The dreaded hamstring strain usually happens at the worst possible time. I can’t count how many times my hamstrings have told me, “Not today.” It wasn’t that long ago that I strained my hamstring jumping in the pool with my sons. It could happen at any time, and for me, embarrassingly, it happened in front of my kids who had a good laugh at my painful expense.
But hamstring strains can and do happen when you’re pushing your performance limits. It’s best to prevent a hamstring strain, but if it’s too late or it becomes chronic, physical therapy is necessary. Luckily, if you have hamstring problems, we can refer you to a PT.
Here, Dr. Bo Babenko, PT, DPT, and Dr. Dan Swinscoe, MPT, CSCS, who have over 30 years of PT experience, detail how to recognize and treat hamstring tightness. Before we get into that, a little background on the hamstring muscles.
Hamstring anatomy and function
Hamstrings are a group of three muscles located at the back of the thigh: biceps femoris (long and short heads), semitendinosus, semimembranosus. They begin at the lower part of the back of the pelvis and insert medially and laterally below the knee on the fibula and tibia.
Exclude the short head of the biceps femoris, which begins at the bottom of the femur.
The main functions of the hamstrings are:
- Hip extension: Squats, deadlifts, hip thrusts.
- Hip hyperextension: Kickback in the buttocks.
- Knee flexion: Variation of hamstring curl.
How do you know if you have a hamstring strain?
If you’re like me, you’ll understand after you rub it a few times. But if that’s not the case, Dr. Bo will let you know.
“The simplest clinical test I use is to have the client sit face up or on their stomach, bend their knees at 90 degrees, and ask them to hold the hamstrings strong to see if they feel pain or weakness. It separates the strings.It indicates hamstring tension.
The hamstring in particular has three main parts, so any slight tension can be compensated for by other aspects of the surrounding muscles. If you put the strain on one, the other two can do most of the work. Pain should be your primary guide, but your physical therapist’s assessment should help guide you to more specific next steps.
You can often tell by feeling an unusual tearing sensation during exercise, but even simple hamstring tasks, such as kicking off a shoe with one foot, can cause continued pain. ” Babenko explains.
How to treat hamstring tightness and prevent it from happening
“If you have tension, resting and allowing it to heal should be your main focus. Respect your body’s healing time. For grade 1 strains, it can take up to 6 hours before the healing rate returns to around 90%. It takes about a week. Some are faster, some are slower, based on many variables such as age and diet. To make sure the exercises you introduce are safe and won’t cause you any further harm. It is important to receive an accurate diagnosis.
When working with these clients, I constantly communicate and introduce new exercises very gradually to avoid further tearing of the fibers.
Training your adductors and abductors will strengthen your hamstrings. Another basic rule I have is to avoid “stretching” or lengthening. This can cause further damage and slow or reverse some of the healing process. ” Babenko said.
Above is a late-stage stretch that Dr. Bo uses on clients to stop hamstring tightness.
Swinscoe explains that when hamstring tightness persists, there’s usually something more to it.
“When a simple hamstring strain becomes chronic, or when hamstring stiffness becomes chronic, it usually means the problem isn’t the hamstring; it’s where you feel it. The problem is in the upper part of the pelvis.
For example, if you do sports activities such as sprinting, your back will arch, which is normal. It is the abdominal wall that stabilizes against it, or should.
Still, if it’s not, you’ll need to substitute something, and that something could be your hamstrings. The hamstrings can tilt the pelvis in the same way as the abdominal wall, so if this problem persists, the abdominal wall may need education in motor control rather than strength. ” Swimskow explains.
The two exercises in the video above provide all the “education” you need.
Straight from the horse’s mouth, this is it. If your hamstring problems persist, don’t hesitate to seek the help of a physical therapist. They don’t just inflict pain for fun.