This week's highlight is a muscle we have all likely realized needs some attention at one time or another: The Hamstrings.
You will find stretches for the Hamstrings in almost every school Physical Education program, such as the standing toe touch and the sit and reach stretch. The reason for this prevalence is because the hamstrings are so commonly shortened from all the sitting we do, and because they affect so many joints, including our knees, hips, low back and entire spine!
However, if you've been reading these issues of Muscle News, you know that stretching alone is not enough to eliminate trigger points and myofascial dysfunction. Stretching often only lengthens the already loose areas of the muscle, but leaves the tight bands of trigger points still contracted and short. Treating the trigger points first with heat and compression and then stretching the full muscle is the effective method developed by President Kennedy's physician, Dr. Janet Travell. Perhaps future Physical Education classes will teach trigger point self-care techniques in addition to stretching.
What are the symptoms of trigger points in the Hamstrings?
Let's look at the referred pain pattern for the Hamstrings: Trigger points in the hamstrings cause referred pain mainly behind the knee, the back of the thigh and the buttocks.
 This pain is often aggravated while walking and sitting, sometimes causing shortening of our stride or even limping. Bending over can be painful and it is difficult to touch our toes. Sleeping can also be painful, especially when sleeping on our sides.
Fortunately, trigger points in the Hamstrings can be treated with simple self-care techniques. Let's perform the following quick tests and self-care tips to identify possible trigger points and myofascial dysfunction in your Hamstrings.
*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional. Please consult your physician to determine whether these self-care tips are appropriate for you.
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(2) Quick Self-Tests to Tell if You have Trigger Points in Your Hamstrings:
Follow the instructions below to test whether myofascial trigger points in your Hamstrings might be causing your back of the knee, thigh or buttock pain:
TEST 1: Standing Toe Touch
 
PASS FAIL
Stand with your knees straight and your feet no more than shoulder width apart. Bend forward at the waist and attempt to touch your toes with your finger tips. STOP at the point you feel any pain or discomfort in your low back, thighs or legs. A Passing result is when you can touch the tips of your fingers to your toes without any pain. A Failing result occurs when you cannot reach your toes without pain. If you like, you can have someone measure the distance away from the floor as a way of keeping track of your progress over time.
TEST 2: Hamstring Palpation
As always, palpation (the medical term for pressing, feeling and squeezing to evaluate body tissue) is often the most effective test to identify myofascial trigger points in your Hamstring muscles.
 One way the Hamstrings can be palpated is by bending your knee up toward your chest and pressing with your finger tips into the bands of muscle behind your thigh. The hamstrings are ropy muscles, especially on the inner thigh (Semitendinosus and Semimembranosus), so it may be best to pinch the muscle between your thumb and fingers (pincer technique). On the outer thigh (Biceps femoris), the pincer technique may not work as well as finger tips. Press gently to tolerance and cover the entire span of the muscle shown by the x's. Feel for taut bands of muscle tissue and notice if any pain or other symptoms increase.
Simple Self-Care Remedies
Here are simple self-care tips for relieving myofascial pain and dysfunction in your Hamstrings: Step 1: Warming Up with Moist Heat
To relax and warm up the fibers of the Hamstrings, soak in a warm bath or place moist heat such as a Fomentek bag under or over the back of your thighs for 10-15 minutes.
Step 2: Compression
 Leaning either up against a couch/chair or against a wall, place your self-care tool underneath the hamstrings, starting at the sit bones right beneath the buttocks. Slide/Roll the tool down the back of the thigh, searching for tender spots and tight bands of muscle in the Hamstrings.
 When you find a tender spot, press into the muscle to pain tolerance ("good pain" - not pain that is sharp or makes you want to withdraw). Hold for 10 seconds while completing at least two full breaths in and out. Then continue searching for more trigger points.
Step 3: Doorway Stretch for the Hamstrings To stretch your Hamstrings, lie on your back in a doorway with one leg up against the wall and the other leg flat (or slightly bent) on the floor through the doorway (as shown). You can use a strap or jump rope to keep the leg steady. Move as close to the doorway as possible without straining your hamstring.  If you can scoot all the way to the doorway, you can use your strap to pull the foot off the wall for a deeper stretch. Breathe and relax, stretching a little more with each exhalation. Perform this stretch 2-3 times per day. Hold the stretch for 30 seconds and then let the leg down to rest for 10 seconds. Here is a self-care video for the Hamstrings and other muscles using several different self care tools. Watch the first couple of minutes to practice simple ways to improve the function of your Hamstrings and other muscles.  Perpetuating Factors: CHAIR SEAT VICTIMS A major controllable perpetuating factor that causes trigger points to return in the Hamstrings is when they are being compressed by the edge of your chair seat. Many of us have to sit in chairs for long periods of time. Unfortunately, chairs tend be about the same height regardless of how short or tall we may be. For those of us under 6 feet tall, this often results in the edge of our chair seats pressing into the back of our thighs when we are sitting. The prolonged compression cuts off nerve and blood flow and activates trigger points in the Hamstrings.  The solution is a simple change in ergonomics. If you must sit, check to make sure your fingers can slide easily between your chair seat edge and your thighs. If you cannot, then the chair seat is compressing your hamstrings. Use a foot rest, preferably an angled one, so that the back of your thighs lift off the edge of your chair seat at rest (as shown).  A Standing Desk is also very helpful. It helps to alternately raise one leg (as shown). Or you can also bend the front knee slightly and stretch the other leg back to get a good hamstring stretch. |
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Sincerely,
Your Friends at The Pressure Positive Co.
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Link Highlights:  National Association of Myofascial Trigger Point Therapists________________ |
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