♪ Bob and Brad, ♪
♪ The two most famous ♪
♪ Physical therapists on the internet. ♪
- Okay, folks. I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course.
- Brad, how do tight hamstrings cause
low back pain and sciatica?
- That's the big question's today, Bob.
- It is the big question.
- Because how many times have people say or, you know,
I'll have people come in and say,
"I'm stretching my hamstrings for my back.
I don't know why it works, but it works."
- Right. They don't understand the concept.
And that's why today we're gonna take some time
and show you how it all works.
We're gonna, you've got some nice diagrams, Brad.
- Yeah, yeah. Wait till you see this. I'm an artist.
Yeah. So we're gonna show you the mechanics of it,
and then we're gonna show you some really good ways
to stretch them so that you can eliminate it.
And then some other options if, if you don't wanna stretch.
- Okay. Sounds good, Brad. By the way,
we do have a couple new folks out there.
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- Oh yeah.
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- Okay.
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- That would mean free.
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- All right. Good deal.
- All right.
- Okay. Let's go to the hamstring issue with
- Napoleon Bonaparte. - Napoleon.
- So let's go to the hamstrings.
There are three hamstrings to deal with.
Not that you really need to know this,
but all three of them run on each side.
The semimembranosus, semitendinosus,
- And biceps femoris.
- There you go.
And they all connect or insert on the ischial tuberosity.
That's your sit bone. That's, when you sit on a hard surface
you can feel that.
So they connect there, and they go down,
and this is an important part of hamstring mechanics
with the hip and the knee, is they go across the knee joint.
So look what happens.
Here we got this, represent the hamstrings and, you know,
they're on slack pretty much here,
but if you bend the knee...
- They really go on slack.
- They really go on slack, okay?
However, bending the knee like this,
they're probably pulling the knee up.
- Yeah. They're pulling the knee up. Right.
So what do you mean, if you go like this,
you're, you're slacking them.
Or I guess like this.
- Exactly. Whatever. If you bend the knee,
there's less distance from here to here,
less hamstring tightness.
- That becomes important.
- Right. Because this is what happens.
Bob, why don't you just bend forward with straight knees?
You're gonna pick something up off the floor.
Now what's going on with his hamstring in relationship
to his back is what the question is.
Now, let, let's do it this way so you can see this.
Bob, can you, can you grab?
- Yep. I'll hold him right here.
- Right there. Okay. Let's get him straight up and down.
So here we got slack hamstrings,
and as you've bend forward, look what happens.
This point moves up,
so that it pulls tighter and tighter on the hamstrings.
And if you got loose hamstrings, it doesn't matter.
You can keep on flexing.
But if you've got tight hamstrings
and you only get halfway down in your hamstrings,
that's as far as they go, 'cause they're tight.
Then the back has to start to flex and bend.
- Yeah. Either the hamstring's gonna take the stress,
or the back's gonna take the stress.
- Exactly. Now I've got a diagram, I think.
- Yeah. That'll probably be clear of it then.
- It will. But now you have a relationship
with the human skeleton here.
But let's go to my outstanding diagram.
- Thanks, Napoleon. - You bet.
- Where are you, Brad?
- Over here. Okay.
Now. Yeah, this is gonna get me
a Pulitzer Prize winner here.
Okay. How tight hamstrings affect back pain.
So if you look at here, can you zoom in Matt?
We got Matt today instead of-
- [Bob] Pulitzer Prize, by the way, is for writing,
not drawing.
- Well I know, but I, I have some writing now.
- [Bob] Oh you do. Okay.
- It's brief.
Okay. So here we go.
The guy's got a smile on his face.
The triangle represents the pelvis,
and the bottom here is where it connects
to that ischial tuberosity and below the knee.
And then the red line represents a hamstring.
These numbers are arbitrary just to make the point.
Let's say it's 30 centimeters from here to here, okay?
Everything is fine and dandy.
This person's got flexible hamstring.
We go over to, to letter B.
This person, bends forward with a straight back
to pick something up just like Bob did before.
And they're gonna need, instead of 30 centimeters,
the distance goes another eight centimeters.
But because the hamstrings are flexible,
it's easy to do. Everything bends.
The back does not take any stress
'cause the hamstrings stretch out easily.
However, we go to this person with tight hamstrings.
The hamstrings, instead of going to 38 centimeters,
are only allowed to 33 centimeters.
Again, the numbers are just arbitrary.
The point is, is the hamstrings are too tight.
And the pelvis only bent, or only rotates half,
half the rotation that it needs.
So then the back, as you can see right here,
is flexed like a banana.
- So yeah, if I'm like this and I go like this,
and my hamstrings won't let me go any further.
The movement in order for me get down
has to come from somewhere.
So I, I start rounding out my back
which is really bad on your back. Really hard on it.
- Right. Puts a lot of stress on it,
and that's what the lines are for, stress.
Oh, that's where I'm gonna make big points
with the artist people.
And the other good point is,
because we know they're biarticular muscle,
if you flex the knee and keep the pelvis
in the same position, actually you don't,
the, the flexibility or the, the length of the hamstring
is not near as important.
So if you lift-
- So I can have tight hamstrings,
but if I lift correctly, I keep the back straight.
The hamstrings are still not real tight.
I can lift all the way to the floor.
- Exactly. So, so that's really the best answer.
However, in real life, how many people lift like that
every time they pick something up?
- Right, sometimes you can't.
You're reaching into a box or something like that.
- Exactly. Something gets in the way.
- All right, you're gonna show how to test your hamstrings?
- Right. Yeah. So if you're wondering,
"Gee are my hamstrings tight, or are they not?"
So we do the infamous 90, 90 test.
We do have a video just on this to go through the details,
but this is gonna be just a screen.
So some, the person will lay down on his back,
probably on the floor, a bed would be too soft,
and you bring up so we got a 90 degree angle here
between the hip and the trunk.
And then at this point,
you've gotta keep the knee perfectly still
and the femur vertical.
And Bob's gonna lift up as far as he can.
Do you feel a stretch in your hamstrings, Bob?
- Yep. That's as far as I go.
- Right. So that is semi-tight.
Just telling you from my experience.
If you can do this and you can straighten your leg,
let's say so your knee can be
perfectly straight up and down like this,
you don't have tight hamstrings.
- I'm glad you didn't try to make it go that way, Brad.
That was just as bad.
- Now I've worked with people that'll go from here,
and they'll get up to about here,
and that's as far as they can straighten it.
Those, you know, if that's you you've got tight hamstrings.
- You've got a lot of stress on the back then
when you're lifting.
- When you're bending over.
And you'll know it when you bend.
So that's just a good screen.
Now let's go through a few stretches
so that you can loosen those hamstrings up
and take the stress off your back.
- I'll give you the materials, Brad.
- Sure.
- [Bob] You wanna start with the cane?
- Sure. We can even, we'll start without the cane.
- Okay. Sure.
- So we're gonna go in the same position
that Bob was in to assess him or screen it.
You can just put your hands here and you can do like this.
And that'll stretch them and hold it.
But that's, that's kind of a lot of work.
- [Bob] You can have someone help you.
- Yep. You can have a partner help you.
Or if you're by yourself and you happen to have a cane
like this, these seem to work good.
You could do a hook cane as well,
but this just makes it easier.
Keep the knees straight, okay?
So the hamstring is lengthened and just pull up.
Now one thing you're gonna find out, if you do this
and you put the cane up here and you pull,
you pull your ankle this way at the same time,
then you're gonna start stretching the nerve,
and it gets really uncomfortable.
- And you're stretching the calf too at the same time.
- Exactly.
- So, so preferably not.
- Keep it down by the heel. And right there.
Keep this leg down, straight. This up.
And you're gonna hold that 30 seconds
and do that two or three times.
Those hamstrings will straighten out.
If you want to get the old stretch out strap.
These are really handy as well.
These are from OPTP.com.
- Yep. Just put that with your shoe, without your shoe.
And the nice thing about this is
they've got straps like that, so it really makes it easy.
- They got handles all the way along.
I think they got 10 handles, Brad.
- Yeah. All the way around.
Now it is important, if you start doing this
with your knee bent,
it is absolutely doing no good for your hamstring stretch.
So make sure the knee is straight
and that relates to our earlier part of the video.
All right. Make sure you do both legs,
'cause if you don't, you start walking in circles.
Very important.
- That's his favorite bad joke, by the way.
- Oh gosh.
- So let's talk about body mechanics, right Brad?
- Sure.
- So you can avoid some of this if you,
if you have bad hamstrings
by just doing proper body mechanics,
and we just happen to have the perfect crate that-
- Yeah. Works out good for that.
- Obviously, just like Bob says,
how many times do you lift something that is
ideal to lift like this?
Well, not always, but there are a number of times.
If you can, Bob's gonna show what's going on with my back.
- [Bob] So we always like to use this as a visual
because, if he's doing it right, if he's lifting right,
he's gonna have three contact points.
Head, back, and sacrum, or pelvis.
So go ahead, Brad. Let's see if you can do it right.
- We're gonna do a good one here.
We're gonna go down like this and there we go.
So that takes the hamstring issue out of it a great deal.
Okay. Now a common mistake is this.
You can bend your knee and still do this,
and things are not lined up, are they Bob?
- [Bob] Nope.
- So I gotta get back like this.
- Yep. You're right. People say,
"Oh, you just bend your knees and you doing it correctly."
It's like, no, you can lift wrong
even when you bend your knees.
- Exactly. All right.
So, oh, there is one more
one more thing for people are pretty nimble and able
for a quick hamstring stretch.
- Oh sure.
- You can simply go like this, but again,
the knee has to be fully extended. The back,
why don't you put the, think about the,
the stick on the back.
And I'm gonna bend forward like this as opposed to
rounding my back back like that.
So you go like this.
- You're still right in there, Brad.
- Oh, nice stretch. Okay.
- Good.
- Nice job, Bob. Thank you.
- Yeah. Well you too, Brad. Nice artist.
- Yeah. I'm thinking I'll get some kind of award
out of that.
- I'm sure somebody will award you something.
- I believe that.
- Take care.
- Thanks for watching.