Video and Transcript: Four Exercises to Address Hamstring Tightness

Hi, everyone! Dr. Orit Hickman here from Pain Science Physical Therapy.

This video is going to address the complaint that a lot of patients have for hamstring tightness. There are actually three common reasons why patients will experience hamstring tightness, and we’re going to address all three, each with a specific exercise. So, the-the patients that come in typically will think that their hamstrings are tight because the muscles themselves are tight. And, when we say a muscle is tight, we mean that the muscle has gotten short, so the length of the muscle is not long enough. 

So, the most common way that you would address this is by stretching the hamstring muscles, hamstrings can feel tight for two other reasons. One can be that the sciatic nerve, which travels down the back of the leg, can be irritated or sensitive to stretch. So, that’s a common reason for patients to experience what they feel is hamstring tightness, and it’s really sciatic nerve irritation. The third is hamstring muscle weakness. The hamstrings can get tight or feel tight because they’re actually not very strong. 

So, we’re going to address all three of these reasons today. If you try any of these three exercises and you find [yourself saying], “Oh, I feel like my hamstrings are tight, but when I do nerve gliding exercises, they actually feel better,” then your cause is probably not true muscle tightness. It’s probably related to nerve irritation. So, again, we’re going to address all three of these common complaints today with just three specific exercises.

The hamstring muscles come from the back of the end of the pelvis and come down the back of the leg behind the knee. So, the most common way that patients will stretch the hamstrings is that they will have their legs straight out in front of them or use a strap to stretch the leg. So, I’m going to grab a strap, and I’m going to show you-I’m going to show you… Actually, I’m going to show you-I lied. I’m going to show you two different stretches for the hamstrings. So, if the hamstrings are tight, you can kind of lean forward in sitting. And, a lot of times, patients will say, “Oh, my hamstring muscles are really tight, and I can feel that stretch.” To stretch a muscle, you want to hold it for about 20 to 30 seconds. Try not to bounce. You’re just gently holding that stretch. So, I’m just leaning forward to feel a pull behind this muscle back in here. 

The other way that patients will do this, or that we instruct patients to do this, is by using a strap. So, I’ve got a strap behind-on my-on my foot here, and I’m just stretching and pushing that heel up to the ceiling to get a pull behind the hamstring muscle. And, the goal here is to keep my back as out of this activity as possible, so that’s why laying down is really nice because, a lot of times, when patients do this stretch, when you do this stretch in sitting, patients will kind of round their back and lean forward. You don’t need to do very much to get a stretch in this muscle. If you sit up nice and tall and just lean forward slightly, you’ll get a stretch. So, again, I ended up showing you two stretches for the hamstrings muscles. When you stretch, you’ll hold for 20 to 30 seconds. You repeat this a couple of times. Maybe do this one to two times a day. 

So, that’s one of the reasons that hamstring muscles can feel tight. The other can be sciatic nerve irritation. And, I’m going to just show you one exercise for the sciatic nerve. If you check out, I have another video on nerve glides. I have one in sitting and one in laying down for sciatic nerves. Address those-use those exercises if you find that this nerve glide actually really does help because it then means that your sciatic nerve is irritated and it’s not liking being stretched versus the hamstring muscle being tight. 

So, for this sciatic nerve glide, what I would do is I’d have you lay-you can start with both knees bent, but, as it feels like it’s comfortable, you can straighten out the leg that you’re not gliding. You’re going to hold behind the thigh, and you’re just going to lift and lower the bottom leg. And, as you can see, this is not a stretch. I’m not holding this for any length of time. I’m just moving the leg, and I’m doing this [for] about five to ten repetitions. I’ll still feel it kind of pull behind my leg, but the test will be if I go to sit up and move around, if my leg feels less tight, like-then I can say, “Oh, okay. Maybe, maybe the reason I’m feeling tightness is actually not due to muscle tightness, but it’s actually due to nerve irritation. 

So, I just-I jumped ahead there. One of the things that you can do is, if you suspect that your hamstring tightness is because of a nerve, then, you know, I can lean forward and go, “Oh, it feels really, really tight behind my hamstring.” Let’s say I stretch it, and it doesn’t change much. Then, I can lay down. I can do nerve glides [for] five to ten repetitions just like this, up and down with that lower leg keeping that foot relaxed. And then, you can go to sit up again, bring that leg in front, lean forward, and go, “Oh, I can get further. Huh. I guess it wasn’t my hamstring. I guess it was my nerve.” That’s a way that you can test and see.

The third exercise might not feel like it gives you an immediate result, but, again, the underlying reason could be hamstring weakness. And, we do tend to, as a population in the United States, we have-most of our jobs are sitting jobs, so our hamstrings don’t get a lot of work because we’re sitting around a lot. And so, strengthening them can be beneficial. They’re very, very important muscles for sit-to-stand activities and just standing in general. Because of their attachment to the back of the pelvis, they help to hold you up. 

So, one of the exercises I like to use-and I’m going to show you this today with a small weight. I’ve got a small kettlebell. It’s about 10 lbs. But, with this exercise, what you do is you stay standing nice and tall, and you keep your back straight, and then you hinge at your hips. This is called a deadlift. 

Now, when I do this, I don’t know if you can see this, but my knees are not locked straight. They’re slightly bent. My feet are about hip width apart. My trunk-my core muscles are very nice and stable and controlled so that I can keep my back in a neutral position. And, again, I’m just going to hinge. I’m going to hinge from my hips. So, when I do this, I’m not rounding in my back. Right? This is a no-no. I’m keeping my tailbone slightly lifted to the sky, and I’m just moving my spine as a unit. So, the-really the only thing that moves right now is that my hips slide back just ever so slightly, but this is not a large motion. I’m not going very far. Right? I’m leaning forward slightly, and then I’m coming up from that position. 

I’m going to show you what this looks like from the front. Okay? So, again, my feet are about hip width apart, I’m holding the bell, the kettlebell, in front. I’m keeping my core nice and tight [and] my shoulders just gently down and back. My knees are slightly bent, so they’re soft. And, I’m coming forward. I’m hinging forward. And then, I’m coming back up. 

I don’t know if you guys remember [that] they used to have these little birds that had fluid on one end, and the bird would kind of [teeter-totter sound], these glass ball birds. And, that was kind of-that’s kind of what I think of when I-when I think about my body. I go, “Okay. I’m just hinging at my hips as I come down and come back up.” 

I’ll just show you one more time. I’ll show you from this other side as well, so you can see in all directions. Right? Core is tight, shoulders down and back, light weight in hand, and I’m just doing a deadlift. We call this a Romanian deadlift. So, just a slight hinge and back up again. 

And, the longer-the more you do this, you can start to feel it. You can feel your back muscles start to engage with this. Your butt muscles get engaged and your hamstring muscles because the hamstrings are really, really key for pulling that pelvis and spine back up again. But, it’s a wonderful core exercise as well. And so, if you’re experiencing chronic hamstring tightness, it can be because the hamstrings are weak. This is a simple exercise to start working with.

None of the things that I’ve shown you today should cause any pain. They should change things, and, again, you have an option here to try three different things to see: am I dealing with hamstring muscle tightness, sciatic nerve irritation, or hamstring muscle weakness? If you try any of these things and you find that you sort of hit a roadblock, I’d recommend that you meet with a physical therapist to get a better sense of what’s causing my hamstring tightness.

I hope that this was a helpful video. Please feel free to leave any comment below. Give me a thumbs-up if you thought it was great and please subscribe to get more videos like this one. And, I hope you have a great day!