Here’s how you do it. Tight hamstrings can contribute to lower back pain. Improve movement quality (learn to move from the hips and re-activate the glutes). As your hamstring relaxes, slowly move closer to the wall or doorframe. 2010;90:438-449, Tabary JC, Tabary C, Tardieu C, et al. The sensation of “tight hamstrings” can lead to low back pain, postural dysfunctions, as well as general pain. Tight hamstrings and lower back pain are one in the same, they are a pain in the butt! For the athlete with ‘tight hamstrings,’ learn to incorporate a proper warm up that includes dynamic movements and short duration stretching (if warranted) that will improve mobility and movement quality without a decrease in performance. If you do have low back pain that is caused by inflamed nerve roots, then your pain will only increase if you perform a straight leg maneuver. Now does this mean we should never stretch? But when a trainer told me that I should actually pay more attention to my hamstrings, things started to make a lot of sense. However, nowadays the tides are turning in how we approach the body in this manner. “It’s important to include both of these actions when training your hamstrings.” He recommends doing seated or lying leg curls, but also hip extensions like through a Romanian deadlift. Interesting read. To stretch or not to stretch: the role of stretching in injury prevention and performance. While lying on your back, relax your muscles and have a friend raise one of your legs as far as possible without your knee bending. There are definitely some athletes who would benefit from a certain amount of stretching and mobility work in order to improve their flexibility, get into better technical positions, and move more efficiently during their training and competition. Journal of Physiology (London). All rights reserved. A review. Well+Good decodes and demystifies what it means to live a well life, inside and out. 1991;14:250-255, Kokkonen J, Nelson AG, Cornwell A. If you’re suffering from chronic lower back pain, stretching should be used intelligently especially when dealing with symptoms such as sciatica or hip pain. A constant posterior tilt will force the back muscles to overwork. Standing Hamstring Stretch Stretching your hamstrings, glutes and hip flexors can help to keep your back, hips and knees healthy. Just a bit of caution. It could very well be possible with enough time and repetition. Hamstring Stretch in Doorway : This stretch should be performed very gently in a pain free range. If you do a simple Google search, you could easily come up with a number of studies that link low back pain with ‘tight’ hamstrings.1-4. Many people exposure to a lower back pain or sciatica, can now take advantage to minimize their injury by focusing on regular hamstring stretches exercises. 1072;224:231-244, Gossman MR, Sahrmann, Rose SJ. Mobility is different. When a muscle or group of muscles like the hamstrings are stretched (like when you lie on your back and a friend pushes your leg to the sky) there are some short-term changes that occur. “Pilates hamstring exercises on the reformer and Cadillac are ideal for finding balanced hamstrings,” says Bloom. This is why your low back or legs feel “stiff” after sitting all day in a chair but the if you get up and walk around for a few minutes you feel much better. “They ask for evenness, stability, and range of motion that creates healthy hamstrings and a pain-free back.” Of course, if you’re not around Pilates equipment, you can turn to regular hamstring curls at the gym. The Ultimate Guide To Finding Your True Strength, I’ve heard it time and time again like a record on repeat from patients, “My doctor told me I need to stretch my hamstrings because they’re causing my low back pain.” The idea that low back pain is caused by tight hamstrings and stretching them is the solution to fixing the injury is one held by many in the medical and physical therapy profession. I’m going to clue you into a little secret: most elite athletes have very abnormal traits that give them the ability to do things most of us ‘normal’ people cannot. If an athlete is unable to perform this portion of the clean due to excessive hamstrings tightness, we can then look into using different stretches to address the problem. © 2020 Well+Good LLC. The pain is worsening because the inflamed nerve is being stretched during this maneuver. Here’s the kicker, this isn’t the case. Thixotropic changes in human muscle stiffness and effects of fatigue. The second and more probable theory for how flexibility is improved through stretching is by a change in sensation. All three originate from the sitting bones in your hips, though the biceps has two heads and the other originates from the back of … There was no difference in the muscle stiffness between those with ‘tight’ hamstrings and those in the low back pain group. When low back pain begins, the patient may put a stretching program into action by stretching the hamstring muscles in the back of their thighs. What may surprise you is that there is a way to improve your flexibility without any stretching at all! J Sport Rehabil. Preventing lower back pain Tight hamstrings reduce the mobility of the pelvis, which can put pressure on the lower back. Back ad hip extensor activies during trunk flexion/extension: effects of low back pain and rehabilitation. J Athl Train. Acute muscle stretching inhibits maximal strength performance. But, it’s not unusual to experience lower back pain right after static stretching. Theoretically, there are two ways we can improve flexibility. Remember “muscle length testing” was developed years ago based on the idea that there is a “normal” or ideal range of muscle length for optimal movement and safety. A prospective study of back pain in young men during their military service. Blindly stretching away an athlete’s hamstrings stiffness with long duration stretching just because he or she appears “abnormal” on paper is not always a good idea. Passive energy return after repeated stretches of the hamstring muscle-tendon unit. Stretching has so many restorative benefits. After sticking your spoon into the bowl and stirring it around however it becomes more gel-like. 2006;6:87-91, Kundson D, Magnusson P, McHugh M. Current issues in flexibility fitness. If you need to prop up and modify the pose a lot in order to tolerate the pain… 2009; 106: 1249-56, Common Running Pains: How To Treat Them - Aktiv Intel, How to Correctly Treat Piriformis Syndrome. There is a growing amount of research lately showing that this type of stretching before exercise can lead to a decrease in strength, power and speed, therefore limiting an athlete’s performance.19,28 Basically, long duration stretching deadens an athlete’s natural set of ‘muscular springs,’ which means Jim could potentially hinder his ability to lift big weights if he stretched like some would advise! Jim has great hip mobility and coordination of his core stability and posterior chain muscles, and can show great looking technique during his barbell lifts of the clean and snatch. Next, we need to make sure the lower back is loose and mobile, after all, its where the nerve originates from. Kind regards, Does Stretching The Hamstrings Fix Low Back Pain? J Physiol. If the stretches cause pain, you likely have hamstring tendonitis. Regardless of how long these changes last, the improved range of motion always returns back to ‘baseline.’. The following stretches can gradually lengthen and reduce tension in the hamstring muscle, and in … Instead, I urge you to go about addressing what you find in these athletes in a different manner than we have in the past. Doing the same thing over and over again and expecting a different result. In the strength & conditioning and fitness world, stretches are used to promote better quality movement, increase performance and limit injury risk. Fun, Because It’s Been a Year, We Asked a Dermatologist to Answer the Most-Googled Skin-Care Questions of 2020.  Weakness in the hamstrings can lead to all sorts of problems and affect daily activities. Sadly, overall mobility of the hip joints becomes worse. A generalized warm up (where you elevate your heart rate and improve blood flow to your muscles) is recommended for all athletes before training or competition to promote this thixotropic effect. Journal of Exercise Science & Physiotherapy. The hamstrings in both the flexible group and ‘tight’ group showed a similar ‘defensive reaction’ as the they were stretched. Alston W, Carlson KE, Feldman DJ, Grimm Z, Gerontinos E. A quantitative study of muscle factors in the chronic low back syndrome. Similarly, try your regular hamstring stretches before and after to see what changes. Med Sci Sports Exerc. Those with low back pain had the lowest hip range of motion via the SLR test (even worse than those with just ‘tight’ hamstrings). As someone who still struggles to stand properly (it’s true), I’ve developed all sorts of muscle pain—especially in my lower back. J Am Geriatr Soc.1966;14:1041–1047. Simply put, if your hamstring is too tight, your knee will have a … And here are some yoga twists for lower back pain that can also help. Read our Privacy Policy and Terms and Conditions. I always knew about flexibility/activity relation, and there is no one size fit all flexibility default. When you peal back the lid, the yogurt is sometimes clumped together. The causes of back pain are many and various. Modify the pose to accommodate any pain or joint issues. Thixotropy is the ability of a tissue (like muscle) to become more pliable or liquid after motion and return to a stiffer gel-like state when resting. Keep it going and Educate the community!! One of the most common assessments performed in doctor’s offices across the world to assess hamstring flexibility is a passive straight leg raise (SLR) test. Effects of static stretching on the maximal length and resistance to passive stretch of short hamstring muscles. Tight hamstring muscles are actually a common contributor to lower back pain, but can be treated at home with a little knowledge and a few stretches. Love what you guys preach and teach! We were taught in school that this means the person has ‘tight’ or short hamstrings. Very refreshing to read and also a great to get these insights confirmed via science and reasearch. If you are giving a stretch just for the sake of stretching, you have already failed your client/athlete. Research has shown that we can decrease our muscles level of stiffness (and therefore increase elasticity and flexibility) through a dynamic warm up! I have been attempting to stretch with maybe slight progress. Hamstring stretches also strengthen the back extensor muscles to keep the spine from excessively flexing. Although article have good insight, I have a query regarding “Duration of Stretching” as Kisner Colby recommends about 60 seconds for having good results. 2018;28(3):794-806, McHugh MP, Cosgrave CH. The first model is called the mechanical theory. However, while ‘tight’ hamstrings may be a common finding in those with low back pain, I’ve come to find in my years of treating patients as a physical therapist that it is NOT a direct cause. This is an example of a thixotropic effect and just like the spoon stirring up the yogurt, your body’s muscles become more less stiff and become more movable in response to movement. There are three theories under this model that try to justify the changes in flexibility. J Sports Rhabil. Does this mean we should automatically prescribe hamstring stretches for this athlete? The constant pull of these tight muscles forces the lumbar spine into a forward bent posture, this is BIG problem during physical activity. I am yet to find a decent way of stretching without causing lower back pain later on. We must first discuss the difference between flexibility and mobility. Yet again, the changes we find in improved flexibility with stretching programs even up to 8 weeks in length are not because we are actually lengthening the muscle fibers but instead due to the change we create in how we perceive and tolerate the force of a stretch.26,36. Hamstring Stretching Exercises. Tightness of hamstring and psoas major muscles. ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription. Moderate-duration static stretch reduce active and passive plantar flexor moment but not Achilles tendon stiffness or active muscle length. Health care providers usually describe these symptoms as radiculopathy, or inflammation of a specific spinal nerve root (e.g. The most obvious effect is improved flexibility (meaning you have more range of motion and can lift your leg higher during the next stretch), however this effect doesn’t always last very long. This isn’t to say that those who participate in extremely rigorous stretching programs for years and years (such as those in gymnastics or ballet) couldn’t alter the extensibility of their muscles. Relationship between mechanical factors and incidence of low back pain. Unfortunately, almost all of the studies published on the effects of stretching have only lasted between 3-8 weeks in length. For example, one research study showed that the improved hamstring flexibility seen after 5 rounds of a stretching protocol only lasted for 6 minutes!34 At 32 minutes after the stretching had stopped, the muscles had completely returned to their pre-stretch suppleness. Yes, it could! Scand J Med Sci Sports. 2002;32(9):447-60, Leinonen V, Kankaanpää M, Airaksinen O, Hänninen O. Med Sci Sports Exerc. This difference was attributed to a heightened arousal or sensitivity to movement that occurs in those with back pain. Spine. 2000;32:1160-1164, Weppler CH, Maggnusson SP. Strengthening and stretching … Tight hamstring muscles are a common contributor to lower back pain. What you’re feeling when you warm-up is a “thixotropic” affect. Without a balanced position of your pelvis and proper support from the muscles in the area, low back pain is possible. This, in turn, pulls the low back out of alignment by flattening its normal lordotic arch which can overstretch and or weaken your back muscles. However, if you took Jim and without looking at the quality of his movement and had him perform the SLR test, you may find he has relatively ‘tight’ hamstrings as he is unable to lift his free leg straight past 80 degrees. If you’ve ever had an issue with your L3/S1, these types of hamstring stretches will irritate the hell out that area. Stretching the hamstrings is also beneficial. Try to keep your back with a neutral arch. Duration of stretching effect on range of motion in lower extremities. JOSPT.                   “When assessing the patient’s straight leg raise, they were unable to raise either leg past 70 degrees. Other more extensive stretching protocols however have shown that the effects of stretching can last anywhere from 60 to 90 minutes!23 This means the amount of time spent stretching and the length a stretch is held both have an effect on how long the short-term benefits of improved flexibility are seen. Every aspect of a training or rehab program has a purpose. Scand J Med Sci Sports. Let’s now switch gears and talk about why so many of us are quick to stretch the hamstrings, especially for those who have back pain. Treatment For most people, using the RICE method (rest, ice, compression, and elevation) for … Pain in your back during the exercise means that your spine has flexed excessively or too soon. Here's the other but though, You can easily correct your issue and fast. The three step process for fixing back pain: The first is one that we have discussed briefly in prior blog articles. Review of length-associated changes in muscle. Back and hip extensor fatigability in chronic low back pain patients and controls. The further their legs were stretched, the more electrical activity rose in all of the hamstring muscles. Stretching is used to improve flexibility. The semimembranosus, semitendinosus and biceps femoris are the three different parts of the hamstrings and where they attach on your body may be key to back pain. Most medical books on the topic of stretching would have you believe increases in flexibility are often due to the mechanical model and the muscle itself is actually lengthening when stretching. A mechanism for altered flexibility in human skeletal muscle. 2. I’ve tried a lot of things to deal with this lower back discomfort—which makes me feel more geriatric than I truly am—from trying a posture trainer to doing all sorts of back-strengthening workouts. The hamstrings are a group of muscles that extend from your hip to your knee, along the back of your upper leg. Experimental evidence and clinical implications. […] University has an amazing article on lower back issues due to […]. Phys Ther. This concept is based on the idea that if improved range of motion is seen after stretching, it can either be due to increased muscular length or decreased muscular stiffness. “You can use hamstring exercises to train the hamstrings to be even, both in length and in strength and both from right to left and within each hamstring group,” says Bloom. 1984;9:106-119, Halbertsma JP, Göeken LN. 2010;20:169-81, Kay AD & Blazevich AJ. 2001;36(1):44-48, Magnusson SP, Aagaard P, Nielson JJ. The reason? Focus on those hammies, and you’ll wind up complaining less and less about that much-dreaded lower back pain. The hamstrings work closely with the glutes and quads to move the legs. In: Vleeming A, Mooney V, Dorman T, Snijders C, Stoeckart R, eds. Not at all. This means we need to stretch the hamstrings as a part of the rehabilitation plan to decrease the back pain.”. The researchers concluded that this decreased range of motion was only due to the hamstrings and did not have to do with any pelvic tilting or back mobility issues. Hamstring stiffness returns more rapidly after static stretching than range of motion, stretch tolerance, and isometric peak torque. 2000;3(9):1-8, Moller M, Ekstrand J, Oberg B, Gillquist J. I also suffer from lower back pains during the outdoor rides. (crossfitter in Netherlands), Very helpful and informative. 2006;2:3-12, Magnussson SP, Simonsen EB, Aagaard, P, et al. 2012 Jan; 44(1): 154-64, American College of Sports Medicine. Post was not sent - check your email addresses! Over the past few decades there has been a tremendous amount of research published demonstrating the effectiveness of stretching in both the medical and strength & conditioning fields.12-22 But how does stretching really work? Focus on those hammies, and you’ll wind up complaining less and less about that much-dreaded lower back pain. … If your neck or shoulders are in knots, try shoulder flossing to stretch them all out. Mobilizing your lower back … Sure. Hamstring stiffness returns more rapidly after static stretching than range of motion, stretch tolerance, and isometric peak torque. Been struggling with hamstrings for a while, Reading into the matter and seeing a sports doctor and phys.therapist. Mobility should always be evaluated before flexibility. If your neck or shoulders are in knots, try … Over the time, the compensation for the tight hamstring puts our lumbar spine and our lower back muscles in great disadvantage and risk for pain and injuries. When they are loaded with tension they have the ability to explode with power and propel your body down a track or a barbell over your head with tremendous force. For example, during the first pull portion of the barbell clean, the hamstrings are lengthening as the hips rise faster than the knees extend. Searles says it’s equally important to work on different functions of your hamstrings, too. Bad hamstring stretches can potentially irritate the low back by causing excessive lumbar flexion, which is a curve of the back is rounded. 2017;18:1-23, Lakie M, Robson LG. This exercise will help you develop awareness of excessive spinal flexion during daily activities. So the key is really working to balance out your muscles by strengthening the hamstrings so that your body doesn’t have to turn to the lower back to do a bunch of movements. One major importance of Stretches the hamstrings muscle, to improve the muscle flexibility and it’s strengthen, which will lead to relief the lower back pain. J Sports Rehabil. Archives of Physical Medicine and Rehabilitation. Let’s take the example of Jim the national level Olympic weightlifter. 2016;34(23):2155-2159, Freitas SR, Mendes B, Le Sant G, et al. The latest research has shown that much of the short-term increases in flexibility comes from the improving your stretch tolerance (or pain tolerance) and NOT by actually increasing your muscles length!24-26, 36 Basically after stretching your hamstrings for a few sets of 30 seconds, you have more flexibility because of your ability to tolerate a greater amount of stretch before you tap out! The combination of the general and specific warm up are key for improving flexibility, mobility and movement quality to help an athlete perform at their best and be as safe as possible. 2017;18:1-23, Haab T, Wydra G. The effect of age on hamstring passive properties after a 10-week stretch training. If you ask him to bend over and touch his toes he will perform what looks like a barbell RDL without any weight in his hands because his body has been programmed to move correctly about the hips over and over again in the gym. L5 radiculopathy). Rounding my back not having my knee flat. Also the electrical activity they did record did not increase at the same gradual pace as those who were pain free. Muscles forces the lumbar spine school that this means the person has ‘tight’ short... This occurs because their lower back pain after stretching hamstrings system is going haywire due to the wall doorframe! Has yet to find the answers for this question the Camel pose the! 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Al, et al i am yet to find the answers for this?! All, its where the nerve originates from free movement extensor muscles to.... Back pain.” yet to find the answers for this question pain that also. … stretching has so many restorative benefits and resistance to passive stretch of short hamstring muscles run through the of. Ad hip extensor activies during trunk flexion/extension: effects of fatigue support the. ’ ll wind up complaining less and less about that much-dreaded lower back most of. Lumbar spine into a forward bent posture, this is BIG problem physical...