Fixing 'Tight' Hamstrings in Under One Minute

Are your hamstrings tight or just unable to relax? When patients first come into our office many have been told they have 'tight' hamstrings. And surprise, simply stretching the hamstrings hasn't provided great results. What if the restriction wasn't in the hamstring muscle itself, but lied in our nervous systems ability to allow full relaxation of the hamstring muscle.

What Do We Mean by Motor Control Issue?

Let's start by talking about the difference between a soft tissue restriction and and motor control restriction. Soft tissue restriction is pretty straight forward, adhesions/scar tissue/etc in muscles that limit range of motion. Soft tissue restrictions respond well to manual therapy like massage or loaded mobility exercises. 

A motor control deficiency is a bit more complicated but involves improper firing of our nervous system (or neuromuscular system). Motor control deficiencies respond better to exercises that 'fire up' our nervous system and allow our muscles to reach their full range of motion.

The next step is determining if our tight hamstrings are caused by actually tightness in the hamstring muscle or misfiring of our neuromuscular system.

Differentiating Soft Tissue Restriction vs. Motor Control Restriction

Laying on our back, keeping our leg straight, actively lift leg straight up. We should be able to get to at least 90 degrees. If we can't, we follow that up with a passive ROM test. Have someone lift your leg straight up (while you relax leg). We can observe two different scenarios:

  1. No increase in range of motion. If active and passive range of motion is the same, that suggests that the there actually is a restriction in the soft tissues (the hamstrings in this case) and manual therapy to lengthen the hamstring is indicated.
  2. An increase in range of motion with passive range of motion. This suggests that the soft tissue do have the ability to get . If there was an actual restriction in the soft tissues, the passive range of motion would be limited (Scenario 1). Because there is sufficient (or increased) range of motion with the passive test, we are thinking that we have more of a motor control deficiency and finding the right exercise will be more effective.

Fixing a Motor Control Restriction

If determined that the restriction is indeed caused by a motor control restriction we need to implement an exercise designed to 'fire up' our nervous system. This can be done without any attention paid specifically to the hamstrings.

Banded Pull Aparts are an easy exercise to 'fire up' our central nervous system to allow relaxation of our hamstring muscles.

Test/ReTest

As always, to make sure we're not completely full of s*&% we can do an easy test/retest to see if there's any improvement. Here is the difference we discovered with 45 seconds of banded pull aparts (no touching hamstrings!) Went from fingers barely touching to getting entire palm on floor.

 
 
Hamstring Tightness.jpg
 

Evolve Performance Healthcare specializes in improving movement and strength to provide sustainable pain relief. If you have questions or interested to see if we can help, please feel free to reach out.

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