With back pain, one of the most common recommendations I see out there is that 'tight' hamstring muscles are one the main causes and they need stretching out. In this article I am going to be looking at how effective this actually is, I will be looking at the research carried out into this area and also see if there is anything more effective we can do to help with back pain.
Many years ago, when I worked at a well known health club and when I was on my first training course as a Pilates instructor (which wasn’t as good as I had hoped) we were taught how to test the hamstring muscles. Lying on our backs with our legs straight on the floor, another instructor would hold our ankle and just above our knee and then proceed to lift our leg straight until a restriction was felt. If the leg could only go to 80 degrees or less, then it was assumed the hamstrings were 'tight' and need a good old stretch out. We were taught this was extremely common with individuals with back pain. So off we went back to work in the gym carrying out this simple but effective (we hoped) test.
Did it work? Not really. Whilst having some saying a little bit of stretch felt nice, I can honestly say it rarely made any difference to any individuals back pain.
So this led me to look further into this.
Before I go any further, I am sure (and hope) you wouldn’t just take the word of an article on the internet such as this one. Therefore here are the following research papers I have looked at on the subject (I have included links at the end, should you wish to read in full):
· “No difference was observed between LBP (lower back pain) and asymptomatic (no pain) volunteers in hamstring tightness”.1 Read full research article here
/· “There is no evidence to recommend hamstring extensibility interventions (passive stretching) as a means of reducing pain”.2 Read full research article here.
· “Nerve mobilization is superior to hamstring stretching in alleviating lower back pain of patients”.3 Read full research article here.
An important point to mention is the actual effectiveness of stretching. I won’t go into great detail (as that will probably need another article or two!) but another research paper looked at how long stretching increased flexibility for. The answer... 6 minutes! “Our findings suggest that a sequence of 5 modified hold-relax stretches produced significantly increased hamstring flexibility that lasted 6 minutes after the stretching protocol ended”.4 Read full research article here.
Over the years of treating people for back pain, and soon realising the hamstring stretching give little relief, I decided to take different approaches. Generally I found the following to be more successful:
· The feeling of hamstring 'tightness' was just that, a feeling. The hamstring area felt tight but was in actual fact fatigued (tired), usually due to weakness in the hamstring muscles.
· Hamstrings were actually feeling 'tight' due to tension in the sciatic nerve, rather than an actual short or 'tight' hamstring muscle.
· Biomechanics of pelvis and hip had more of an influence to lower back pain and improvement was felt once corrected, as opposed to stretching/massaging the hamstrings.
· Eccentric strengthening (Strengthening whilst lengthening) was more effective than simple stretching.
These are the main factors I find when treating people for lower back pain, but there can be other factors and sometimes it can be a combination of the above. These were most common factors I see in back pain.
If you have being stretching your hamstrings to help with back pain, but you finding little relief, it might be worth looking at what other areas could be causing your back pain, in most cases (but not all, of course) I have found activation of hamstrings and correcting the biomechanics of pelvis to be most effective.
Here are some short video’s I have made for more information on this subject.
Time to stop stretching hamstrings.
Hamstrings. Are they really 'tight'? Or just tired?
What to do if your hamstrings are really 'tight'?
Should you have any further questions please feel free to get in touch or comment below.
About the author
I am a Manual Therapist covering a range of different disciplines including massage & Biomechanics. I also run small specialist Pilates classes around Corfe Mullen, Broadstone, Wareham, Wimborne & Poole. Instead of just purely rubbing the pain, I always look to see if I can find a potential cause (or causes of the pain) and then work on treating this.
Pilates Instructor & Therapist, helping you understand why we do what we do!