As a physical therapist working for the past decade, I have heard this phrase time and time again from clients, patients, and athletes that I’ve treated. How could it be that some people “Just have tight hamstrings”? I never really bought into this theory that one was could just be born with chronic hamstring tightness and that it could be prevalent in so many individuals. Throughout my career, I have found specific trends that can lead to chronic hamstring tightness, pathologic movement patterns, and eventual injury in the form of back pain, muscle strains, and lower leg/foot pain.

Stabilizing Resting Tension of the Hamstrings

In the above picture, notice the excessive arching of his low back as he tries to kick his leg backwards into hip extension. This demonstrates a lack of anterior core stability requiring the hamstrings to counter-act the anterior tilt of the pelvis.

Here, the hamstrings are required to constantly contract at a sub-maximal level to prevent excessive arching of the low back, and create a relative posterior pelvic tilt maintaining a suitable alignment. In this situation, the hamstrings will never fully relax or lengthen to their full potential, leading to over-use injury, and increased risk of hamstring strains.

By assessing this dysfunction, we need to address the lack of anterior stability. By training a client to use their anterior musculature to maintain a neutral spine whether they are walking, running, or lifting. In the picture on the Left, notice the client is unable to stabilize his core while performing the dead-bug exercise, however with proper cueing in the picture on the Right, he is using his abdominals to maintain a neutral spine while dynamically moving his extremities.

Below, the Goblet squat is used to train the client to use his core stabilizers to maintain proper spinal alignment. In the picture on the Left, the hamstrings are forced to maintain tension against an arching back, while on the Right, the spinal alignment has been corrected.

Hamstring Versus Gluteal Dominance

People generally present with either hamstring or gluteal dominant movement patterns. By this, I mean that when a person is pushing through their leg, either to squat, step-up, or similar motion, they will recruit primarily either their hamstring or gluteal muscles. Ideally, we would like to see clients use the bigger, stronger, more advantageous gluteal muscles for such actions, however this is frequently not the case. Unfortunately, we frequently observe gluteal muscles that have shut down due to pain, poor core stability, or muscle tightness.

If pain is present, this must be addressed prior to strengthening of the gluteals. We cannot strengthen the gluteals if painful, as the body will compensate to avoid further pain, limiting our ability to correct a poor movement pattern.

Hip flexor tightness can create a phenomenon called “reciprocal inhibition” in which the opposing muscles are shut down by the nervous system (in this case the gluteals) while tension persists in the flexors. In order to counter-act this, the hip flexors must be released and/or stretched back to their normal resting state seen below.

When flexibility has been addressed, we need to begin “neuromuscular re-education” and train the glutes to become a dominant structure for leg propulsion. Various exercises have been demonstrated to be affective in increasing gluteal activation versus hamstrings. Bret Contreras, Strength and Conditioning Specialist, has thoroughly researched the hip thrust exercise seen below. This exercise has been shown to isolate glute activation at high levels of maximal voluntary contraction, while minimally recruiting the hamstrings musculature. As the hips are brought into increasing extension, the glutes are required to perform more work, while due to continued knee flexion, the hamstrings remain ineffective in assisting with the motion.

The cure for your “chronic hamstring tightness” begins with correcting these muscular imbalances and training the body to move properly once again. At SRC, our therapists will take the time to assess and correct various movement patterns, including patterns like I’ve outlined above, to create biomechanical balance and more importantly, prevent injury with your active lifestyle.

Feel free to call us at 855-437-6444 or email me at dave@sportsrehabconsulting.com for additional information.

Author: Dave Cimino, DPT, SCS, CSCS