Stretch What's Tight.....?

That’s what we’re all taught in PT school right?  Strengthen what is weak and stretch what is tight…  Or in todays parlance – mobilize and stabilize.

 

Is it that simple though?  How many clients do you work with who had a tight hamstring, you stretched it and fixed the problem…  Not just got some transient improvement for a couple of hours, but genuinely addressed the tightness?



We should be a bit smarter than that by now.  The question what is tight is not enough – we need to be asking why its tight.

 

There are a number of reasons a muscle can ‘feel tight’ – ranging from genuine tissue length restrictions through to protective tension and alignment issues.

 

So how do we know what it is? We do assessments!

As ‘The Injury Whisperer’  Dean Somerset says: “If you aren’t assessing you’re just guessing.”

Try this simple assessment and correction for the any of your male general fitness clients who are suffering from the ‘tight hamstring’ epidemic:

 

Take a look at the line of their shorts from the side.  If you note a significant downslope on the waistband from back to front they are likely to be sitting in an anterior pelvic tilt (a very common posture for a desk-bound male).

 

[caption id="attachment_75" align="alignnone" width="300"] Anterior pelvic tilt - or 'lower body cross syndrome'[/caption]

Have them perform an active straight leg raise – take a note of where they get to.

 

[caption id="attachment_76" align="alignnone" width="300"] Active straight leg raise to assess hip flexion[/caption]

Then have them perform a maximal effort front plank with a neutral pelvis keep in mind if they are starting from a position of anterior tilt they will need to aggressively fire their glutes to back to neutral – in fact it would do no harm for these folks to be cued slightly into a posterior tilt (flat back).  Have them take 6-8 deep diaphragmatic breaths with a forceful exhalation – if it’s a genuine max effort plank this will be enough to have most people shaking like the proverbial dog on a comfort break.

Next  - re test the active straight leg raise and see if they perform any better…

 

Now if they perform better on the re-test you have given the person increased range through hip flexion.

 

But hang on -  you haven’t stretched their tight hamstring!

 

If we get a positive result with this correction – then the restriction was as a result of protective tension – and we have simply given the client a platform allowing the hamstring to ‘switch off’ and permit a movement that was previously considered as threatening.