Hamstring tightness appears to be an epidemic with the patients we see in outpatient physical therapy. I don’t know how many times I have had a patient who states “my hamstrings have always been tight”. Decreased hamstring flexibility can occur for many reasons, including:
- Inherent stiffness of soft tissue- these people generally are “stiff” throughout their body
- History of trauma to the hamstrings musculature- chronic soft tissue tightness post-injury as people fail to regain normal extensibility of the muscle and scar tissue builds up
- Secondary to neurological history. People with lumbar disc injuries have decreased flexibility of the nervous system secondary to nerve compression (from discal pressure or inflammation), affecting the nerves to move in the leg and appearing as hamstring tightness. Other diagnoses, such as spondylolisthesis, generally include tight hamstrings
- Compensation patterns secondary to a low back pain history. These individuals have been taught that bending their back is harmful and they stay more erect during functional squatting activities and obtain tight hamstrings over time
Are you experiencing body inflexibility or hamstring tightness in your day-to-day activities? Contact Life’s Work Physical Therapy in Portland, Oregon, for an effective diagnostics and treatment evaluation.
During a squat (lifting a box off the floor, or going from sitting-to-standing from a chair), we require ample hamstring flexibility in order to decrease the stresses on our low back. During a squat, proper technique has you bend forward at the waist and sitting back, which places your hamstrings on a relative stretch. When you are unable to do this action due to tight hamstrings, you either have to excessively flex at your low back, or stay more erect and bend your knees far over your ankles to squat down. Poor squatting technique does the following to your body:
- Staying more erect with your back during a squat:
- Knees shear forward over your toes, placing an increased shear and compressive stress on your knee joints
- Increases the demand on your quadriceps (front of the thigh) muscles, increasing stress in your kneecap (patellofemoral) joints
- Forces you to excessively extend (increased lordosis) in your low back, decreasing core stabilization and compressing the posterior portion of your spine that is not made to bear significant weight
- Decreases the ability to use your glutes and hamstring muscles effectively, making you overuse the quads and back muscles to perform the lift.
- Bending forward at your back during the squat:
- Decreases effectiveness of your hamstrings and glutes to produce power for the lift
- Increases pressure in your lumbar discs
- Forces the lumbar musculature to become a primary lifter, instead of the leg muscles
Learning how to effectively squat requires a mirror, a chair behind you (in case you fall backwards), and a stick. Once a patient is ready to embark in squatting, I routinely take them through these steps, which helps gain dynamic hamstring flexibility and an understanding of proper technique prior to functionally progressing the squat with weight or other squatting exercises.
- Stand and face the mirror sideways, with the stick going down your low back (the stick should touch the back of your head, your mid-back, and your tailbone).
- Find a neutral spine of your pelvis (not all the way arched, not fully flat-backed); tighten your core (kegel contraction, if familiar).
- Maintain this stick position during the entire exercise
- Bend forward at the waist, keeping your knees straight and weight back on your heels. Bend forward until a stretch is felt in your hamstrings (behind knees, or mid-thigh posteriorly).
- Sit back, as if sitting DEEP into the chair, keeping the weight back on the heels (you should be able to tap your toes up/down the entire squat)
- Keeping your core contracted, rise up by FIRST pulling your knees straight and staying bent forward at the waist
- Lastly, rise up tall by using your glutes and hamstring musculature
- When you are all the way up, your core should still be contracted and the stick STILL touching all three points of your body.
I understand that we functionally don’t squat with our weight back on our heels; we first learn to crawl before we walk. After you master this technique, then we learn how to keep the weight on the balls of the feet while squatting, and combining all the steps into one functional squat motion, THEN learn to do it without the stick.
Squatting is essentially for performing daily activities- from standing up from the couch or toilet to picking something up off the floor. Hamstring flexibility is important for this, allowing you to place the majority of the lift on the parts of the body made to be powerful, such as your glutes and hamstrings, without overusing your quadriceps or back muscles.
At Life’s Work Physical Therapy, our expert team clinicians utilize a holistic approach to uniquely diagnosing, treating and strengthening your body from injury while self-empowering our clients to maintain a healthier, pain-free lifestyle. Don’t take our word for it – our statistics and testimonials prove that we have the highest patient satisfaction rate among other physical therapy clinics! Contact us today to schedule an appointment.