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Hamstring tightness? Should you be stretching or strengthening?

Hamstring tightness? Should you be stretching or strengthening?

Corley McBeth, DPT

Many people struggle with hamstring ‘tightness’ despite regular, sometimes daily, stretching. The tightness never seems to go away. Let’s talk about why this is happening and what you can do about it.

The hamstrings are comprised of three muscles: the semimembranosus, semitendinosus and biceps femoris. They are the primary bulk of muscle on the back of the thigh – originating on your ischial tuberosity (or “sits bone”) and running down behind the knee, where they attach on the bones of the lower leg (the tibia and fibula). This means that the hamstrings cross two joints, the hip and the knee. They are the primary flexors of the knee joint (meaning they bend the knee), as well as secondary hip extensors (meaning they help straighten the hip). The hamstrings also assist in providing rotational control at the knee, in addition to pelvic stability due to their anchoring role at the ischial tuberosities. They also play a role in deceleration when they contract eccentrically (meaning they are contracting while lengthening). This serves to slow the rate of knee extension, such as when you are trying to slow down from running to walking.

When we are focusing on stretching a muscle, it is important to differentiate muscle ‘shortness’ from ‘tightness.’ True muscle shortness is a structural issue related to a decrease in the length of the muscle fibers. Muscles become shortened due to immobilization or disuse, most often associated with casts/braces or non-weight bearing status following an injury and/or surgery. When muscles have shortened in this manner, it is called a contracture.

Muscle ‘tightness’ on the other hand, is neurologically driven and is a sensation associated with a muscle remaining in a contracted or tense state. Often the muscle is receiving input telling it to contract because the body is trying to generate stability. The nervous system may be increasing tone in the muscle as a protective response. The sensation of tightness might lead us to believe we need to stretch that muscle; however, providing input that stabilizes rather than stretches will likely be more effective in these situations.

“Muscle ‘tightness,’ on the other hand, is neurologically driven and is a sensation associated with a muscle remaining in a contracted or tense state.”

 

In many individuals experiencing ‘tight’ hamstrings, the hamstrings may actually be relatively overlengthened for optimal performance of a specific task. To improve postural control at the pelvis and/or knee, the nervous system will send excitatory input telling hamstrings to contract.  Without sufficient tension in the hamstrings (force production), the movement strategy for a particular task will be achieved through compensatory strategies impacting the performance of other muscles such as the abdominals, back extensors, hip flexors, etc. For example, consider lifting a heavy object from the floor using a hip bending strategy (i.e. deadlifting).  Without sufficient tension from the hamstrings, back extensors will create more compression on the spine.  One can debate whether this is good or bad for the back.

“Tight” muscles, despite the fact they are remaining in a relatively contracted state, are not necessarily strong muscles.  It may mean strengthening is the best course.

If you experience chronic hamstring ‘tightness,’ or have a history of hamstring strain and/or low back pain it is recommended to seek out a physical therapist for a formal evaluation. Expert advice based upon your specific experience and goals is very effective. An individualized assessment will help to address your mobility, stability, and overall movement patterns, which will increase the effectiveness of your stretching and strengthening routine.

Corley McBeth, DPT

Why you should be deadlifting

Why You Should Be Deadlifting

By Corley McBeth, DPT

 

There seems to be no exercise more effective than the deadlift in instilling fear in the hearts of patients. I cannot tell you the number of excuses, hesitations, and outright refusals I have heard regarding its performance. It would seem that we still mistakenly believe that the squat is the safest and most optimal way of lifting and moving load (thanks WebMD), but I am here to tell you that just is not the case. Mechanically speaking, the deadlift, when performed correctly, is the proper way to lift – whether it be a case of wine, a heavy moving box, or a piece of furniture. It is the ultimate functional movement.

So why are we so terrified of it? Usually it’s something along the lines of “my back is weak/sore/painful” or “that’s how I hurt myself” or “but I might hurt my back”. However none of those are a good reason to avoid it – in fact, those are all reasons you should be doing it! There are many contributing causes to back pain. Back pain can stem from weak glutes and hamstrings making it difficult to effectively move the load you required of the task. It can also come from weak spinal erectors and/or weak abdominal and pelvic floor muscles. A properly performed deadlift challenges your body to maintain a specific spinal position thereby training it to remain stable when exposed to high shear forces. You will get more benefit from a properly performed deadlift than you will from hundreds of crunches or a 3-minute plank hold.

This is because deadlifts are a total body exercise. Not only does the deadlift help facilitate strong and powerful glute and hamstring muscles and effectively challenge your core, it also places greater demand on the upper body than a squat. Squats don’t have the same effect on your scapula and rotator cuff in terms of stability, nor do they require the same muscle activity from your biceps and latissimus dorsi muscles. Deadlifts are also one of the safest weight lifting exercises to perform – you aren’t going to get pinned under weight or risk getting pulled over backward. They don’t require a spotter, you simply drop the weight if you get into trouble.

That being said, deadlifts, when performed correctly, are not bad for your back. Poorly performed deadlifts, regardless of weight, can place you at risk of injury. One must first have the required mobility as well as the appropriate stability, in order to perform a deadlift with proper form. And no, it’s not just for powerlifters. Deadlifts can be and should be performed by just about everybody.  Sure, you may need instruction and supervision during the learning process. There are many variations and modifications to allow for a safe and appropriate progression to lifting and moving heavy loads with the deadlift. Your physical therapist or other trained fitness professional can help to properly assess and instruct you in the correct performance of this movement (see video below for an example, but please use feedback for practice). Keep doing your squats, but don’t neglect the deadlift – your glutes, hamstrings and core will thank you.