Jolie Bookspan. MEd, PhD, FAWM
Director Neck and Back Pain Sports Medicine
and the Academy of Functional Exercise Medicine - School of Healthy Medicine
Copyright & Reprint Instructions Protected by Copyscape Plagiarism Checker
Hamstring flexibility is not correlated with back pain (when standing, running, exercise, and most sitting). Where did the confusion come from that mistakenly led to the popular practice of hamstring stretching for back pain?
Plus, the off-shoot misidentification, where relief felt from bending forward mistakenly put crunches and flexion-based core strengthening exercise into lower back pain rehab.
This page explains where those two practices became thought of as related to back pain, tells what works better, and why.
You are on my large free web site - DrBookspan.com. I am a research scientist. I put my work in phyology and evidence-based sports medicine on this site for you to have fun smarter methods for healthy, mobile, happy life, and better physical training in all kinds of environments (heat, cold, altitude, undersea, and more). There are many articles here on my site as a public service. Find main navigation links (Site Map) at the bottom of this page (and every page on this site), along with Buttons to LIKE and SHARE. This page tells interesting work I did about your hamstrings.
The Quick Story
I did initial work (pilot study) that found no relation between amount of hamstring flexibility and any incidence of lower back pain. It went against common practice of prescribing hamstring stretching for back pain. My results were not well received. I was boo'd at a prestigious sports medicine conference.
I quietly put my results on the shelf, and continued over years to re-check relation, and find out why there was no relation and what else might be involved.
In the meantime, respected names in spine research found the same results in their studies - no relation between hamstring flexibility and incidence of back pain.
I had already conducted years of studies that found that too much inward curve of the lower back (hyperlordosis/ swayback) caused pain with extended standing, from the too-sharp angle physically compressing and shortening the area (explained on the Back Pain With Standing page, and a bit about the studies on my Ab Syllabus). In continuing work, I found that during the act of stretching hamstrings, the inward curve of the lower back reduces, and stretches - only during those few seconds, of course. For the many people with lower back pain from too much inward curve, the reduced angle, and temporary lumbar lengthening provided temporary relief from the compressed pinching ache and tightness that hyperlordosis produces. Of course, when they stood up and went back to standing swaybacked (too much inward angle), the same compression and shortening eventually caused pain to return - and they felt they needed to bend forward and stretch again to relieve it. The brief reversal of symptoms during back stretching became mistaken for relief from the hamstring stretch. Brief hamstring stretching became further confused with hamstring flexibility. Like "whispering down the lane" it next changed into hamstring flexibility prescriptions for any kind of back pain. Then worse, people thought that the temporary bending forward during crunches and other flexion exercise such as during Pilates was curing back pain, and that it was strengthening (or other mythology) that was the cure, when it was just temporary reversal of the bad posture of lumbar sway which was causing the real problem. Temporary bending forward felt good after crushing the lower spine with all the excess inward sway, but it was not a cure or prevention.
It was mistaken identity. The resulting myth would have been harmless, except that without fixing the real causes the damage from swayback accumulates, and ironically, the same forward-rounding and forward bending (flexion) that co-occurs during certain hamstring stretches and conventional core exercise puts herniating forces on discs, over time. It is one of several reasons that hamstring stretches and "hip hinges" are common causes of lower back and disc pain, not a fix. It wasn't fixing the cause. It wasn't even a healthy way for temporary relief. It is further irony that standing swaybacked maintains the lower back in the very position that perpetuates tightness and lumbar shortening.
There are more interesting reasons furthering the confusion. For one, injured hamstrings may hurt at the place the hamstrings attach to your "sit" bones - the very area assumed to be sciatic pain alone. Stretching the hamstring helps the injured hamstring, and the pain where they attach to your pelvis, wrongly thought to be sciatica. More on this on my Stretching Smarter page and Fix Lower Back Pain page. Other times, tightness in the posterior hip and upper leg make pain or tightness in the lower back. Hamstring stretches can, incidentally, stretch those areas and take away the separate cause of pain, leaving people to wrongly credit the hamstrings. Seems harmless, except that true causes go unexamined and un-prevented, leaving people to take much time and money to do conventional scattershot "cures" hoping something will work, accidentally or not.
What to do instead? If you get the kind of lower back pain felt with long standing, walking & running, and feel that bending over forward, or sitting, or raising legs brings relief and stretches out the ache, you probably stand with too much lumbar arch (hyperlordosis). Instead of keeping the bad posture and getting recurring lower back pain, then doing hamstring stretches to try to temporarily curb it, prevent the entire problem with neutral spine. Then you don't over-curve and compress the lumbar spine (you stop your swayback with healthy standing position) and don't cause any back pain in the first place. Then, to get a healthy lower back stretch built into your regular day, use good bending, explained on the Fix Lower Back Pain page and in my books. For effective and functional hamstring stretches without flexion, see my book Stretching Smarter Stretching Healthier, with one helpful stretch in my web site Stretching Smarter article. It is a whole world of healthier smarter movement mechanics and daily habits. You won't get the pain and will also move and stretch in healthier way to stop future damage. This is also why people think that various treatments "work" when they go and lie down with knees bent for the treatment. Of course the pain will lessen along with the painful swayback when they lie down that way. It does not matter if they get needles, or oils, or massage, it was lying down that stopped the cause temporarily, then these same people claim the treatment must work, because the pain COMES BACK and they feel better to go to their ongoing treatments where they lie with knees bent and temporarily stop the real cause, unknowing.
Do Tight Hamstrings Change Hip Tilt?
Not when you are standing. It is easy to see this for yourself.
Hamstrings attach to your "sit bones" which are the "bumps" on the bottom of your pelvis. There are claims that tight hamstrings pull the sit bones downward and/or inward so that the pelvis tilts posteriorly. To see if this really happens, you can easily check people with tight hamstrings. Some allow (or intentionally produce) a poor posture called anterior pelvic tilt - shown by the yellow lines on the model in the photo below. If tight hamstrings did pull the pelvis down in back, then people with tight hamstrings (most people) would not (and could not) tilt the pelvis anteriorly, producing this poor posture in the photo below:
If it were true that tight hamstrings pull the pelvis down in back, it would prevent anterior tilt, show in yellow lines of photo above. You can see that the pelvis is UP in back, not pulled downward. Many people stand with this anterior tilt whether they have tight hamstrings or not. My page with information to fix an anterior tilt is: Back Pain With Standing.
Consider all the people who do have tight hamstrings and also a too large lumbar angle (tilt their hip forward / swayback) - maybe even yourself. Why didn't tightness prevent the swayback or even pull to neutral spine? Because hamstrings don't work that way, and swayback can occur from tightness in the front of the hip, not the back. It can also occur from tightness in other places, and even without any tightness (when it's just slouching).
When do tight hamstrings change hip tilt? When you sit on the floor with legs straight out in front of you. In that position, tight hamstrings can't lengthen enough to let the pelvis sit level. The pelvis tilts posteriorly and the lower back rounds, as in my drawing of Backman! below:
Sitting with your back rounded for long periods presses discs outwards and makes muscles ache. In this case, you could blame tight hamstrings for the ache, but it is the bad sitting. Most people don't sit on the floor with legs straight out, they sit in chairs with knees bent. Hamstrings are not involved if you sit with your back rounded when your knees are bent. In that case, it doesn't matter if your hamstrings are tight not not, you are just slouching and that is what hurts.
Tight hamstrings can also restrict kicks when standing. When people stand and kick one leg high up in front, if their hamstring is tight, they will usually round their back to compensate - the movement has to come from somewhere, and since it is not coming from the leg, it comes from the back. In this case, high hard repeated kicks, repeatedly forcibly rounding the spine could potentially make pain. In that case, tight hamstrings would be involved. However it is not the case as a generality, when sitting in chairs, or cross legged on the floor, or standing, or for most exercises, and so on.
When Hamstring Pain is Confused for Back Pain and Disc Pain
Another possible reason hamstrings are thought related to back pain is when an injured hamstring is confused for injury somewhere else nearby in the back or posterior hip. A hurt disc commonly hurts deep in the posterior hip - in the buttock cheek - even if the disc itself is physically located higher up.
A hamstring "pull"can also be confused for sciatica. If a "pull" (strain or tear) occurs where the hamstring attaches to the hip - on the "sit bumps," the pain of a hurt or tight hamstring can wrongly be thought to be disc or lower back pain, even S.I. pain. The term "lower back pain" usually encompasses the posterior of the hip, so that records of pain may say "lower back" pain and would be accurate for the general location, but not the cause.
A tight or shortened hamstring or a spasm may yank at the attachment (on that sore sit bone) when extended, as when taking long or high steps, kicks, or even during a "straight leg raise test" for disc, and felt in posterior hip / buttock cheek, making a sore lower back. Disc herniation also hurts with the spine flexion that often occurs with these same moves.
Pain that goes down the back of the leg from a hurt hamstring may be confused for pain down the back of the leg from a disc impinging the nerve. ( It should not be confused when you know what you are doing, but often is).
A good differential is needed to identify a hamstring component from all the other reasons. Also, several different injuries can occur at the same time. That is sometimes why a scattershot (but wrong) approach of stretching sometimes helps for one reason, even if the main cause is something else. Then "pain comes and goes" or "it helps a little." Identifying and fixing all the contributors is needed. It's better to understand and use direct correct fixes to stop damage quickly, than let time pass in pain trying random things.
Disclosure and Conflict of Interest Disclaimer
This study was not funded by anyone or any agency, and has no financial relation or obligation to anyone. Funding agencies have gone out of their way to meticulously ignore me. I have no financial relationship with any manufacturer, vendor, service or product provider discussed in this study. These studies were done before I wrote the book The Ab Revolution. The training manual that became the book was the result of the findings of my work, not the other way around. The book is also not commercially funded or related to any product sales. The story is here - look for "A Short Story of My Work Developing These Methods."
The Exciting Details
To get to the more exciting part, skip this and scroll down to "What Does This All Mean?"
The Hamstring Studies
1. My Pilot Study - I Found No Relation Between Hamstring Flexibility and Lower Back Pain:It was so often repeated that you have to stretch your hamstrings to prevent or fix back pain, but why? I set out to find if there were any relation between the two. People often repeat the mistaken idea that tight hamstrings tilt your hip that reduces the lumbar angle, making back pain, but hamstrings don't work that way and if they were that tight, you couldn't take a step forward. (Plus if that were true, the prescription would be to make hamstrings tighter to reduce the too large angle, called hyperlordosis, which causes much lower back pain). Many years ago, I looked at 167 of my patients and students. I carefully measured hamstring flexibility and noted if they had back pain at the time, or at any time in the past. Running the data comparing flexibility to incidence of any lower back pain, resulted in no relation, no correlation, nothing that linked the two.
Quick overview of flexibility measurement (continuous data measures):
FOr these purposes, zero degrees is lying flat on your back with both legs down on the floor together,
45 degrees is one leg lifted to diagonal, 90 degrees is leg able to stretch to perpendicular - pointing to ceiling, and so on.
I collected flexibility in degrees - continuous numbers from zero to 180 if they lifted leg all the way back to their ear in a lying down split.
I measured flexibility in the dominant leg, non-dominant leg, and both legs together to make it more like a "sit and reach test" but preventing the lower back from flexing or rounding, to better isolate hamstrings.
I presented my work at scientific conferences and they practically threw tomatoes at me, saying my work could not be true because "everyone knew" that hamstring tightness meant you would have back pain and therefore stretching would fix it and that meant that hamstring flexibility was a predictor of back pain. There were so many inductive leaps and faulty premises in those statements that it was hard to address them in ways that would appease or enlighten the mob. These were doctors who were even keeping people out of jobs if they had tight hamstrings. They said that tight hamstrings necessarily meant the people would get back pain, and the employers didn't want to pay Workmen's Compensation claims. That's how bad this myth had gotten.
2. Then What Happened?In subsequent years, highly respected researchers did their own studies - and found no relation between hamstring flexibility and back pain.
During that time, I did more work on separating if hamstring flexibility itself, or something in the act or motion of hamstring stretching brought relief. With no correlation between hamstring flexibility and lower back pain, what else might hamstring stretching do or include?
Not a lot of my work is published in journals. I am busy trying to get work done and don't present or publish all (or even much of) my work Publish?? I'm trying to accomplish something here!
For the many who have been asking, I put some of the results of my studies of my patients with knee pain on my Lower Body page and a few of my lower back pain studies on my Ab Workshop syllabus. Here are the results of this study on hamstrings:
3. The Next Work - Comparison of Neutral Spine and Hamstring Stretch for Relief of Hyperlordotic Lumbar Pain
A widespread prescription for lower back pain (LBP) is hamstring stretching. Some patients report relief from hamstring stretching, others, no effect or worsening. A pilot study of 167 subjects found no relation between hamstring flexibility and LBP. Subsequent independent studies confirm no relation between hamstring flexibility and LBP (1,2,3). Disc injury (4) and osteoporotic fracture (5) can be caused and worsened flexion, such as that involved in conventional hamstring stretch.
Previous work determined that hyperlordosis (swayback) results in one form of lower back pain (LBP) by compression of facets and soft tissue, and shortening lumbar height (6,7). Neutral spine (NS) lengthens and unloads, directly stopping LBP(8,9). Momentary incidental lumbar lengthening during hamstring stretch briefly stops symptoms. Spinal stenosis symptoms also often reduce with flexion (7). It is proposed that temporarily reversing swayback with hamstring stretching became confused with the separate entity of flexibility. The purpose of this study is to compare a neutral spine method, Ab Revolution (AR) with conventional hamstring stretching (HS) for LBP from hyperlordosis.
METHODS / ANALYSIS
Pilot study of 167 subjects measured degrees hamstring flexibility using straight leg raise test, compared to nominal measures of active LBP, previous LBP, or never LBP. Of initial 167 N, 113 had active LBP. Of these 113, 92 reported wanting to bend forward, lift one leg, sit, or bring knees to chest to relieve symptoms.
Following the pilot study, a new study group was formed from original subjects. Of the initial Pilot study, four had been lost to follow up. The remaining 88 were divided into two groups: Neutral spine training group called Ab Revolution (AR) N=44, and a group receiving daily conventional hamstring stretching (HS) N=44. Hamstring stretch group (HS) performed hamstring stretches of their choosing or prescribed by their physical therapist twice daily.
Nominal outcome measures of ability to employ neutral spine (NS), flexibility (increase, decrease, no change), and LBP were assessed at day 1, 6 weeks, and 6 months, analyzed using Chi-Square.
Of the Hamstring Stretch (HS) group, 41 of 44 increased hamstring flexibility, and there was no significant lasting reduction in LBP, 39 had brief symptom relief during hamstring stretching but return of pain with upright stance and activities of daily living, 43 of 44 were measured as not using neutral spine when standing or ambulating (no NS). 18 of 44 had increase in LBP.
Subjects using neutral spine training (Ab Revolution or AR) showed significant reduction of LBP during daily activities at day 1, 6 weeks, and 6 months. At 6 months 40 of 44 had no LBP. LBP was not correlated to change in hamstring flexibility in either group.
1. Incidental lumbar flexion from hamstring stretching, not hamstring flexibility, reduces LBP by reversing swayback - at the time of stretching.
2. Temporary reversal of symptoms from swayback (hyperlordotic lower back pain) occurring during hamstring stretching, became mistaken for relief from the hamstring stretch itself. Hamstring stretching became further confused and combined in practice with hamstring flexibility. Hamstring flexibility prescriptions became further derivative to include any kind of hamstring stretches for any kind of back pain.
3. The temporary bending forward during crunches and other flexion based "core" exercise does not cure back pain through strengthening. The temporary reversal of the original problem of slouching with too much inward lumbar curve provides temporary relief that is mistaken for real change or cure. The pain from hyperlordosis comes back as soon as the person stands and resumes the real cause - not weakness, but standing in hyperlordosis. Crunches and core exercises do not change that. This is why there is only temporary relief from conventional exercises, or chronic pain that "has to be managed through recurring flexion" or intermittent pain that is confusing and "no one understands why it comes and goes." No amount of strengthening or core exercise makes you prevent the hyperlordosis which is the root of this one kind of pain.
4. Hamstring stretching is not curative for lower back pain
5. Hamstring stretching and flexion based core exercises may aggravate specific lower back pain, and over time, create new lower back injury.
6. Lumbar lengthening and restoring neutral vertebral angle through neutral spine technique (AB Revolution AR) gives sustainable pain relief by directly stopping cause of LBP from swayback (hyperlordosis).
7. Using neutral spine through AR is functional; stopping cause of LBP and integrating needed resting and active length of lumbar spine during activities of daily living.
1 Jones MA, Stratton G, Reilly T, Unnithan VB. Biological risk indicators for recurrent non-specific low back pain in adolescents. Br J Sports Med. 2005 Mar;39(3):137-40.
2. Grenier SG, Russell C, McGill SM. Relationships between lumbar flexibility, sit-and-reach test, and a previous history of low back discomfort in industrial workers. Can J Appl Physiol. 2003 Apr;28(2):165-77.
3. Jackson AW, Morrow JR Jr, Brill PA, Kohl HW 3rd, Gordon NF, Blair SN. Relations of sit-up and sit-and-reach tests to low back pain in adults. J Orthop Sports Phys Ther. 1998 Jan;27(1):22-6.
4. Veres SP, Robertson PA, Broom ND. The morphology of acute disc herniation: a clinically relevant model defining the role of flexion. Spine (Phila Pa 1976). 2009 Oct 1;34(21):2288-96.
5. Tzermiadianos MN, Renner SM, Phillips FM, Hadjipavlou AG, Zindrick MR, Havey RM, Voronov M, Patwardhan AG. Altered disc pressure profile after an osteoporotic vertebral fracture is a risk factor for adjacent vertebral body fracture. Eur Spine J. 2008 Nov;17(11):1522-30. Epub 2008 Sep 16.
6. Bookspan, J. Identifying and Reversing Hyperlordosis as a Factor in Lower Back Pain. Medicine and Science in Sports and Exercise, 39:5 May 2007.
7. Bookspan, J. Hyperlordosis Retraining Method Relieves Lumbar Disc and Stenosis Pain—An Unexpected Finding. Medicine and Science in Sports and Exercise, 41:5, 2009.
8. Bookspan, J. Ab Revolution functional core retraining relieves low back pain more effectively than conventional physical therapy. Medicine and Science in Sports and Exercise, 38:5, 2006.
9. Bookspan, J. Functional Core Retraining Superior To Conventional And Pilates Core Training In Remediating Low Back Pain. Med Sci in Sports and Exercise, 37:5. 2005.
In these references - respected names in spine research found the same results in their studies - no relation between hamstring flexibility and incidence of back pain.
"Even historians fail to learn from history."
- Professor John Gill - Star Trek episode 52 Stardate unknown, Patterns of Force
- Study publication (abstract): Bookspan, Comparison of Neutral Spine and Hamstring Stretch for Relief of Hyperlordotic Lumbar Pain J. Medicine and Science in Sports and Exercise, Volume 44:5 Supplement. 2012.
- Study presentation at the 59th Annual Meeting and 2nd World Congress on Exercise is Medicine of the American College of Sports Medicine at the Moscone Convention Center in San Francisco, CA, 1 June, 2012.
What Does This All Mean?
1. This means you can have a quicker more direct way to stop this kind of lower back pain
Stop the cause by using neutral spine. Neutral spine is used during standing, walking, sports, and all your regular activities.
Hyperlordotic lumbar posture (swayback) has been previously identified as a direct contributor to lower back pain during and after standing, carrying, and ambulation (walking, running, upright movement) (6,7,8). The increased lumbar angle of hyperlordosis physically compresses bone, nerve, and soft tissue. Think of a straw pinched backwards. Two types of hyperlordosis are shown:below - hip tilt (middle) and thoracic lean (right). Both may also appear together. For comparison, neutral spine is at left:
Another example of "thoracic lean-back"
(That is what I have named it as I haven't seen it identified in any previous sports medicine sources).
Same kind of swayback as in my drawing above.
Thank you for photo by n0nick http://flickr.com/photos/n0thing/41750513/
2. Hyperlordosis is common among athletes and non-athletes regardless of abdominal strength, as strength alone does not cause movement
Movement out of poor posture is what corrects hyperlordosis. Moreover, overly arched (hyperlordotic) posture is mistakenly encouraged as good posture, as a method to lift or squat more weight, as the weight is shifted to the facet joints and off the muscles making the lift seem easier, with long term consequences from the joint loading - example below at left with neutral spine comparison at right. Hyperlordosis seemed to be a fad in the fitness industry in the 1990s and decade of 2000.
3. Overarched spine (left) was a fad in fitness and the cause of much lower back pain, even though it made lifting easier
Lifting was easier because it shifted load to the lower spine and off the muscles For spine health, it's better to use your muscles than rest the load on the joints. Save your slouching and bad form for emergencies.
Correcting hyperextended angulation to neutral spine has been identified to directly unload and correct the source of pain in hyperlordosis(6) disc and stenosis pain(7) more effectively than conventional strengthening programs (8,9).
4. When Stretching Helps?
Stretch programs for lower back pain are common in therapy programs, however with often unsatisfactorily low or inconsistent success rates. Conventional hamstring stretches are non-specific—they do not directly train reduction of hyperlordosis (or any other movement) during standing, gait, exercise, and activities of daily living.
An interesting reason hamstrings were misidentified with back pain is that sore hamstrings and hamstring pulls (ironically, some from bad stretches and movements) may hurt where hamstrings attach to your "sit" bones (ischial tuberocities - the bottom bumps of your pelvis/ hip) - the very area often assumed to be sciatic pain alone (lots of things can hurt there). Then a mistaken diagnosis of sciatica or disc pain occurs and stretching the hamstring helps. Then a mistaken association with stretching hamstrings fixing sciatica.
Sometimes the muscles and other soft tissue of the backside, posterior hip, upper thigh can get so tight that they restrict movement and yank, causing sharp pain or ache. Other times tightness can squeeze or compress nerves, sending pain along the path of thee nerve down the hip and leg. Stretching them in good ways that lets them stretch without further compression, can relieve that particular cause of pain. The problem comes when that specific case is confused or misdiagnosed as back pain or sciatica from disc or causes related to the back, and believing that the stretches fixed it, when it was a different cause and different reason for the fix. Does it matter why? For all the many people who do not have this cause and are given stretches, they continue pain, increase pain, and time, health,and money flow away.
When the pain was really from discs and soft tissue from chronic bad bending, the hamstring stretches and"hip hinges" themselves make things worse in the long run. These stretches feel good for a moment (like smoking a cigarette) but damage little by little, and reinforce bad habits. More about why the fad stretch of "hip-hinges" does not help is also covered in the article on Fixing Lower Back Pain.
5. How to stretch your hamstrings without putting herniating sheer and force on the lower discs, and in functional way - a way you actually need and use in real life
A functional stretch is done in the same position, and using the same actions, as needed in real life, and is one that you actually do during real life activity. An example of a functional hamstring stretch would be standing upright and lifting one leg to kick for sports, martial arts, dance, for leaps in obstacle courses and Parcours, and some moves in bouldering and climbing. Check my drawing below of Backman! doing a functional hamstring stretch, then try the following:
- Stand upright.
- Notice both your feet. Make sure your feet are both facing straight forward, not turned out, even a small amount.
- Lift one leg straight in front of you. Any height that gives the stretch you want. Keep both your knees straight, not "locked" or firced straight.
- Make sure the foot you are standing on is still facing straight forward, not turned out, even a small amount. If it is turned, then either hop to straighten it, or put your other foot down, adjust, and figure how to lift one leg without twisting the other foot. This will be healthy training for walking, running and other movement.
- Notice now tempting it is to use bad habits of bending forward, rounding your back, and other slouches that reduce the real stretch - on the hamstrings. Remember, stand upright.
- Notice it helps you practice balance.
- Hold your leg up with your hands if that helps you get more height until you strengthen enough. Make sure you don't round your shoulders or learn forward to reach your leg. Learning and practicing to stand straight is one of the purposes and benefits of doing this hamstring stretch in a functional way.
- Notice that you use standing on one leg and lifting the other to various heights in real life, from kicking and dancing, to stepping up heights, and others.
- This new functional hamstring stretch may feel harder than your usual (bent forward) hamstring stretches because it gives more direct stretch to the hamstrings, when done right, and you must stand and balance as in real life. You may not have really stretched your hamstrings previously, and have been reducing stretch by rounding your back or tilting the hip.
- Transfer this knowledge of preventing slouching, keeping balance, and getting needed range from the hamstrings to your standing activities.
- Practice this and feel positive about increasing real life skills you need in a healthier smarter way.
- Send your success photos - success AT DrBookspan DOT com..
I have been finding over years of collecting patient results and in actual studies that "moving stretches" are highly effective as a stretch, as a movement re-trainer, and to help quicken the body's normal repair of damaged areas. In many cases, the "moving stretches" that I have developed are better than "holdIng" static hamstring (and many other) stretches. Moving in needed ranges (small excursions up and down, side to side, diagonals and so on) while maintaining healthy hamstring stretch positioning makes effective stretch, loosens tight hip areas, and helps rehab a "dinged" hamstring attachment, as long as stretch range is less than any pain or "yanking" feeling on the damaged area.
Above, my students Karen and Annie demonstrate the standing hamstring stretch.
Can you spot two positioning mistakes that they (deliberately) demonstrating for your benefit?
Karen (left) demonstrates keeping the standing foot turned outward (incorrect) while Annie (on right) demonstrates keeping the standing foot facing straight forward.Karen keeps the hip and pelvis vertical as needed. Annie deominstrated curling the pelvis under too much. Make sure you can spot these easy things for yourself, so that you are are stretching what you think you are stretching.
Here is Another Hamstring Stretch Using a Wall - Standing Upright, Not Bending Forward
- Stand no more than one arm- length from a wall. Stand straight. Both feet pointing forward, not out.
- Lift one leg to press the foot and heel toward the wall, directly in front of you. The wall will feel too close if you have tight hamstrings, but that is why you are stretching them. Don't move back.
- Stand upright. Lift and straighten your upper back. Don't round your back, or let your hip curl under you. This is a functional hamstring stretch - you need to stand, lift legs, and balance without being so tight you are pulled into unhealthful rounding.
- If your hip curls under (tilts instead of staying vertical), it may be because the front muscles of your hip are too tight, or it could be a simple bad habit of standing with the pelvis tilted instead of vertical. Use this retraining drill to stretch and straighten, not further round the back.
- Next when you get good at this, do it without the wall. Lift your leg in front of you and stand straight and balance on your own.
If your lower back is tight, or you get the kind of lower back pain felt with long standing, walking & running, and feel you want to bend forward to stretch out the ache, you probably stand with too much lumbar arch (hyperlordosis). Prevent that with neutral spine - summarized in my Abs Article, and explained fully in my books, particularly The Ab Revolution. Neutral spine give you built-in needed length and natural stretch so that the areas doesn't get tight in the first place.
Get functional built-in lower back stretch every time you use good bending with a partial-squat, done with neutral spine. During regular daily life, you need to crouch and reach many dozens, even hundreds of times. Get that built-in to your day with good bending, sample drawing below. Full "Asian squats" done right, can be a wonderful way to get regular safe built-on stretch to the lower back. More is summarized on the Fix Lower Back Pain page, and explained in detail in my books.
Bad bending with swayback on left. Good bending using the partial squat on the right.
Mistaking Correlation for Cause and Effect is a Classic Serious Mistake in Science
The myth of hamstring flexibility as curative for back pain came mostly from misunderstanding the temporary lumbar stretch co-occurring with hamstring stretching, which reduces - only for the moment of stretch - the hyperlordosis that causes one kind of back pain.
The same mistaken identity seems to be the reason people mistakenly believe ab training and the forward bending of yoga, Pilates and other pop exercise systems "helps" - it just feels good for the moment for people with lumbar pain from swayback because they are temporary stretching it the other way. It's not a healthy fix and not a long term one. Strengthening abdominal or core muscles does not "support" or fix back pain. it is using them to prevent swayback that is how abs help the back. More on the Abs page.
Appreciation and thanks to Paul Jenkins for proofreading and math checking for this study. He is my Academy Director of Silly Syndromes who keeps us laughing (and sane) in the world of crazy fitness claims. Appreciation and thanks to Peggy Santamaria for making (yet another) banner for me to use at my presentation of this work. Ms. Santamaria is my Academy Director of Developmental Ability - teaching my work to developmentally disabled adults, who go on to gainful employment doing healthy landscaping, snow removal, cleaning, mail room work, and more. See my Academy Honors page for some of their photos and good work, and Academy for more of all we do and how you can be part.The ACSM fellow who sponsored this work for presentation at the 59th Annual Meeting and 2nd World Congress on Exercise is Medicine is Catherine Ratzin Jackson, Ph.D., FACSM, who states, "The present study challenges current thinking and the evidence is compelling."
Drawings of Backman!™ © Dr. Jolie Bookspan
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Top level book for all athletes to train thinking, spirit, and top performance. Healthy Martial Arts is the top of the line book (of my books) for exercises and athletes. Sun Tzu's "The Art of War" is the classic strategy manual in business and power. "Healthy Martial Arts" is the strategy manual for your life. For everyone, not only martial artists, who want to move, live, eat, and be happy in healthy ways. Direct from Amazon - Healthy Martial Arts.
Fix Your Own Pain Without Drugs or Surgery
Neck pain, back pain, shoulder and hip pain, knee pain, ankle and foot injuries, wrist pain, and "when everything hurts," featuring actual patient stories in every chapter. Many common exercise contribute to pain and aren't natural movement patterns. Learn fun healthy ways to get healthy movement back as part of your real life.
Print edition from Amazon.
Print and eBook Instant download from the publishers, Healthy Learning and Coaches Choice: https://healthylearning.com/m-1422-jolie-bookspan.aspx
Stretching Smarter Stretching Healthier
Fun, innovative, immediately useful. Almost 200 simple fun line drawings zero in on each concept.
Print and Kindle from Amazon and instant eBook download from Kobo Books.
The Ab Revolution Fourth Edition - No More Crunches No More Back Pain Print 4th Edition.
Core training the way your body actually needs. Part 1 - Learn neutral spine to stop a major form of lower back pain. Part 2 - Apply Part 1 for functional strengthening from simple moves to the toughest you can get. Parts 1 and 2 let you get started quickly and clearly. Details on the anatomy and physiology are expanded and moved to Part 3, plus other improvements in photos and organization in the 4th edition.
Click for print edition from Amazon.com.
Also available in Kindle.
Health & Fitness THIRD Edition
Fix pain plus healthy living - How to be happy healthy and fit for the rest of your life. One book with everything to get started. More photos, clearer descriptions than previous editions.
Order directly from Amazon.
Print and eBook Instant download from the publisher: https://healthylearning.com/m-1422-jolie-bookspan.aspx
Diving Physiology In Plain English
New BLUE cover edition. The diving cult classic! Plus other diving and hyperbaric medicine books and resources.
Signed collector copy direct from the author. See this and more diving and hyperbarics books on the BOOKS page.
I am Dr. Jolie Bookspan - The Fitness Fixer
- My column ran from 2006 to 2010 on Healthline.com. Over that time, I wrote almost 800 Fitness Fixer articles. They didn't repeat popular fitness. They gave fun ways to be healthy, that I developed from my original laboratory research.
- When Healthline discontinued the column, at first they removed almost all of the needed photos, and all the movies I made to help understanding and teach you how to do these new fun ideas. Then they started removing all my articles and redirecting links for many of them to articles to their own articles with their advertising.
- I maintain the large index of Fitness Fixer articles on this web site. Click Index to find fun topics. I am trying to keep up with identifying the ones they remove.
- Quick updates, FUN, Contests, Class updates, Invitations to World Health projects, Send your reader successes and ideas, More.
Gifts For Healthy Movement
Open our RESORT
For healthy life training - maybe at your campus, studio or cruise ship? Also join fun and instructive Dr. Bookspan projects - help the world, be in my next books, write rhymes about your pain fixes. Click Projects.
“We have to abandon the idea that schooling is something restricted to youth. How can it be, in a
world where half the things a man knows at 20 are no longer true at 40 - and half the things he
knows at 40 hadn't been discovered when he was 20?”
~ Arthur C. Clarke (1917 - 2008), British science fiction author, inventor, futurist
Don't worry about people stealing your ideas. If your ideas are any good, you'll have to ram them down people's throats.
- Howard Aiken
Information, drawings, and photos are © protected copyright. To cite this article or any parts, put author Dr. Jolie Bookspan, and link to this site DrBookspan.com at the top and bottom of your reprinting. A suggestion to get my books is also nice. No Derivative Works License means no changes to content, wording or links.
If this information fixes your pain, send it to a friend (the article, not the pain) including full citation and links.
This information is © and here to benefit the world.
Pass goodness on. "Make health contagious."
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