Monday, March 9, 2009

Achy Hamstrings

Achy Hamstrings

I am sure most of you have, at one time or another experienced achy hamstrings. Hamstring trigger points elicit a very annoying, dull, achy pain, often in the gluteal region, down the back of your thigh, and my all time favorite, the back of the knee.

Hamstring trigger points are often exacerbated with walking, rising out of a chair, or sitting. The pain can also make sleeping difficult.

Some common causes of hamstring trigger points are weak gluteus maximus muscles, compression of the muscle at the front edge of a chair, lying in bed or sitting for long periods with knees bent, riding a bike with the seat too low, and swimming the front crawl.

If your gluteal muscles are weak, the hamstring become taxed, as they have to work harder than usual to help extend your thigh (normally a job done primarily by the gluteus maximus, and aided by hamstrings and adductor magnus, which is an inner thigh muscle. This is a good reason to keep your gluteals nice and strong –not to mention a perky butt!

Compression and lack of oxygen to the hamstrings is a very common side effect of prolonged sitting, especially in a chair with a hard, squared off front edge. Solid wood kitchen chairs with no padding are a prime example. This affects shorter people more (and children), because their feet cannot touch the floor, so the entire weight of their legs is pushing into the front of the chair.

Patio furniture is another common culprit in compressing the hamstrings, even in taller folks. Patio chairs made with a metal frame, covered with soft fabric or plastic lining will sag when you sit in them, causing your hamstrings to be squished by the metal frame.

Using a footrest to take the pressure off your hamstrings will help – you can use a phone book, pillow, rolled up towel, whatever works! It is a good idea to use booster seats for small children on hard kitchen chairs, so that they can sit in the booster with their feet on the seat of the chair for support.

Keeping your hamstrings in a shortened position for prolonged periods can also flair trigger points. Lying in bed sick for a few days, curled up in fetal position is a sure fire way to experience hamstring pain. Long car and airplane trips are hard on the hamstrings also, so try to get up and move around as frequently as possible in situations like this.

With spring just around the corner, we will all be hauling our bikes out of the garage. Please check to be sure that your seat is high enough. I often see people cycling down the road and want to roll my window down and tell them to raise their seat. When sitting on your bike, your leg should be almost but not quite straight when bottom pedal is at 6:00 and the top pedal is at 12:00. You need a slight bend in the knee, just to reiterate.

Tight hamstrings can also lead to low back pain. Because the hamstrings attach to the ischeal tuberosities (sit bones), at he back of the pelvis, they can pull the pelvis backward, causing the lumbar spine (low back) to be stretched and flatten the natural curve of the low back. In order to maintain balance, your head moves forward. Other muscles are then activated to maintain this posture, such as the quadratus lumborum muscles in the low back, lumbar spine erector muscles, and even the abdominals. These muscles in turn become overworked and develop trigger points. Guess where they refer? Yup, the low back.

This is one reason why I often also work hamstrings when someone comes in complaining of low back pain. If you focus only on the low back muscles, the pain may ease temporarily, but unless you relax the pull on the pelvis, those low back muscles will just tighten up again.

The bathtub is a great place to stretch your hamstrings. The warmth of the water will ease tension, and relax you in preparation. Sitting in the tub with your legs out in front of you, flex your feet and lean your upper body forward over your legs, just until you feel a gentle sensation in the back of your legs. Hold there, breathing, letting gravity take you slowly further into the stretch. When you no longer feel the stretch, come back up for a second and then repeat. Remember to keep your stretching gentle. No pain no gain is not a motto for proper stretching!

Another great way to stretch your hamstrings is lying on your back, with affected leg stretched up (you can use a strap or belt to help, as shown in the picture, or hold your leg at calf or ankle with your hands). The goal is to straighten and lengthen your leg, relax, breath, and take your time.

If someone you know is feeling pain in the hamstring area, please share this article with them. Their problem could be resolved with nothing more than a footrest or a higher bike seat!


The Right Fit - Specialized Fitness Programs said...

Thanks for your advice on hamstrings - I have been experiencing discomfort low in the hamstrings ...almost at the back of my knees. It has made it very difficult to do any hamstring contractions and I even notice it in bed when trying to move the covers with my legs. From what I read, you are suggesting doing more stretches and massage. Should I avoid trying any more strenghtening exercises until this settles down?

Denise Mackinnon, RMT said...

I would find a good trigger point/massage therapist, and have the hamstring worked on first. Hot baths or hot tub and I would recommend active range of motion over stretching. Avoid exercises that isolate the hamstrings at the moment (curl machine), and be careful of any activities or movements you are doing which might cause you to hyper-extend at the knees. If you are female, but lay off the heals for now if you wear them.

Anonymous said...

Ouch! I have a disc and hamstring strain. I've been seeing a chiro for a week and feel better after. However by nighttime I awake w/ pain as if no treatment has been this normal or should I be looking for other treatment? I've taken Motrin prescribed by MD, now Alleve, physical therapy only gave me stretching exercises... Any other suggestions would be helpful!

Denise Mackinnon, RMT said...

Be patient! Your body needs time to heal itself. Do the exercises your physio suggested in the evening, and don't push into pain. Only go as far as is comfortable.
I hope you are feeling better soon!

Karen said...

Hi - I have a job where I sit all day and spend a lot of time in the car commuting back and forth to work. I have been getting achy hamstrings and went to the doctor, and he did a bunch of bloodwork to rule out illness. I ride my horse 3 times per week but it is really hard to consistently get exercise b/c of my job. I appreciate any suggestions you may have. I think your post about the hamstring being deprived of oxygen b/c of the chair feels right to me. I am fine walking and with my legs raised.

Denise Mackinnon, RMT said...

Hi Karen, sorry it has taken me so long to reply!
My first thought reading your post was that horse riding might be exacerbating your hamstring issue. When you are riding, with your feet in the stirrups, the hamstrings are slightly shortened and active the entire time. This combined with the sitting and driving might just be aggravating latent trigger points in your hamstrings.
Try using a foam roller, Kong dog toy or tennis ball to do some self massage through the hamstrings. Yoga and massage therapy might help also.

Lee said...

I'm suffering a bit at the moment after doing three hikes and nearly thirty miles in the last week. I find that maintaining my legs in a bent position helps.

Philstar said...

I have just had spinal surgery three weeks ago. I am feeling pain in my legs as you have described. Walking of course helps.

What is a foam roller? Perhaps I should buy one to help me get through this.

Christina said...

For the past couple of days my hamstrings have been aching painfully as if Ive over stretched them, but in truth I hardly workout.. I woke up one morning from a dream that I was running to or from something and they have been hurting ever since... At the moment I am sick with a headache, nausea, and achyness. I feel horrible, woke up the same way, just felt sick from this morning. I read somewhere these are linked but not sure... Help?

Denise Mackinnon, RMT said...

Hi Christina, it is very difficult to say what is causing your hamstring issue, without an assessment, as there are many possibilities. It is possible that you were tensing your muscles during your dream. It is also possible that you are experiencing aching muscles due to the flu. Another possibility is that, if you have been lying on your side with your legs bent (fetal position), for a day or two due to the flu, that this position has caused them to shorten and tighten a bit. It could be something else entirely!
If the issue doesn't resolve on its own within a few days, I would recommend going to see your MD, or physiotherapist, have an assessment done, and try any treatment or home care he/she recommends.

Anonymous said...

I have high hamstring tendinitis and it won't heal. I can't jog and have constant ache at the base of my bum. I've been told not to stretch and to isolate the glutes and hamstrings to strengthen them, is that correct? I'm seeing a physio now whose massaging my hamstring's and trigger points. How long do you think it'll take to heal and what do you suggest to help them heal?

Denise Mackinnon, RMT said...

I agree with what you have been told. Add a bit of stretching to the hipflexors (iliopsoas muscles) and quads bilaterally. The body heals in its own time - impossible to give you a timeline without knowing more - your physio should be able to provide you with that info.

Kimberly said...

Thank you for your post. I have been suffering with pain behind my knee for nearly 1 year, which my doctors think is hamstring tendonitis. It started when I pulled my hamstring dancing and it never healed properly. I stretch regularly and have tried 3, 6-week courses of Physio with different therapists but nothing helps. Sometimes it goes away for 1-2 weeks at a time but returns often for no specific reason and when it does, I have serious pain behind my knee, when sitting, standing, walking or lying down. It prevents me from doing almost anything and hurts with every step so I become afraid to walk. The pain is behind my left knee all the way to the lateral side. One doctor thought it could also be popliteus tendonitis. Do you have any advice for me? Thank you.

Denise Mackinnon, RMT said...

Sorry to hear you have had such a long standing issue Kimberly. It sounds like you have been doing things right with the physio sessions etc. Unfortunately these injuries sometimes just take a very long time. One thing that often happens, is once the pain is gone we tend to jump right back into activity like nothing ever happened. This can tax your tissues and possibly cause the issue to flare again. The tissues will need time to lengthen, strengthen and mobilize if you haven't been using them much during recovery. Be patient with healing and also patient with reintroducing normal activity levels.
Don't do things that aggravate it, but do maintain your exercise and fitness levels within pain free limits. Eat healthy (cut sugar out as much as possible), hydrate and be patient. The severity of initial injury can be a factor as well - maybe it was more than just a "pull". Age and overall health can also factor in to your ability to heal. I bruised ribs and sprained a hand on two separate occasions, and both took over a year to completely heal (one hasn't completely healed even after a year - don't think it will on my 44 year old body!)

Danielle Potts said...

Thankyou so much for this post, very informative and really helpful xx

Liz said...

I was walking/race walking a 5 k race March 18. In the middle of my race I felt something pull in the back of my knee and it caused pain when walking so I slowed my pace and was able to finish then race. After the race I iced the whole knee. Now, my hamstring hurts and I have pain behind my knee and have been walking with a limp. It hurts when sitting in a booth and then get up to walk or when I first get out of bed and take the first few steps. Can a hamstring sprain hurt for this long and what can I do to fix it.

Denise Mackinnon said...

Hi Liz, sorry to hear about your hamstring issue. Yes, it can absolutely hurt for this long. Our bodies are amazing at healing, but it does take time, especially with a more serious injury. I would suggest seeing a physiotherapist or massage therapist, or your family doctor to get the injury assessed. Feeling a "pull" or "pop" could mean a more significant injury to the tendon/muscle, and you should have it checked out.