Tight hamstrings? Or something else...

​One thing we always test when assessing any lower body problem is the ability to lift a straight leg up into the air when lying down on your back.  We check the patients ability to do it on their own and we also check how far we can raise it.  More often than not the response we get when the back of the leg starts to feel tight is "my hamstrings are really tight".

Although yes this is one reason, we find it is by far not the only one.  In fact we find that the hamstrings are "tight" (we will get to what tight actually means later ) however there are other more relevant issues that limit this movement.

The first one is pain.  This could be in the lower back, the pelvis, the back of the knee or in other muscle groups apart from the hamstring (like the glute or the calf).  Pain itself will limit movement but even if you are moving through the pain, you need to recognise that pain with this kind of activity that isnt a stretchy pain isnt normal.

The second one is restriction in other areas.  The straight leg raise requires movement through more structures than just the hamstring.  If you have tightness in your gasstroncnemius (calf), back of the knee, gluteals or lower back muscles then it could limit you.  Also if you restriction in your knee joint, hip joint, pelvis and lumbar spine then it could also reduce your range.

So what can you do to see if you have an issue.
1.  Do you have pain during this? (apart from the pain of a muscle stretching for the first time in years)
2.  Is there a difference between the two sides?
3.  Do you feel the tightness any where apart from the back of the thigh?
4.  Is there a big difference between how high you can lift it yourself (without using your hands) vs how far you can stretch it with a towel or belt?

If you find the answer to any of these is yes then theres a good chance that there is an underlying issue that could cause you problems down the track (or is already part of the issue with the problems you already have).

And a last note on what "tightness" is.  The term tight is a fairly general term and can mean several things.  Each with its own way of managing it.  A shortened muscle from disuse needs to be stretched with long holds, restrictions in the joint may need dynamic stretches or treatment for the joint, a muscle can be tight because it is overactive or hypertonic.  This may be more about a weak muscle than a "tight" one.  There are other reasons but thats just a quick note on what tightness may or may not actually be.

So next time you try and stretch out your hamstring pay more attention to what you are feeling.  It may tell you a lot about what's happening in your lower body.