Should You Perform a Hamstring Stretch for Chronically Tight Hamstrings?

by Chris Centeno, MD /

Hamstring Stretch for Chronically Tight Hamstrings

If you ask any active person, tight hamstrings seem to be a bane of modern society. Why? Should you be stretching them all the time if they never fully let go? Is there a better way to solve the problem? Let’s explore these topics.

Why Are My Hamstrings so Tight?

Are your hamstrings often so tight that you’re constantly having to roll them out, or perform a hamstring stretch to help them feel better? The problem may be sourced primarily in the spine; the tight hamstrings may just be a warning sign of a bigger problem. To understand this, you first need to understand the anatomy and how these muscles work.

The hamstrings are actually a series of muscles that make up one large muscle group. So a hamstring stretch involves the group of muscles, not just one muscle. They run the length of the upper leg, their tendons anchoring at the upper end of the leg into the ischial tuberosity, or the butt bone where you sit, and inserting at the lower end, just below the knee, into the tibia leg bone or fibula leg bone (lower-leg bones). This is why when you do a hamstring stretch, you feel it in these other areas of the leg, including the knee, as well. The hamstrings are interconnected and specialized leg muscles designed to help transmit force to the ground from the spine.

It’s also important to note, as shown in the image of the butt area below, that fibers from the hamstrings don’t just connect at the site of the ischial tuberosity and stop. Additional fibers continue upward beyond the anchor point.

So where do the fibers that stretch beyond the ischial tuberosity go? They anchor into the pelvis, which is the termination site for the spinal column. We can also trace some “crossing fibers” up to the thoracodorsal fascia all the way up to the head. In reality, the hamstrings as a singular distinct unit doesn’t actually exist; it’s part of a much larger anatomical complex.

Understanding the anatomy makes it easier to understand why low back injuries could be the source of your chronic hamstring tightness and why a hamstring stretch is unlikely to help much or have any lasting effect. The S1 nerves in your low back supply the hamstring muscles in your legs, and when these nerves become irritated or experience injuries, you can feel it in the muscle as it can become chronically tight, meaning it’ll stay tight all the time. Doesn’t this mean you would also have pain at the irritated site in your back? Not necessarily. Though the tight muscles may certainly be a sign of a smoldering low back issue, many times, the only symptom of an irritated S1 is a tight hamstring in the leg.

Even if your MRI or ultrasound shows a tear or other injuries in the hamstring, this is still typically part of a much bigger issue in the body, so surgical repair of the tear is unlikely to help or address the real problem—an irritated nerve in the back. Watch my video below for more on why your hamstrings are tight and why surgery should be avoided:

Is It Good to Stretch a Pulled Hamstring?

Most people who have tight hamstrings are told by physical therapists, personal trainers, massage therapists, and so on that they just need to do a hamstring stretch to help loosen the leg muscle. They invest in foam rollers and spend a great deal of time “rolling out” the painful muscles. If a hamstring stretch was the right solution, however, it wouldn’t keep coming back. The muscle wouldn’t be chronically tight with only brief periods of relief after a hamstring stretch.

In addition, while performing a hamstring stretch for a chronically tight muscle may provide mild, temporary relief of pain, it’s best to treat the source of the problem so you don’t have to keep performing those stretches. If the primary problem is an irritated S1 nerve, for example, a hamstring stretch may temporarily relax the tight muscle, but until the back is addressed, the hamstring will continue to just tighten back up and could even create more injuries (e.g. Achilles tendon tear, hamstrings tear, knee pain or injury, etc.) down the road as treatment is delayed.

How Can I Loosen My Hamstrings?

If a hamstring stretch isn’t a long-term solution, how can you loosen the chronically tight leg muscle? There are regenerative medicine solutions to treat the irritated nerve in the low back. If additional damage has been done to the hamstrings and surrounding body structures over time, such as a hamstring tear, a knee issue, or an Achilles tendon tear, this, too, may need to be treated.

Patients with knee arthritis pain or low back pain often complain their hamstrings are tight. There have been associations made between nerve irritation in the low back (which may or may not present as back pain) and chronic tightness and pain in the hamstrings and other muscles. Hamstrings with a disrupted nerve supply from the back weaken and get smaller over time. This means surrounding structures in the leg, such as the knee, cartilage, and knee meniscus, are less able to be protected. Treating the back and leg structures without surgery is the key to loosening the hamstring and maintaining biomechanical alignment and proper function.

To nonsurgically treat the irritated S1 nerve in the low back, oftentimes, growth factors can be isolated from your own blood platelets and injected around the irritated nerve using precise image guidance. This should relieve and loosen the chronically tight hamstring muscle. If other injuries do exist, these, too, can be treated nonsurgically with a patient’s own orthobiologics, such as platelets or stem cells, depending on the problem.

The upshot? Chronically tight hamstrings may feel like a leg problem but is usually a warning sign that there is a back problem, whether there is back pain or not. A hamstring stretch is not the best solution as while it might provide temporary relief, it won’t solve the problem and may only delay proper treatment, putting you at risk for further injuries. Surgery should also be avoided as it will likely lead to more issues later. Addressing nerve irritation in the low back is imperative to keeping you active, preventing further damage, such as tears, and protecting other muscles and surrounding structures.

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2 thoughts on “Should You Perform a Hamstring Stretch for Chronically Tight Hamstrings?

  1. Jamie Litrun

    It seems when I stretch my hamstrings my fibrillation s get more intense for a period of time.

    1. Regenexx Team

      Hi Jamie,
      Atrial Fibrillation?

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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