward movement of the tibia that the quads produce. The bigger the difference between the quads and hamstrings increases anterior shear force at the knee flexion angles that occur during single leg landing and pivoting movements that we already know are high risk. 

Read our article - ACL Injuries In Female Athletes for more detail on this.

Stability Test - Prone Hip Extension

An example of an stability test is the prone leg lift for the gluteus maximus. Lie down on your stomach and bending one knee to 90 degrees, lift the thigh a little off the floor. You should be able to get a strong contraction of gluteal muscle to do this and be able to hold the static contraction for 60 seconds. If this position places too much strain on the hamstring or lower back, or the leg starts shaking, then you are unable to recruit the gluteal muscles sufficiently to hold this position. I also like to use the bridge with this test to see if the hamstrings cramp during a single leg hold. See the video below for how to do this.

What About Touching Your Toes?

When people have trouble touching their toes, they usually blame it on having tight hamstrings, because that’s what they feel when doing the movement. But as we discussed earlier this is usually just a reaction to something else. Gray Cook in his book "Movement" discusses this in great detail and he has many videos on this exact subject I encourage you to check out.

He describes this best below when people cannot touch their toes it is usually do to one of 4 things.

  • Insufficient posterior weight shift backward—If you’re unable to shift your posterior weight backward as the upper body half of your body leans down and forward, your hamstrings will contract to prevent you from losing balance and falling forward. In this case, the hamstrings are merely acting as parking brakes to stop you from hurting yourself.
  • Stiff lower back—Some people are unwilling to round their backs in a toe touch. Oddly, these same people are more than willing to round their backs dangerously under load, for example when deadlifting.
  • Stiffness in the cervical or thoracic spine—Similarly, stiffness in the cervical and thoracic spine can also limit the distance someone can reach toward the floor.
  • Increased tension in the plantar flexors—Increased tension is mainly found in the gastrocnemius, which crosses both the knee and the ankle joint. Tension in the plantar flexors will almost always be felt in the hamstrings unless there’s associate pain.

This is why I don't find this a reliable test but a very misleading one that could set you up for all types of trouble. The true hamstring tight person will fail the tests above and you will see a posterior tilt of the pelvis.

If however a person who presents to me with a lordosis type posture (anterior tilt pelvis) but struggles to touch their toes I am highly suspect of a hip stiffness or lower back stiffness. They are prone to extension related back pain, SIJ problems and various other hip problems for the hip is stuck in anterior tilt. This person will respond much better to stretching their quads and hips and leaving the hamstrings alone.

This is where Yoga and excessive stretching of hamstrings exacerbates this person's taut hamstrings and eventually leads to back problems. This person really needs to stop stretching altogether and strengthen. Their loss of stability is requiring "stiffness" to protect them. See the video below for more details on this.

How To Strengthen The Hamstrings But Maintain Optimal Flexibility

When it comes to strengthening the hamstrings I hope you know that I am going to say it will have more to do with the glutes and controlling hip mobility than applying an isolated hamstring exercise. This is something that seems to elude the sporting community when it comes to dealing with hamstring strains. Like everyone they are in a reactive mode where if there is a problem here we need a specific exercise, manual therapy or even surgery to correct it. All the while completely ignoring the reason it became tight in the first place.

In AFL Football the overuse of the nordic hamstring curl is a perfect example of this.

I don't have a video of my own for this for I never use this exercise!

I acknowledge it has some great benefits in terms of eccentric strength and allowing the hamstring to strengthen in a lengthened position but I find it is highly over rated and another example of body building principles taking over the way we are designed to move. A hamstring tear is not a problem with the hamstring, but a problem somewhere else. The nordic curl does not address this at all and in fact tries to ignore that the real reason people constantly tear their hamstrings is from 4 things.

  1. Poor pelvic stability
  2. Poor hip mobility
  3. Weak glutes
  4. Dysfunctional movement patterns.

Meaning that if I address these 4 things I don't need to muck about with isolated non functional exercises as there is nothing to isolate.

How To Improve Pelvic Stability

We have covered this subject in great detail in our previous article you can read here - "Best Exercises For Improving Pelvic Stability"

Below is 2 videos that you can use to improve this. The first one is a very simple exercise and the second is a perfect one for the person who has poor hip/pelvic disassociation that we saw earlier with the leg lifting test.

How To Improve Hip Mobility

It is important to check this for you may in fact have great stability but are forced to lose it if your hips are not mobile enough. There is stacks of ways you can do this. The key is to test what your hip function is like and if there is a stiffness use various methods to improve it. Ideas on how to mobilize your hip are in the videos below. And I encourage you to read our detailed article "Are Tight Hips The Cause Of Your Back & Knee Pain" for more information on how to do this.

How To Strengthen Glutes & Improve Movement

Now you should have already downloaded your glutes checklist by now and read the article I gave you the link for earlier.

So I am going to show where the real secret to strengthening the hamstrings is. And this really incorporates all the previous factors all at once!

This is where you use single leg deadlift exercises that progress from basic stability to high velocity jumping and landing exercises. The deadlift itself is a great way to stretch hamstrings with load but it is better than the nordic curl for it needs glute strength. If you improve your stability, strength and power with this exercise you will have little trouble. The glutes will be forced to work the hardest, with some assistance from the hamstrings, while the hips allow for great hip movement and pelvic stabilizers work hard to maintain stability. This is where the football players should be spending their time training their hamstrings to prevent tears. The nordic curl has no glute or stability requirement needed, but in most cases it is the lack of these two things that the hamstrings are overloaded.

Check out the videos below of how to do this. There is 2 versions of the deadlift to try, the harder single leg version and the much easier Romanian Deadlift that will give your hamstrings a great stretch but in line with keeping a neutral lumbar curve.

A great Free Report you can download below that goes into great detail about this movement and many others.

Summary

I hope you have found this article useful and it not gives you a better insight into how the hamstrings develop tightness as protective mechanism. Just trying to remove your stiffness without resolving why it was there in the first place is craziness and will only put you on a merry go round of pain. You can never under rate learning to move correctly. This is the fastest and most effective way to prevent and rehabilitate injury bar none! So whatever you do spend the time to get this right. Whether you have back pain or hamstring strains from playing sports, you will benefit from learning how to move and address the source of your problem and not the symptoms.

If you suffer with back pain I encourage you to get a copy of our Back Pain Secrets program below. Click here for more information.

And if you live in Melbourne and would like to know more about our Personal Training programs for injury or sports click the image below to request a free consultation and I will be in touch within 24 hours to schedule an appointment.