Written on June 12, 2012 at 9:13 am, by Eric Cressey
There might not be a more obnoxious and stubborn athletic injury than the hamstrings strain. When it is really bad, it can bother you when you're simply walking or sitting on it. Then, when a hamstrings strain finally feels like it's getting better, you build up to near your top speed with sprinting - and it starts barking at you again. In other words, a pulled hamstrings is like a crazy, unpredictable mother-in-law; just when you think you've finally won her over, she brings you back down to Earth and reminds you how much more she liked your wife's old boyfriend.
However, not all hamstrings pain cases are true strains; more commonly, they present as a feeling of "tight hamstrings." If one is going to effective prevent this discomfort, rehabilitate it, or train around it, it's important to realize what is causing the hamstrings tightness in the first place. Here are five reasons:
1. Protective Tension of the Hamstrings
This is readily apparent in someone who has a crazy anterior pelvic tilt, which puts a big stretch on the hamstrings, which posteriorly tilt the pelvis. When someone is extremely anteriorly tilted, the hamstrings are constantly "on" to prevent someone from ending up with extension-based back pain, such as spondylolysis (vertebral fractures), spondylolisthesis (vertebral "slippage"), and lumbar erector tightness/strains. This is a problem most commonly seen in females (greater anterior pelvic tilt than men) and athletes:
Doing a lot of longer duration static stretching for the hamstrings in this population usually isn't a great idea, as you run the risk of making someone more unstable - particularly in the case of females, who have less rigid ligamentous restraints (more congenital laxity) to protect them. To that end, our approach with these folks is to use the warm-ups to foam roll the area, then do some hamstrings mobilizations to transiently reduce stiffness in the hamstrings.
After this reduction in stiffness, we work to build stability in synergists to the hamstrings in posterior pelvic tilt. In other words, there's a heavy emphasis on glute activation and anterior core recruitment both with a strength training program and postural reeducation for the other 23 hours of the day.
At the end of the training session, with the male athletes, we may do some shorter duration hamstrings stretching just to "dissipate" a little eccentric stress. I like ten seconds in each of these three positions:
The thing to remember is that while you can do everything right with these athletes in training, what they do with their posture during the rest of their lives is of paramount importance. If they continue to stand around in anterior tilt and don't help the new stiffness they've developed "stick," they'll continue to over-rely on their already tight hamstrings.
2. Neural Tension
Just because you feel hamstrings tightness doesn't mean that the hamstrings are actually the source of the problem. In fact, it's not uncommon at all for those with lumbar disc issues to present with radicular pain, tightness, or numbness/tingling into the legs - especially the hamstrings. The symptoms may also come from nerve entrapment (most commonly the sciatic nerve) on soft tissue structures further down the chain. Just aggressively stretching the hamstrings can actually make these symptoms worse, so it's important to see a medical professional to rule out causes further up with the appropriate clinical exams, such as the slump test.
3. Truly Tight Hamstrings
In order for hamstrings to really be short, one would have to spend a lot of time with the knee flexed and hip extended - so just imagine the position you're in at the top of a standing leg curl. That's a hard pose to hold for an extended period of time, much less do so on a regular basis.
That said, some folks do get somewhat close to that on a daily basis in the sitting position, and are therefore the most likely to really have "tight hamstrings." They have to be in posterior pelvic tilt and knee flexion for a considerable chunk of the day - and even then, it's still pretty tough to be truly short, as they are still in hip flexion.
These folks usually can't distinguish hip flexion from lumbar flexion, so if you do a standing hip flexion assessment, rather than maintain the neutral spine we see in this photo, they'll go into lumbar flexion (butt will "tuck under").
The same trend will usually be noticeable with any kind of squat unless they have a tremendous amount of core stiffness to overcome the posterior hip stiffness that's present. If you test these folks on an straight leg raise, it isn't pretty, as the pelvis is already posteriorly tilted. In a pelvis that starts in "neutral" on a straight leg raise, roughly the first 1/3 of movement that you see comes from posterior tilt of the pelvis before the femur ever starts to flex on the acetabulum of the pelvis. These folks are usually already posteriorly tilt, so that 1/3 is already used up; you're really only measuring hip flexion and not hip flexion PLUS posterior pelvic tilt. And, as you can imagine, if someone is truly short in the hamstrings, that straight leg raise isn't going to be pretty. Obviously, these folks usually have a terrible toe touch pattern as well.
This should also educate you on why you can't treat all hamstrings strains the same. In the protective tension example earlier, we needed to work to regain stability to hold a position of a bit more posterior pelvic tilt. We'd cue glute activation, and use exercises that draw folks back into posterior tilt (e.g., reverse crunches). If you have someone has a pulled hamstrings because they are truly short from already being in posterior pelvic tilt, though, some of these cues and exercises would be contraindicated. You'd be feeding the dysfunction.
While manual therapy and stretching for the posterior hip is valuable, again, it must be followed by stabilization work at adjacent joints with the pelvis in a neutral position. These folks can benefit from training hip flexion above 90 degrees as well, as it educates them on how to flex the hip without rounding the lumbar spine. This is one reason why I think a lot of the chop and lift exercises we've learned from Gray Cook are so fantastic; they teach us anti-rotation and anti-extension stability in various positions of hip flexion while the pelvis is in neutral. They make changes "stick" better.
4. Previous Hamstrings Strain
Not to be overlooked in this discussion is the simple fact that the single-best predictor of hamstrings strains is a previous hamstrings injury. One you have an injury, that area may never be the same from a tissue density standpoint - whether it's the surrounding fascia or the muscle or tendon itself. A previous injury can leave athletes feeling "tight" in the region, so regular manual therapy can certainly help in this regard.
Anecdotally, the athletes with the long-term problems seem to be the ones with the pulls up on the gluteal fold, right where the hamstrings tendons attach to the ischial tuberosity. The area gets "gunked up"in a lot of athletes as it is because of all the tissues coming together and exerting force in a small area, but it's especially problematic in those who have a previous injury in the region. Perhaps more problematic, though, is the fact that we sit on our proximal hamstrings attachments - and that isn't exactly good for blood flow and tissue regeneration.
I haven't seen any research on it, but I have a feeling that if you looked at this region in a lot athletes with ultrasound (similar to this study with patellar tendons), you'd find a ton of people walking around with substantial degenerative changes that could be diagnosed as tendinosis even though they haven't actually hit a symptomatic threshold. My guess is that it's even worse in the posterior hip region because a) we sit on it, b) the ischial tuberosity is a more "congested" area than the anterior knee), and c) the study I noted above used 14-18 year-old athletes, and degenerative problems will get worse as one gets older (meaning this study likely undercut the true prevalence across the entire population).
Very simply, an athlete with a previous hamstrings strain needs to stay on top of quality manual therapy on the area, and be cognizant of maintaining mobility and stability in the right places. They have less wiggle room with which to work.
5. Acute Hamstrings Strain or Tendinosis
Of course, the fifth reason you hamstrings might be tight is because you might actually have a hamstrings injury! It could be an actual hamstrings strain, or just a tendinosis (overuse issue where tissue loading exceeds tissue tolerance for loading). There is no one perfect recommendation in this regard, as a tendinosis or grade 1 hamstrings strain is going to be much more tolerable than a grade 3 hamstrings strain where you have bruising all along the back of your thigh.
In terms of maintaining a training effect with the less serious ones, here are a few suggestions:
a. When you are ready to deadlift, use trap bar deadlifts instead of conventional or sumo deadlift variations. I explain a bit more about how the positioning of the center of gravity makes this more hamstrings friendly HERE.
b. Shorten up your stride on single-leg exercises. This makes the movement slightly more quad dominant, but allows you to still get the benefits of controlling the frontal and transverse planes with appropriate glute and adductor recruitment at the hip.
c. Go with step-up and reverse sled dragging variations. Eliminating the eccentric component can take a considerably amount of stress off the hamstrings, and both these exercises get the job done well.
d. If you're going to squat, start with front squats at the beginning, and reintegrate back squat and box squat variations later on, as they will be more hamstrings intensive.
e. Understand anatomy. If you are in hip flexion and knee extension, you're going to really be stretching the hamstrings and likely irritating them in the process. Select exercises that don't hit these painful end-ranges, and then gradually reintroduce more dramatic ranges of motion as the issues subside.
f. Do hill sprints before you do regular sprints. Your stride is going to be a bit shorter with hill sprints, and that'll take a considerable amount of stress off the hamstrings at heel strike (pretty good research on uphill vs. downhill sprinting HERE, for those who are interested). Just don't go out and run as hard as you can the first time out; propulsive forces are still quite high.
Of course, this just speaks to how to train around a pulled hamstrings; there is really a lot more to look at if you want to really understand why they occur and how to prevent or address them. In my eyes, this post was necessarily "geeky," as it is important that we don't dumb down complex injuries to "just stretch it out." This recommendation is analogous to a doctor just telling someone to take some NSAIDs for regular headaches; it doesn't get to the root of the problem, and it may actually make things worse.
A thought provoking post. And as usual very thorough and informative. Almost everyone that walks in my door complains of “tight hamstrings,” and most don’t actually have a hamstring strain or tear, though it might feel like it to them at times. The actual reason for “tight hamstrings,” is as individualized as the athlete that walks in the door. This post will be a great resource, putting the most common issues with hamstrings and corrective techniques all in one place! Nice work Eric.
Great post!!! Did you get a chance to read the manuscript that Mal McHugh and I published “The Role of Neural Tension in Hamstring Flexibility.” You would enjoy reading the discussion of the paper. Keep up the great work!!!
I would guess that most strength/power/speed athletes with hill sprints, especially uphill, would not have a heel strike, but would naturally adapt to or continue a fore-foot strike.
The hill running study abstract did not mention specifics: if the runners were untrained or trained, sprinters or distance runners or fore-foot or rear-foot strikers?
Great write-up. I’ve dealt with my share of hamstring issues since 2007 and know #4 all too well. Thought I’d share my experience. In ’07 and ’09 I suffered strains to my left hamstring. The first took about 8 weeks to recover. The second injury was much more severe, took two years before I was pain free. The latter injury was a pull at the gluteal fold, like you mentioned. Left hip was in extreme flexion and abduction. Heard a pop, felt it go from medial to lateral. At that point it was a “dead muscle” followed by much bruising. You’re right, I haven’t been the same on that leg since. What I do find interesting, in comparison to what you wrote, is that my left hamstring is not “tight” anymore. It’s actually more lax than before the injury. Another result of this particular injury is that my left glute is more developed than my right. Athletes should also be aware of the how injuries like this change little things; how we walk, movement patterns, how we sit. Things that can cause other imbalances. I didn’t realize these things until nearly two years later. I have a slight torso imbalance to correct because the injury caused me to lean over to once side while sitting due to pain. My right hamstring became tighter because of favoring one side and now have experienced two minor strains in my right hamstring in the past 18 months.
Again, thanks for the write-up, as usual this is very useful information that I can use to help me “get right” eventually.
Hamstrings wouldn’t necessarily be the big culprit; if you think about it, you’d need to have the hip flexed and knee extended to really be “running out” of hamstrings ROM. It has more to do with the constant positioning of posterior pelvic tilt than the hamstrings actually being short/stiff; we get “stable” in the wrong position.
Check out this great blog from Zach Moore on the topic:
Eric,
I’m usually in 100% agreement with everything on your site, with that said, I can’t agree with the statement of “needing to eliminate the eccentric portion to eliminate stress on the hamstring.” While it is true that this may eliminate stress, it is building inherent instability into the hamstring. The hamstrings are the major decelerator of the lower extremity (mainly in men) so when we eliminate the eccentric load in early rehab of acute injuries we set the hamstring up for re-injury down the road. Still worship this site though!
nice point about not static stretching the Hamstrings too much. Especially in the ACL population we want some strong hamstrings as well as a neutral pelvis. That anterior tilted pelvis can bring the knees in genu valgus.
Also liked the point of distinguishing between neural tension and hamstrings tightness. Stretching a short nerve isn’t always the most pleasant feeling(ie: It feels like hell) and we know techniques such as flossing might be an effective way to lengthen nerves without the pain.
Beau – thanks for your contributions. That said, we’re talking about 2-3 weeks of training, not the long haul. This really has more to do with maintaining some semblance of a training effect while an athlete is on the shelf and doesn’t have a large pain-free exercise pool from which to draw. Training the hamstrings eccentrically means lengthening the injured tissue under load – and while it certainly has benefit, pushing too hard too soon also obviously has drawbacks. Better safe than sorry, right?
Eric, Great article. Thank you for your informative and down to earth approach to these injuries. DO you approach ‘hamstring health’ the same with your post-op ACL using hamstring grafts? Also, your point about testing these folks on an straight leg raise, I would imagine they lie in anterior tilt – and not posterior. So if the pelvis starts in “neutral” I dont see how that first 1/3 of movement that you see comes from posterior tilt. Thank you again!
Another great article Eric.
Along the lines of #2 for many of my athletes with “tight” hamstring I have focused more on releasing of the hip rotators with some PNF and fascial stretching. Concurrently the hamstrings seem to release as well.
Hey Eric, im not sure if you will ever read this, or if you get alot of this, if its the second, im sorry.
But if you got the time; I have a pretty bad anterior pelvic tilt, and i would really love if you would share what you teach your students to do, the other 23 hours of day?
T – You have to make them constantly aware of how they’re standing/sitting. Activate anterior core, glutes, and deep neck flexors a bit more – and focus on getting the shoulder blades to sit back a bit more without pulling aggressively into depression.
Im sure you get alot of request, but i would be very gratefull if you would write something about how to stand and walk to fix pelvic tilt, as im gonna start the neanderthal work out this week.
So what can be done to reduce neural tightness? I’ve had two lumbar microdiscectomies and definitely have residual tightness (very positive slump test) but have never gotten much mileage from neural flossing, foam rolling, or static stretching. PNF works short term but is gone in a few hours or overnight so no lasting ROM changes.
Could be a number of things….positional instability, a nerve that’s hung up, or just some of those neural issues needing time to resolve on their own. Have you seen a Maitland provider? They tend to be great with radicular symptoms. http://ozpt.com/index.php
Thanks for the input Eric! Though I had never heard of Maitland, after checking out the link, I found out I had seen a Maitland trained therapist, though she never actually did any mobilization or manual therapy! Guess that explains a few things…
Hey Eric,
What would you do for someone who has incredibly tight hamstrings as well as an unstable core? I have a friend who does foam rolling as well as some active stretching but his hamstrings are still tight. He is also unstable to the point where single leg work such as non-weighted single leg RDL’s will have him shift to one side. He understands what it means to have good form but he just is unable to do most excercises
It really comes down to regressing him to the point that he can be successful with certain exercises to build stability within the ROM that he has. Also, he may need to be referred out to screen for neural tension.
Just keep in mind that some of these issues take time to address. Be patient and consistent!
I have never had a problem with my hamstrings until I began to train, with a team, for half marathons/marathons. It was not until we had run 23 miles for the first time that my hamstrings started to feel “tight”, which I thought it was just a matter of my body getting used to running that long of a period of time. This was in August of this year.
Since then, I have run a half marathon and a marathon. At one point, I figured it was lactic acid build up from running so long. However, in these passed months, my hamstrings have that feeling.
I do yoga routines specific for hamstrings at times. I stretch, though I heard that is not good, I have also incorporated single leg dead lifts, hip thrusts, and hamstrings curls into my work out routine. I even attempt to compress them when I run, but fear that if I run/do drills like I want to, it will just get worse.
Mind you, I have never had hamstring issues before I ran that 23 miler during training. I have had lower back issues about 4 years ago, but I have revived it, so I am not sure if maybe my lower back is not as strong as I thought it was and that is why my hamstrings are acting crazy since that training run?
Help please, its so irritating like you said..just when you think they are better…
Iv learned a bit from reading this and the comments. I tore one of my hamstrings (right one) about 12 years ago playing high school soccer. I did the therapy and everything and got better. I was also a sprinter in track and a long distance runner. A few years after hs I tore my acl playing soccer. I never got it my acl fixed and that was about 5 years ago when I tore my acl. All my injury’s have been from soccer .. I wish I would have listened to my parents and stuck with track lol. Also to add I was very ignorant and never worked out my legs cause I thought playing soccer and running was enough. And I think I am and have been paying the price for skipping the leg workouts in hs. Anyways a few months ago I started running again. I started running a mile on the treadmill I have been trying to hit my goal of running a 5 min mile so far I am around 6:45min mile. I have noticed some imbalances on my body after training again and worse of all my hamstrings hurt both of them its the high up part of the hamstrings like near the butt! And speaking of butt I don’t really have a big one so I don’t know if that has anything to do with the pelvic tilt that is talked about here. But anyways I know I gave a lot of extra information I just wanted to know if there was any advice on getting them to stop that pinching pain. I read on here over stretching them is bad and I am a victim of that! I remember I used to have this massage machine and it would eliminate that pinching pain. But don’t know if that was even safe!
my left hamstring is so tight because i damaged a lower tendon and my inner aductor turned off, and made my hamstrings clench. these excercise are great! thanks so much. these will be helpful.
This was an amazing article. I am 32 yr old female with the lousy posture you mention early on. I’ve been seeing a chiropractor for about a month and a half to improve posture, and my hamstrings have been hurting more. I sit at a desk all day but am still active. The exercises you post are great. I will mention this article to my dr and see if some of your recommended exercises are something I can do 🙂
Hi,
thanks for this article; it seems that I have “truly tight hamstrings”. I couldnt quite get the best treatment for this cause from the article.
I think you recommend:
– stretching for the posterior hip
– stabilization work at adjacent joints
– training hip flexion above 90 degrees
– chop and lift exercises
What about stretching the hamstrings?
Also, I’m unfortunately a bit lost regarding concrete examples of the above recommendations; there is one video posted in the “truly tight hamstrings” section; I guess it shows stabilization work, right?
hey, i did a bunch of the exercise from the first one and now my core/hips/back are all messed up…i thought maybe i had protective tension because i appeared to have an anterior pelvic tilt and really tight hamstrings…now i’m sitting on my tailbone and my back is rounded out, my glutes and lower abs are falling off my hip bones…any idea what i could’ve done…are there exercises to reverse what i did? please help, it’s causing me serious distress.
Very informative article. Several years ago, I popped my hamstring off the bone, it took a year plus to find a dr to do the repair. I just started rehab when I was in a car accident so that rehab was put on the back burner while I took care of accident injuries. The hammy is a little tight at time and rolling out helps.
Bur I notice when I do a squat, even though my head thinks I’m going down the same on both legs, when I look in a mirror it’s obvious the the good side goes down about 3-4 inches lower.
This past month, I’ve been recovering from rotator cuff surgery and just hanging out on the couch. Now I notice my hammy is really sore. I haven’t worked out other than walking from bed to the couch, fridge or bathroom.
Any suggestions for easy stretches the traditional ones just hurt too much
Definitely get up and more around more! Sitting (especially if you do so in anterior tilt) will exacerbate proximal hamstrings issues. Just moving around will make a big difference, as it promotes blood flow to the area and reduces the progression of degenerative changes.
Awesome article. I train with kettlebells and working with both a trainer and Physical Therapist, but still struggling to treat this feeling of tight hamstrings and while doing heavy deadlifts, felt a popping sensation. No pain, nothing tore. PT says Hamstrings are not the source, unstable SI is causing it. Doing PT exercises, using a SI belt, but cannot get over the tight feeling the hamstrings. Just wondering if there is anything else I can do. If it’s not the hamstring itself, will stabilizing the SI relieve that tight feeling and until then, how do I train when it feels so tight. I guess i’m afraid something will tear…am I overthinking it?
It’s extremely tough to say for sure what’s up with you without evaluating you in person and asking more about your history of symptoms, activities, etc. Could be a tissue quality thing, or poor stabilization elsewhere.
As usual, we will be cross-posting this link and quoting liberally from this for a future BALL lesson on basic hamstring care…*one* of the key takeaways from this article (for inexperienced yet eager athletes – typical BALL folks) is the need for pre-warm up foam roller work. Is this a fair statement, or would you modify it?
Eric,
What about extreme right hamstrings due to bilateral pelvic tilt and flatback/cspine best ways to stretch? Return the pelvis some dregree?
Thanks.
During Pilates, i popped my hamstring off the bone. It took a year to find a Dr willing to re-attach. By that time it was nearly a 1/3 down my leg. It was re-attached with 3 screws
We had just started rehab when I was in a car accident. Naturally those injuries took priority and the hamstring fell to the wayside.
So I do have a tight hamstring. Didnt realize how tight until I was doing squats in the mirror and I thought felt they were equal the good leg goes down a good 2-3 inches lower than the tight one. I try to stretch it daily with a yoga strap but I fell I’m missing the spot.
June 12th, 2012 at 9:50 am
Nice, Eric.
June 12th, 2012 at 10:18 am
A thought provoking post. And as usual very thorough and informative. Almost everyone that walks in my door complains of “tight hamstrings,” and most don’t actually have a hamstring strain or tear, though it might feel like it to them at times. The actual reason for “tight hamstrings,” is as individualized as the athlete that walks in the door. This post will be a great resource, putting the most common issues with hamstrings and corrective techniques all in one place! Nice work Eric.
June 12th, 2012 at 10:29 am
Great post!!! Did you get a chance to read the manuscript that Mal McHugh and I published “The Role of Neural Tension in Hamstring Flexibility.” You would enjoy reading the discussion of the paper. Keep up the great work!!!
June 12th, 2012 at 11:11 am
I would guess that most strength/power/speed athletes with hill sprints, especially uphill, would not have a heel strike, but would naturally adapt to or continue a fore-foot strike.
The hill running study abstract did not mention specifics: if the runners were untrained or trained, sprinters or distance runners or fore-foot or rear-foot strikers?
June 12th, 2012 at 12:15 pm
Great write-up. I’ve dealt with my share of hamstring issues since 2007 and know #4 all too well. Thought I’d share my experience. In ’07 and ’09 I suffered strains to my left hamstring. The first took about 8 weeks to recover. The second injury was much more severe, took two years before I was pain free. The latter injury was a pull at the gluteal fold, like you mentioned. Left hip was in extreme flexion and abduction. Heard a pop, felt it go from medial to lateral. At that point it was a “dead muscle” followed by much bruising. You’re right, I haven’t been the same on that leg since. What I do find interesting, in comparison to what you wrote, is that my left hamstring is not “tight” anymore. It’s actually more lax than before the injury. Another result of this particular injury is that my left glute is more developed than my right. Athletes should also be aware of the how injuries like this change little things; how we walk, movement patterns, how we sit. Things that can cause other imbalances. I didn’t realize these things until nearly two years later. I have a slight torso imbalance to correct because the injury caused me to lean over to once side while sitting due to pain. My right hamstring became tighter because of favoring one side and now have experienced two minor strains in my right hamstring in the past 18 months.
Again, thanks for the write-up, as usual this is very useful information that I can use to help me “get right” eventually.
June 12th, 2012 at 1:42 pm
Big help here, as I just strained my hamstrings sprinting a few weeks ago.
Thanks EC.
June 12th, 2012 at 1:51 pm
Eric,
Similar to 3, but would you recommend someone to examine their hamstrings if you are noticing the “butt wink” at the bottom of a squat?
What else, besides hamstrings which is my first supposition, could be causing this?
June 12th, 2012 at 2:33 pm
Nice work!
1. Protective Tension of the hamstrings
I’ll start the show and go system next week. how do I include the rehab protocol, reverese 1-leg SLDL ect?
June 12th, 2012 at 4:41 pm
Geir,
Show and Go wasn’t intended to be a rehab protocol. Are you actually in pain, or just working to correct an anterior pelvic tilt?
June 12th, 2012 at 4:45 pm
Josh,
Hamstrings wouldn’t necessarily be the big culprit; if you think about it, you’d need to have the hip flexed and knee extended to really be “running out” of hamstrings ROM. It has more to do with the constant positioning of posterior pelvic tilt than the hamstrings actually being short/stiff; we get “stable” in the wrong position.
Check out this great blog from Zach Moore on the topic:
http://zmoore.com/case-study-how-to-improve-positioning-in-the-bottom-of-a-squat/
June 12th, 2012 at 7:31 pm
Eric,
I’m usually in 100% agreement with everything on your site, with that said, I can’t agree with the statement of “needing to eliminate the eccentric portion to eliminate stress on the hamstring.” While it is true that this may eliminate stress, it is building inherent instability into the hamstring. The hamstrings are the major decelerator of the lower extremity (mainly in men) so when we eliminate the eccentric load in early rehab of acute injuries we set the hamstring up for re-injury down the road. Still worship this site though!
Beau
June 12th, 2012 at 7:41 pm
Eric,
nice point about not static stretching the Hamstrings too much. Especially in the ACL population we want some strong hamstrings as well as a neutral pelvis. That anterior tilted pelvis can bring the knees in genu valgus.
Also liked the point of distinguishing between neural tension and hamstrings tightness. Stretching a short nerve isn’t always the most pleasant feeling(ie: It feels like hell) and we know techniques such as flossing might be an effective way to lengthen nerves without the pain.
June 12th, 2012 at 8:05 pm
Beau – thanks for your contributions. That said, we’re talking about 2-3 weeks of training, not the long haul. This really has more to do with maintaining some semblance of a training effect while an athlete is on the shelf and doesn’t have a large pain-free exercise pool from which to draw. Training the hamstrings eccentrically means lengthening the injured tissue under load – and while it certainly has benefit, pushing too hard too soon also obviously has drawbacks. Better safe than sorry, right?
June 12th, 2012 at 10:12 pm
Eric, Great article. Thank you for your informative and down to earth approach to these injuries. DO you approach ‘hamstring health’ the same with your post-op ACL using hamstring grafts? Also, your point about testing these folks on an straight leg raise, I would imagine they lie in anterior tilt – and not posterior. So if the pelvis starts in “neutral” I dont see how that first 1/3 of movement that you see comes from posterior tilt. Thank you again!
June 12th, 2012 at 11:18 pm
Another great article Eric.
Along the lines of #2 for many of my athletes with “tight” hamstring I have focused more on releasing of the hip rotators with some PNF and fascial stretching. Concurrently the hamstrings seem to release as well.
June 13th, 2012 at 5:19 am
Agreed!
June 13th, 2012 at 7:08 am
Adele,
Yes, a lot of these thoughts can be directly applied to the hamstrings graft folks (for some Tommy John Surgeries, too).
I’m not quite sure what you’re asking with the second part of your comment/question. Could you please clarify?
Thanks!
June 13th, 2012 at 9:05 am
How about an obvious reason no 6: Weak hamstrings not strong enough to cope with sporting demands
June 13th, 2012 at 11:44 am
Excellent info Eric. Too much focus is placed on quad dominant movements by beginners and ignorant trainers, leading to imbalances. Great post!
June 18th, 2012 at 1:58 am
excellent exercises. infact all these workouts are ancient things takenaway by the so called modernaisation.
July 5th, 2012 at 7:19 am
Really comprehensive post, I particularly like that you mentioned neural tension coming from the sciatic nerve.
July 5th, 2012 at 5:39 pm
Hey Eric, im not sure if you will ever read this, or if you get alot of this, if its the second, im sorry.
But if you got the time; I have a pretty bad anterior pelvic tilt, and i would really love if you would share what you teach your students to do, the other 23 hours of day?
July 6th, 2012 at 5:43 am
T – You have to make them constantly aware of how they’re standing/sitting. Activate anterior core, glutes, and deep neck flexors a bit more – and focus on getting the shoulder blades to sit back a bit more without pulling aggressively into depression.
July 6th, 2012 at 5:51 am
Thank you, Jeremy. It’s an important one that consistently gets overlooked.
July 10th, 2012 at 8:01 pm
Im sure you get alot of request, but i would be very gratefull if you would write something about how to stand and walk to fix pelvic tilt, as im gonna start the neanderthal work out this week.
July 20th, 2012 at 12:45 pm
So what can be done to reduce neural tightness? I’ve had two lumbar microdiscectomies and definitely have residual tightness (very positive slump test) but have never gotten much mileage from neural flossing, foam rolling, or static stretching. PNF works short term but is gone in a few hours or overnight so no lasting ROM changes.
July 20th, 2012 at 1:27 pm
John,
Could be a number of things….positional instability, a nerve that’s hung up, or just some of those neural issues needing time to resolve on their own. Have you seen a Maitland provider? They tend to be great with radicular symptoms. http://ozpt.com/index.php
July 21st, 2012 at 1:53 pm
Thanks for the input Eric! Though I had never heard of Maitland, after checking out the link, I found out I had seen a Maitland trained therapist, though she never actually did any mobilization or manual therapy! Guess that explains a few things…
July 23rd, 2012 at 5:12 pm
Hey Eric,
What would you do for someone who has incredibly tight hamstrings as well as an unstable core? I have a friend who does foam rolling as well as some active stretching but his hamstrings are still tight. He is also unstable to the point where single leg work such as non-weighted single leg RDL’s will have him shift to one side. He understands what it means to have good form but he just is unable to do most excercises
July 23rd, 2012 at 8:12 pm
Sean,
It really comes down to regressing him to the point that he can be successful with certain exercises to build stability within the ROM that he has. Also, he may need to be referred out to screen for neural tension.
Just keep in mind that some of these issues take time to address. Be patient and consistent!
November 23rd, 2012 at 5:37 am
I have never had a problem with my hamstrings until I began to train, with a team, for half marathons/marathons. It was not until we had run 23 miles for the first time that my hamstrings started to feel “tight”, which I thought it was just a matter of my body getting used to running that long of a period of time. This was in August of this year.
Since then, I have run a half marathon and a marathon. At one point, I figured it was lactic acid build up from running so long. However, in these passed months, my hamstrings have that feeling.
I do yoga routines specific for hamstrings at times. I stretch, though I heard that is not good, I have also incorporated single leg dead lifts, hip thrusts, and hamstrings curls into my work out routine. I even attempt to compress them when I run, but fear that if I run/do drills like I want to, it will just get worse.
Mind you, I have never had hamstring issues before I ran that 23 miler during training. I have had lower back issues about 4 years ago, but I have revived it, so I am not sure if maybe my lower back is not as strong as I thought it was and that is why my hamstrings are acting crazy since that training run?
Help please, its so irritating like you said..just when you think they are better…
November 25th, 2012 at 5:29 pm
Niesha,
Have you sought out the assistance of a physical therapist? Self-diagnosis is tough to do with any injury, and certainly a chronic one like this.
December 26th, 2012 at 10:59 am
Iv learned a bit from reading this and the comments. I tore one of my hamstrings (right one) about 12 years ago playing high school soccer. I did the therapy and everything and got better. I was also a sprinter in track and a long distance runner. A few years after hs I tore my acl playing soccer. I never got it my acl fixed and that was about 5 years ago when I tore my acl. All my injury’s have been from soccer .. I wish I would have listened to my parents and stuck with track lol. Also to add I was very ignorant and never worked out my legs cause I thought playing soccer and running was enough. And I think I am and have been paying the price for skipping the leg workouts in hs. Anyways a few months ago I started running again. I started running a mile on the treadmill I have been trying to hit my goal of running a 5 min mile so far I am around 6:45min mile. I have noticed some imbalances on my body after training again and worse of all my hamstrings hurt both of them its the high up part of the hamstrings like near the butt! And speaking of butt I don’t really have a big one so I don’t know if that has anything to do with the pelvic tilt that is talked about here. But anyways I know I gave a lot of extra information I just wanted to know if there was any advice on getting them to stop that pinching pain. I read on here over stretching them is bad and I am a victim of that! I remember I used to have this massage machine and it would eliminate that pinching pain. But don’t know if that was even safe!
December 30th, 2012 at 12:19 am
My Dad ended up with an artificial hip because of poor hamstring flexibility. He was active. But never stretched because it hurt his ego.
January 24th, 2013 at 5:33 pm
my left hamstring is so tight because i damaged a lower tendon and my inner aductor turned off, and made my hamstrings clench. these excercise are great! thanks so much. these will be helpful.
March 5th, 2013 at 7:41 am
This was an amazing article. I am 32 yr old female with the lousy posture you mention early on. I’ve been seeing a chiropractor for about a month and a half to improve posture, and my hamstrings have been hurting more. I sit at a desk all day but am still active. The exercises you post are great. I will mention this article to my dr and see if some of your recommended exercises are something I can do 🙂
March 5th, 2013 at 5:35 pm
Thanks, Kelly!
March 20th, 2013 at 2:46 am
Hi,
thanks for this article; it seems that I have “truly tight hamstrings”. I couldnt quite get the best treatment for this cause from the article.
I think you recommend:
– stretching for the posterior hip
– stabilization work at adjacent joints
– training hip flexion above 90 degrees
– chop and lift exercises
What about stretching the hamstrings?
Also, I’m unfortunately a bit lost regarding concrete examples of the above recommendations; there is one video posted in the “truly tight hamstrings” section; I guess it shows stabilization work, right?
Thanks a lot!
April 9th, 2013 at 12:12 pm
hey, i did a bunch of the exercise from the first one and now my core/hips/back are all messed up…i thought maybe i had protective tension because i appeared to have an anterior pelvic tilt and really tight hamstrings…now i’m sitting on my tailbone and my back is rounded out, my glutes and lower abs are falling off my hip bones…any idea what i could’ve done…are there exercises to reverse what i did? please help, it’s causing me serious distress.
April 10th, 2013 at 6:04 am
Joe – this is not a rehab plan. You need to seek out a qualified medical professional to help you work through your issues.
April 10th, 2013 at 6:05 am
Joe,
This isn’t a rehab program; it’s an informational article. I’d encourage you to seek out a qualified medical professional in your area.
April 15th, 2013 at 8:16 am
Very informative article. Several years ago, I popped my hamstring off the bone, it took a year plus to find a dr to do the repair. I just started rehab when I was in a car accident so that rehab was put on the back burner while I took care of accident injuries. The hammy is a little tight at time and rolling out helps.
Bur I notice when I do a squat, even though my head thinks I’m going down the same on both legs, when I look in a mirror it’s obvious the the good side goes down about 3-4 inches lower.
This past month, I’ve been recovering from rotator cuff surgery and just hanging out on the couch. Now I notice my hammy is really sore. I haven’t worked out other than walking from bed to the couch, fridge or bathroom.
Any suggestions for easy stretches the traditional ones just hurt too much
April 16th, 2013 at 7:08 am
Debbie,
Definitely get up and more around more! Sitting (especially if you do so in anterior tilt) will exacerbate proximal hamstrings issues. Just moving around will make a big difference, as it promotes blood flow to the area and reduces the progression of degenerative changes.
May 3rd, 2013 at 3:06 pm
Hi Eric,
Awesome article. I train with kettlebells and working with both a trainer and Physical Therapist, but still struggling to treat this feeling of tight hamstrings and while doing heavy deadlifts, felt a popping sensation. No pain, nothing tore. PT says Hamstrings are not the source, unstable SI is causing it. Doing PT exercises, using a SI belt, but cannot get over the tight feeling the hamstrings. Just wondering if there is anything else I can do. If it’s not the hamstring itself, will stabilizing the SI relieve that tight feeling and until then, how do I train when it feels so tight. I guess i’m afraid something will tear…am I overthinking it?
May 5th, 2013 at 6:49 pm
Victoria,
Thanks for the kind words.
It’s extremely tough to say for sure what’s up with you without evaluating you in person and asking more about your history of symptoms, activities, etc. Could be a tissue quality thing, or poor stabilization elsewhere.
May 6th, 2013 at 9:27 pm
As usual, we will be cross-posting this link and quoting liberally from this for a future BALL lesson on basic hamstring care…*one* of the key takeaways from this article (for inexperienced yet eager athletes – typical BALL folks) is the need for pre-warm up foam roller work. Is this a fair statement, or would you modify it?
Ted Browne
Beyond Athletic Life Lessons (BALL)
May 24th, 2013 at 8:17 am
I need more information on tight hamstrings.
August 21st, 2013 at 2:41 pm
Eric,
What about extreme right hamstrings due to bilateral pelvic tilt and flatback/cspine best ways to stretch? Return the pelvis some dregree?
Thanks.
September 20th, 2013 at 8:03 am
During Pilates, i popped my hamstring off the bone. It took a year to find a Dr willing to re-attach. By that time it was nearly a 1/3 down my leg. It was re-attached with 3 screws
We had just started rehab when I was in a car accident. Naturally those injuries took priority and the hamstring fell to the wayside.
So I do have a tight hamstring. Didnt realize how tight until I was doing squats in the mirror and I thought felt they were equal the good leg goes down a good 2-3 inches lower than the tight one. I try to stretch it daily with a yoga strap but I fell I’m missing the spot.
Any suggestions
September 20th, 2013 at 8:15 am
thanks i have assess & correct its very good