Tight Hamstrings Can Cause Lower Back Pain—Here’s What a Physical Therapist Wants You To Do
What are hamstrings, anyway
The hamstrings are a group of three muscles—semitendinosus, semimembranosus, and biceps femoris—that run from your hips along the back of your thighs to your knees, according to the medical information library Statpearls. They're essential for standing, walking, sprinting, and assisting knee mobility. So when they are weak or tight, you might feel it in the lower back. This is because tight hamstrings pull your pelvis backward, making it difficult for the glutes to participate in things like standing and walking, which increases the strain on the lower back, according to Jerome Enad, MD, board-certified orthopedic surgeon specializing in sports medicine. This pulling goes against the spine's natural curvature, contributing to lower back strain. Dr. Enad says this tilt might also reduce the spine's shock absorption, further agitating the nerves in the spine.
Another possible culprit? Hamstrings share some nerves with the back, says Demetris W. Elia, DC. Think of the nerves as interstate highways that run through many body parts. The nerves that control the quads and the hamstrings originate from the low back (lumbar spine), says Dr. Elia. To put it simply, these spinal nerves run from the lower back and connect to muscles in the legs, like the peripheral and the sciatic nerves, he says. When one area has pain or inflammation, it can agitate areas along these nerves, according to the Mayo Clinic. This is not to say that tight hamstrings will always result in nerve pain, but it's another example of how the body is an interconnected system.
What causes tight hamstrings
"Tight hamstrings most commonly result from prolonged sitting at home, at work, and in the car due to the nature of daily life's responsibilities," says Kristen Gasnick, PT, DPT, a board-certified physical therapist specializing in outpatient rehabilitation at Holy Name Medical Center. Sitting for long periods can weaken the hamstrings over time because they are not activated or used as much.
Even though the word "tight" is often used to describe a muscle, in this case, tightness and flexibility are not synonymous. Tightness may refer to the specific sensation of the muscle or the description of the pain that you feel, Alex Tauberg DC, CSCS, owner of The Pittsburgh Chiropractor, says. When you feel tightness, he explains that this is likely the result of hamstrings that need to be strengthened. Individuals that experience tightness may not find relief through stretching alone.
Combatting tight hamstrings with stretches and strengthening is the best way to see improvement, according to Veronica Clark, PT, DPT at Strive Physical Therapy & Sports Rehabilitation. She shared some example stretches and exercises to try, but always consult a professional if you think you may have an injury.
Strengthening exercises
- Supine straight-leg raises: Lay on your back with one knee bent and one knee straight, says Dr. Clark. "Raise the straight leg upward to the height of the opposite knee without bending the leg. Perform 20 to 30 times."
- Bridge: "Lay on your back with knees bent, lift hips off the floor as high as is comfortable without overarching your back and perform 20-30 times," says Dr. Clark. You can hold the position for 5 to 10 seconds each if you'd like additional strengthening, repeat 10 times instead of 20-30 in this instance.
- Standing marches: Stand and march in place. Alternate raising each knee to a 90º angle and return them to the ground, without rounding your back as you lift your leg, Dr. Clark explains Perform 20-30 on both sides.
Stretching exercises
- Hamstring stretch supine stretch: "Lay on your back with a rigid strap (towel, dog leash, etc.) around your foot and while keeping the knee straight pull your leg up until you feel a comfortable stretch in the back of your thigh/knee," Dr. Clark says. "Hold for 30-60 seconds three times."
- Single knee-to-chest: Laying on your back, pull one knee towards your chest to feel a stretch in your buttocks, hold for 30-60 seconds three times on each side," Dr. Clark says.
- Active hamstring stretch: Lay on your back and raise one leg. Grab your thigh underneath and hold it with your hands. Extend the foot upwards via the hinge of your knee. You should feel a comfortable stretch in the back of your thigh. Hold for 10 seconds at full extension and perform 10 times, Dr. Clark adds.
If you're having lower back pain, stretching and strengthening exercises could be one way to explore potential solutions. Remember never to push yourself to do a stretch if you experience pain, and always consult a doctor if you think your symptoms require medical attention.
Standing and walking breaks can also help decrease hamstring tightness, and Dr. Tauberg also stresses the role that strength plays in flexibility and reduced pain. Even though stretching is helpful, strengthening exercises can encourage more muscle growth and increased range of motion over time.
One thing to consider: If you own a massage gun or similar tool, Dr. Elia recommends that you use caution when trying to soothe hamstring or back pain with one of these devices. Repeated impact like this might offer relief in the moment, but it encourages more tightness in the muscle as a response.
If you work a desk job or spend a lot of time in a car, sitting is unavoidable. Everyday life brings a lot of different responsibilities, and sometimes they can strain the body in surprising ways. Ultimately, Dr. Elia recommends that you look at the body as a whole instead of one particular place or muscle. For instance, even if your pain is in your back, the culprit could be something else like your hamstrings. This is because the body is connected, and there is often a chain of events that occur from our daily habits and behaviors.
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