Tight hamstrings and lower back pain. This is a classic question of chronology – like the chicken and the egg. Did your tight hamstrings make your back hurt, or do they feel tight as a result of back pain or injury?
While there is a case for both, it is usually one rather than the other. Keep reading to find out which.
Contents
- Anatomy overview
- Referred pain/tightness
- Neural tension vs muscle length
- How to test & treat
- Rehab integration
Disclaimer:
This article is for educational purposes and is not meant to replace an assessment, diagnosis, or treatment from a qualified professional. Note; no doctor patient relationship has been formed.
Anatomy and Physiology Review
The hamstrings are a group of 3 muscles with 4 total parts:
- Biceps Femoris (short head and long head)
- Semitendinosus
- Semimembranosus
All 4 heads bend your knee when your foot is free (open chain), all except the short head of biceps femoris also act to straighten your hip when your foot is fixed (closed chain). This should make sense because when you stretch your hamstrings you basically pull in the opposite direction – bending your hip and straightening your knee.
There is another significant structure passing down the back of your thigh, nestled right between the hamstring muscles – the sciatic nerve. So when you stretch your hamstrings, you are also tensioning this large nerve which complicates the picture slightly. More on that later.
If you are sick of this science B.S. already and just want help getting rid of back pain just take the quiz now to see if you qualify for the LBPfix program.
Referred pain/tightness
This might be a difficult concept to grasp initially because it is not very intuitive. Referred pain is pain felt somewhere other than the site of injury or disease. You might have heard of this before without knowing it. Maybe you have heard some signs of a heart attack are arm or jaw pain. Referred pain is very common with back and neck issues.
Sciatica is another example of referred pain. Sciatica is some combination of pain, tingling or numbness that goes down the back of your leg and calf. Sciatica is almost always caused by lower back issues like herniated discs or stenosis.
Another example of nerve (neuropathic) pain is hitting your funny bone. A direct blow to a nerve, in this case the ulnar nerve at the elbow, causes pain, tingling, and numbness of varying duration.
Another somewhat unintuitive concept is the different qualities of pain or discomfort. Burning, electrical, squeezing. These are all just feelings, and not actually what is going on. Though it is still important information because it can give insight into the cause of the pain. Pain from nerve injury or irritation is more likely than that from muscle or bone to feel like electrical shock, or tingling/numbness.
Tightness is another feeling often associated with chronic pain or injury. Often people describe tightness at rest, which is not tightness it’s just discomfort. If something is tight, you would only know why pulling on it.
Feeling sore and stiff in and around an injured area is completely normal. Feeling some amount of pain radiating to other nearby areas is also common. A sensation of ‘tightness’ in the gluteal muscles or hamstrings is very common after back injury or with chronic back pain. Like sciatica, this is most often referred pain from your lower back issue.
Tight hamstrings and lower back pain go together like peanut butter and jelly.
Nerve Tension vs. Muscle Length
Even at rest, muscles have a resting ‘tone’, which is basically a low level of activation which keeps some tension in the muscle. This activation or stimulation is controlled subconsciously by your nervous system (brain and spinal cord). The resting tone depends on the specific muscle, the individual, and the context.
Nerves are a fixed length, so unlike muscles, can’t lengthen and shorten. Nerves are also not very elastic, so they can’t stretch very much before tearing. So when you put a significant amount of tension on a nerve it just gets irritated. It will feel uncomfortable almost immediately, like an intense stretch or burning sensation. Shortly after that you will start to feel tingling and potentially numbness if you keep tension on it. A little more tension than that and the nerve will start to tear.
When you stretch your hamstring, let’s say you are lying on your back doing a straight leg raise, you are most likely limited by the tension on your sciatic nerve and/or the muscle tone rather than the actual limit of muscle length or extensibility. This limitation is in place to prevent stretching so far as to actually tear something.
How to test & manage
The straight leg test is actually a very useful orthopedic test to differentiate between different causes of lower back and leg pain. You can also use it to decide why your hamstring feels tight. The key to the test is the foot position. Lift your leg up as high as you can with your toe pointed, then when you hit your limit pull your toes down towards your shin.
If the foot movement intensifies the stretch in your hamstring, it’s not hamstring tension, it’s sciatic nerve tension. Likewise, if the foot movement reproduces or changes your back pain without your hip or knee moving, it is because there is something irritating the nerve root in your back. As mentioned previously, disc herniations and spinal stenosis are the most common causes.
If you are feeling nerve tension, or back pain with nerve symptoms like leg tingling or numbness, don’t stretch it. It probably won’t help and could easily make it worse. If you want to improve your flexibility try to find stretches that don’t put tension on sensitive nerves or put your back into painful positions.
Contrary to popular belief, static stretching is not necessary or even helpful most of the time for lower back pain. The LBPfix program has all sorts of exercises, including some stretches that are tried and true . They are not just cookie cutter recommendations either, they are based on your results in the pain categorization step of the program.
Rehab integration
Stretching your hamstrings can be a useful intervention, it is just not likely to be the most valuable thing you can do. Fixing your back pain will probably get rid of the feeling of tension or discomfort in your hamstrings. This may include some back stretches, some strengthening, and maybe some hip stretches too. All of these things are built into the program in just the right proportions. Click the link below to see if you qualify for the program.
Our Framework: How LBPfix Can Help
1. Identify Your Pain Driver: We classify your pain into one of four movement intolerance types
2. Prescribe the Right Movement Strategy: Once we know your pain type, we match it with corrective movements
3. Build Long-Term Resilience: As pain settles, we help you:
Move confidently without flaring up
Rebuild core control and lifting mechanics
Return to work, sport, or life without setbacks
Ready to Fix Your Low Back Pain?
Take our 2-minute quiz to find out if you’re a good candidate to our program – no strings attached!
