Tight hamstrings? Give me 10 minutes.
What I want to talk to you about today is tight hamstrings and how to deal with them from a brain-based perspective. What has become clear in the research over many years is that whenever we stretch and it feels like we’re making progress, the mental conception that most of us have is that we’re lengthening tissues.
Well, that’s actually not apparently what happens physiologically, because a lot of studies have looked into this. And while we may be able to lengthen tissues a little bit, the primary reason that we can go further into a stretch is neural. In fact, it is basically the brain becoming more accepting of that position. They call it stretch tolerance.
So whenever we look at hamstring tension, hamstring tightness, for whatever reason we’re going to deal with it, a lot of times people focus on what I consider to be the least effective process, which is just stretching the hamstring.
Hamstring tension typically develops as a protective mechanism based on what the brain is experiencing. So what that means then is that we have to take a systems-wide approach, meaning we have to look at the inner ear, breathing, and a whole lot of other stuff if we want to find the primary drivers for the hamstring tension and figure out how to quickly reduce it.
Now, if this sounds interesting to you and you are a movement professional, a doctor, a therapist, a coach, yoga instructor, Pilates instructor, CrossFit, train athletes, whatever it is, if you deal with movement and you’re interested in bridging what you do with modern pain neuroscience and applied neuroscience, click the link, the pinned comment, find an email there. You can contact us or you can schedule a call because we’d love to talk with you, see if what we do would fit with what you need.
All right. So again, let’s get into this. I’m going to give you a little process that I want you to go through. So the first thing that we always do is we assess. I don’t care how you choose to assess. You can have people doing forward bends. You can have them doing active straight leg raises. You can do passive range of motion testing. I recommend that if you’re actually going to be dealing with the hamstrings, you test passive and active ranges of motion, assess where you’re at.
Now, what I encourage you to do is look at like the orthopedic testing literature. Orthopedic testing literature says that if you’re going to, for instance, be testing hamstring flexibility, you should have them do somewhere between 8 and 20 repetitions before you begin any testing, because we want to kind of achieve your optimal range of motion for the day before we begin doing the testing. Then we can have a more concise or clear perspective on whether or not the drills, exercises that we’re using are effective.
So warm yourself up 8 to 20 repetitions. That seems to be the range where most people have gone. Okay, that’s about as far as I’m going to comfortably go right now.
First thing we want to think about then for dealing with hamstring tension is your upper cervical spine, right? Very top of the upper cervical spine and the suboccipital musculature. Whenever we look into some of the research literature, what has been found is that doing suboccipital release work is often as effective or more effective than stretching the hamstrings for improving range of motion. Why is that? Well, whenever we look at the upper cervical spine, it is deeply tied into stabilizing the eyes and stabilizing the inner ear. It’s a many integral connections between the eyes, the inner ear and upper C-spine. So there are a ton of proprioceptive nerve endings in the upper cervical spine. So what we often find in that people that have tight hamstrings is that the tight hamstrings are often overstabilizing the posterior chain of the body because of mild instability in the upper cervical spine, probably because of the visual system or the vestibular system. So first thing you’re going to do, you’re going to test your range of motion, whatever it is. Then we’re going to do some very small upper cervical mobilizations.
You’re going to think about C1, C2. You’re going to be doing a very tight nod. So you’re going to tuck your chin lightly, and that’s the exercise. But I want you to do it repetitively. You’re going to do somewhere between 10 and 15 repetitions, and then you’re going to turn your head to the left slightly, and you’re going to do the same thing. And then you’re going to turn your head to the right slightly and do the same thing. You may want to switch hands. And the reason I have my finger here and my other finger here is I’m trying to guide the motion to just be a mobilization of the upper cervical spine. So again, if I’m here, it’s just a very small tight nod. I’m not doing this. I need to make sure that I’m focusing the efforts in the suboccipital muscles.
After you’ve done that, take a breath, relax, come back, and retest. And if you’re like me, maybe you got a pretty good result from that. First indicator here is that if your hamstrings got a lot looser from working your upper cervical spine, the problem isn’t the tissue. It’s neural. This is what I’m going to keep coming back to.
Now, after we do that, we’re going to now start to include some vision work in this along with some reflexive work for the hamstrings. Often what we see in people with tight hamstrings is that they have an extensor bias in the body, meaning their posterior chain is holding excessive tension, often, once again, because of visual or inner ear issues. So what we like to do is kind of help the brain figure out how to reorganize that tension based off feeling more stable. And how we’re going to do that is we’re going to combine hamstring isometrics with an eye position. The eye position is going to be up.
Whenever I keep my head in neutral and my eyes go up to the ceiling, that facilitates extensor activity in the body. So we’re going to facilitate extensor activity at the same time we’re contracting the hamstrings.
So once again, you’re going to test your hamstring flexibility wherever you’re at. You’re then going to bend your knees. And as I bend my knees, I’m going to begin pulling my heels backwards, right? I’m going to pull my heels backwards into the floor so that I feel my hamstrings contracting. You’re just going to hold that. From there, you’re going to keep your head in neutral. You’re going to take your eyes up to the ceiling. You’re going to hold for five seconds. And you’re going to relax. Close your eyes. Open them. Back up to the ceiling. We’re going to do that for five repetitions the whole time you’re contracting the hamstrings. So don’t lose tension there. So one more time. Eyes up. I’m going to do three reps. Otherwise, you’re just going to sit there and watch me do this. Relax. Shake all that out. And once again, check and see how you’re doing.
So we now have this kind of additive benefit of we have mobilized the upper cervical spine, hopefully made the cervical spine slightly more stable and made your brain more aware of where it is in space. We then have added your visual stimulation along with the hamstring isometrics in order to help the brain again reorganize some of the tension it’s holding. As I said, a lot of times when we see this extensor bias in hamstring tension, it is because the brain feels unstable.
If it feels as if we’re going to fall forward for any reason, it has to engage more tension in the posterior chain to keep us upright. So you can never really separate hamstring problems from the eyes, the inner ear, and the upper cervical spine. So those first two iterations of things I find to be super, super helpful for a lot of people.
Now we’re going to be a little bit more mechanistic. We’re going to work on the nerves themselves. So I’m going to go to a chair. If you have been with us for any period of time, you will have seen about a thousand and a half neuromechanic exercises, nerve flossing, however you want to say it. So whenever we’re working on the hamstrings, we want to think more about the sciatic nerve that could be then divided into the tibial or common fibular nerve.
The way that we address this from a neuromechanical perspective is we’re going to sit in a chair, sit upright. I’m going to pull my toes toward my knee, and I’m going to take my toes to the outside. So once again, pull my toes toward the knee, take the toes toward the outside of the leg. I’m going to lock my knee. Now I’m going to hold tension there as I try to rotate my hip internally. And as soon as you start doing that, you’re probably going to feel a pretty good zinging sensation, nerve sensation, all the way down to the bottom of your foot, depending on your current level of neural tension. Now it is important, if you haven’t watched other videos on this, don’t do this super hard. I tell people on a scale of 10, you go to a 3 max. So for you, if just straightening your leg and pulling your toes slightly toward your knee is like a 7, that’s too much. So you bend your knee a little bit, and you just pull your toes through your knee. Or you straighten your knee, you let your foot relax, and you just turn the toes out. You have to know all the pieces of the exercise, but again, we’re just trying to find that 3 out of 10 intensity.
If we do the entire movement, it involves these things. Toes up, toes out, knee locked, hip in. From here, I lengthen, and then I flex my lumbar spine forward, and then you can add rotation toward or away. You can add lateral tilt toward or away. In most cases, if we rotate away and lateral tilt away, that is going to intensify the effect.
Now, when we achieve our 3 out of 10, we’re not going to just stay there for 30 seconds, because this is not a stretch. We want to move the nerve. How do we move the nerve through the tissue? Well, we pick any joint in the chain. I like to use the knee for most people when they’re getting started. We get to our 3 out of 10 position, and then we just take the tension off, and then we put it back on. Off, on, off, on, off, on. Then I go to a different joint. So, now I’m going to keep my knee locked, and I’m going to point my toes. So, off, on, off, on. I can take my toes in and out, my hip in and out, my lumbar spine into flexion and extension. You want to progressively do 3 to 5 repetitions of the lumbar, the hip, the knee, the foot, and as you do that, you’re basically moving the nerve through the tissues that are surrounding it in each of the areas that may cause a restriction. This feels kind of like a regular stretch, but it isn’t if you’re doing it appropriately. It should feel more neural, like you’re actually getting tension into the nerve itself. So, if you only have hamstring issues on one side, you can just focus on that side. I pretty much tell everyone we’re going to work bilaterally. There are reasons to do that locally, reasons to do that in the spinal cord, and reasons to do that for the brain. So, again, I would just come into the other side, repeat the same process. Toes up and out, knee, hip, lumbar spine. Okay, so you’re going to do that. What do you do next? You stand up, you shake out all the tension, take a breath, then you come back, you retest.
Now, your job right now, we’ve done three different interventions. The question you have to ask yourself is, which one worked best for you? Have they all been pretty good? Are they additive in any way? What a lot of times you’ll see is that when you add tension, this may increase the threat response for people. So, the nerve glide or neuromechanic drill we’re doing right now, you got to be careful with, and you need to retest because you may find that, after I did the nodding, and after I did the isometric contraction with my eyes up, I was feeling really good and loose, and I was more flexible, and then that felt good, but I actually lost a little flexibility. If that’s the case, it’s too threatening. You need to back off a little bit. But again, we’re just trying to show you that this is a neurologic approach rather than foam rolling, massaging, and hammering your hamstrings. There’s so many other ways to get what you need, and if you approach it this way, there are larger benefits.
So, a couple more that I want to also have you think about. The next one I’m going to recommend is for you to use some kind of banded distraction on the hip. For banded distraction, you’re going to want to use a fairly, I won’t say heavy, but you need something that’s going to actually be able to put pressure into your hip. So, I like to use a slightly heavier band. If I’m really going after it, I’ll use a really heavy band, but I’m going to put it very high up, basically as far up in the leg as I can get, and then I’m going to hook it onto my attachment point.
Now, I’m demonstrating this this way because of the camera. I could be facing here, but again, a lot of this comes down to the angle. In general, what we want to start off with is having the hip being pulled laterally. So, the band goes on the inside of the leg. The force of the band is pulling your hip laterally. So, you’re going to have to adjust your tension, and that may mean moving forward, moving back.
From here, what we’re going to do is we’re going to start off with pelvic motions. So, I’ve got a good lateral, and for me, this is kind of lateral posterior pressure with a band. I’m going to bend my knees, and I’m going to simply do a hula hoop motion. I’m going to do three to five repetitions in each direction, and then I’m going to internally rotate my hip, bend my knees again, and repeat those same movements, and then I’m sure you can guess what’s coming next. Now, I’m going to externally rotate my hip, get a little bit more pressure, bend my knees, and repeat those same pelvic movements.
So, basically, the hip is being distracted laterally while the pelvis is moving over the top of it. Now, once I’ve done that, I will often begin doing just kind of light hamstring mobilizations, bend my knees a little bit, and drop into a stretch. You can also do basically like a hip hinge kind of motion. I personally, when I use distraction, I will change the direction of the pull of the band and go through multiple iterations of this. So, right now, like I said, I’m getting a lateral posterior pull, and if I wasn’t facing the camera, I would step around. So, I was getting a lateral straight lateral pull, and then a lateral slightly anterior pull, and then I might face the band. So, I’m getting a full anterior pull, face away, and a posterior pull, and in each one of those, I typically do something similar where I’ll do some pelvic mobilizations, and then I’ll actually do some slight hamstring or hip hinge mobilizations.
Typically, what happens, you do that on one leg, and you stand up, and you’re like, oh, that feels really different. My hip feels really different. A lot of people will find that after doing the distractions with the band, combined with movement, all of a sudden, they’re much more aware of their hips, and they get a dramatic improvement in their hamstring flexibility. Not because we changed the tissue, because we made the brain more aware of the connection point between the hip, the pelvis, and the lumbar spine. We are always again thinking about how well can the brain predict what’s going to happen. The more it understands and has good afferent, like incoming input to the brain from the localized joint, often the more easier it is for it to predict what’s going to happen, and that allows it to decrease some of the protective mechanisms that decrease range of motion. So, this is a very, very powerful tool. There’s lots of different ways to do it. That’s just one way, one example. You can change the angle. You can do it from a kneeling position. You can really do a lot of stuff with the band distraction, but again, it’s not about changing the tissue from our perspective. It’s about making your brain smarter about where your hip is, so when you move, there’s less tension, because your brain doesn’t have to protect it, because it doesn’t know where it’s at. That’s how it works, all right?
Now, finally, the next or last thing I’m going to ask you to do within all of this is I want you to think about your diaphragm and your breathing. Now in most cases what we will find is that if we have a lot of posterior chain tension, a lot of hamstring tension, it doesn’t necessarily mean that you have a poor breathing pattern, but it does typically mean that we will find more tension around the diaphragm than potentially that is ideal. So here’s your test. All that you’re going to do once again is check your current hamstring flexibility. You’re then going to make some claws with your fingers. You’re going to come under your bottom ribs. Now, from here, you’re going to take a breath in, and as you exhale, your fingers are going to dig in under your ribs lightly. And as you’re exhaling, you’re also going to round a little bit. So, you’re going to go into a little thoracic flexion. The goal here is for you to feel for any tension around your diaphragm. And even if you don’t find any sore spots, you’re just going to hold it there. Now, the next thing you’re going to do, you’re gonna keep your fingers embedded. You’re then going to take a breath in. Don’t let your fingers be pushed out as you’re breathing in. All right? So, you’re holding position, breathing in, and then on the exhale, you can round a little bit more. And you can go a little bit deeper. All right? I like to have people do this for maybe 30 to 45 seconds, maybe a minute. Stand up and release it. Take one big breath in. Breathing should feel different. Now see, did it affect your hamstrings?
And for me, that felt pretty good, all right? That actually was a really nice little release, and again, that’s probably because I’m talking and demonstrating on camera, which always makes me nervous even 25 years later. So, this is a little, again, program that you can use starting today with your clients, with yourself.
If you think through what I’m asking you to do, you can go through this whole thing, I guarantee you, in under 10 minutes, probably in around seven minutes, and you can take people from here to here, often without doing a single hamstring stretch, just by understanding that hamstring tension is driven by neurology. Yes, the tissues can be tight, but even if we want to stretch them, if we want to change them, there’s actually very little research evidence that we can do that. We have to build stretch tolerance. Stretch tolerance is about becoming less fearful of the movement. We become less fearful of the movement by understanding the multiple systems that are involved in creating protection in the first place and addressing each of them. The final stage of all this, of course, is that once we have that range of motion, we have to be strong there. So, typically, after I work on all this, we’ve achieved kind of a new range of motion for the day. We’re going to spend a little bit of time doing some extended length isometric work in those positions. That’s typically the safest thing that you can do.
So, when you combine all that together, you can take people who’ve had 30 years of tight hamstrings, and literally in a very short period of time, and I’m talking maybe a few weeks, you can put them into a completely new range of motion. It changes their gait and everything else about them. And the great part is that you’re working not locally. You’re not hammering the hamstrings. You are instead encouraging the brain to release a lot of tension. So, it’s great because you’re also working on other systems that are impacting their body as well. All right.
So, I did this blog by request. Somebody said, hey, you know, what are some brain-based things I can do for my hamstrings? Because I’ve been working on them for five years with foam rolling and massagers and getting hands-on therapy, and I stretch every day and I make very little progress. So, I actually had worked with them, and again, in a matter of three weeks, they went from here to being able to touch the floor, and we never worked on their hamstring once. And so, I was having a conversation with them like, you should put that on YouTube so other people can try it. So, this is a little program I did for them. This isn’t everything, obviously, but this is a good starting point, and more than anything, I think it’s instructive about what we do and how a brain-based approach works. All right.
So, once again, you’re a movement professional, doctor, therapist, or coach of any kind. You like to blend what you’re great at with applied neuroscience, check the pinned comment, drop us an email, or set up a call, because we’d love to chat with you. Good luck.
