Physical Therapy Corner

Hamstring Stretching - How do I do it?

Types of stretching and a few basic stretches for anyone

Taylor Millican, PT, DPT, ART-Cert. (Left)

and

Gina Pongetti, MPT, MA, CSCS, ART-Cert. (Right)

One of the most frequently asked questions I get from athletes and non-athletes alike is: "How do I stretch?”  Often people have misconceptions on stretching or are confused on the correct form/method so the outcome is they just don’t do it.  There is a great deal of information about stretching and flexibility in magazines and on social media.  Who do I listen to?  Which expert is right?  Which magazine is more reputable?  What kind of information do I value?  How, when, why, …you get the picture.

There are different methods of stretching:  static, dynamic, partner-assisted, neuro-muscular, tool assisted and more.  Not one is necessarily “better” than the other, in general, they are all useful for different reasons.  To simplify the matter – static/passive are held for durations of longer than 30 seconds with no motion or change in position.  Dynamic/active stretches are done in a controlled manner with specific motion/movement.  Typically dynamic stretching is done prior to activity to “warm up” a muscle and prepare it for activity.  Static stretching is done after activity (unless preparing for a flexibility-based sport such as gymnastics, dance, etc.).  Neuro-muscular stretching is a way to confuse muscles to hyper-relaxing, or letting go, and taking up the slack.  Tool-assisted is a combination of tone decrease and muscle relaxation that also helps in recovery, often done with rollers and balls.

If I had to pick one muscle group that stretching would benefit, for the majority of the population regardless of sport or activity level, hands down it would be the hamstrings.  We as PT’s get frequent questions about ways to keep this muscle group flexible- some questions from athletes wanting to get an edge, others after injury, and some to simply relieve pain and stiffness.   Athletes tend to have less hip joint ROM with tightness in surrounding muscles, including the hamstrings, hip flexors and gluteals, and are more prone to injury from this reduced range of motion. People with desk jobs often get sore low backs from tightness from prolonged sitting, and even cyclists, from biking in flexed positions.

To start, here is a quick anatomy of the hamstring group.  It is located in the back (posterior aspect) of the thigh.  It is composed of three muscles: on the inside, the semimembranosus; the middle, the bicep femoris; and the outside, the semitendinosus. All serve slightly different purposes.  Their function, in general, is to flex the knee (bend) and help extend the hip (kick back, if you will).  This muscle is necessary when it is activated for walking and running, and needs to be stretched in order to kick or lift the leg forward.  Thus, is frequently injured in sports.  Dysfunction in this muscle can also affect posture and even cause low back pain. Tightness in this group causes a backwards tilt, or tipping under (posterior tilt) of the pelvis thus reducing the arch/curvature in the lumbar spine (think flattening out the low back).  This can make sitting and standing activities painful and difficult.  The good news is this vital group is actually quite easy to stretch.  Here are some of the best hamstring flexibility exercises:

1. Active/dynamic Hamstring: Start by lying on your back with both legs straight.  Use a strap or towel around one foot to assist in bringing one leg straight up- keeping the knee locked out as high as you can (vertical) without the other leg coming off the ground.  Pause at the top of the movement and then return to the starting position.  Repeat for 2x10 reps.

2. Doorway Stretch (Passive): in a doorway lay so the doorway is to your left with the frame between your hip and knee.  Keep right leg straight and cross left leg over to rest on the door frame- your right leg should remain straight through the doorway.  Hold 30 seconds, rest, and repeat two more times.  Then switch and repeat on right leg.

3. Starter Stretch (Active): Start in a track starting position with knees bent, hands on the ground and in a staggered stance with one foot slightly in front of the other.  Slowly straighten knees but keep feet and hands on the ground.  Go until max stretch and then return to starting position.  Your goal (eventually) is two straight legs, hands on ground, and heels flat, too!  Repeat 2x10 reps.

4. Nerve Glides (Active). Starting position is the same as Stretch #1.  Now, bend one knee, place the towel or your hands behind your thigh.  Simply try to straighten and bent your leg, using your thigh muscles, repeatedly.  You should feel a stretch behind the thigh, and in some cases, to your toes.  Repeat 10x, then switch legs 2-3x through.

5. Square Hip Stretch. Stand in front of a chair or box with your leg straight in front of you.  Your bottom foot needs to be completely straight and not turned out.  Your hips need to be “Square” in alignment.  If you open your hips, you will not feel the stretch!  Make a slight “arch” in your back (chest up, tip hips) and lean forward.  Do not round your back, you will lose the stretch!  Hold for 30-45 seconds.  Switch legs.