Extreme Hamstring Tightness: Should I Stretch?

author : AMSSM
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Member Question

I am constantly tinkering with my bike setup. If my elbow pads are as low as I can get without killing my neck, I have to lower my saddle, and if my saddle is high enough so I don't hurt my knees, I have to raise my elbow pads because I cannot reach the bottom of the pedal stroke without hamstring pain. In the morning, my fingertips can just barely touch my kneecaps upon bending forward…yeah, its bad.

I have been doing quite a bit of research and its unclear whether one should stretch or not, and very little-to-no info on people who are as tight as me.

Stretch or no stretch? If stretch - how, how much, how often? If no stretch - what instead?

Answer by Stuart Lisle, MD
Member AMSSM

Your problem with the bike fit certainly sounds quite frustrating! First off, I would like to address your question of stretching in general. Certainly there is a lot of conflicting information out about stretching. For many years, good old static stretching (stretch and hold for a certain amount of time) was considered a standard warm-up routine. This was then called into question when some studies suggested that power/force was diminished when athletes performed static stretching before exercise. However, more recent studies have suggested that may not necessarily be the case. Needless to say there is conflicting evidence out to support one view versus the other. Also, most of the conflict is specific to static stretching before exercise and there is less controversy over dynamic stretching (stretch of active muscle like in plyometrics) or post-exercise stretching. In my opinion, each athlete should then be a case by case basis when the decision is made to stretch or not. Take a longtime runner for example who never gets injured and does not stretch, then there is probably no need for him or her to begin a stretching routine. On the other hand, if someone has a potential benefit from stretching, it would be a good idea to incorporate it.

In your case, the goal of your bike position is first off to be comfortable in order to provide the maximum force for a long period of time, and secondly to be as aerodynamic as possible. It sounds like your hamstring tightness is limiting your ability to drop the elbow pads to get in a more aerodynamic position and keep the seat high enough to keep your knees comfortable. If you were able to increase you hamstring flexibility, that would likely aid in your ability to obtain a better position. Therefore in your particular case, the potential benefit of stretching certainly outweighs any debatable negatives of stretching. Now, the question is how and when to stretch.

The best stretching routine is one that you are able and willing to perform consistently. If you are trying to improve flexibility, it should probably be done on a daily basis. You should focus on stretches for the hamstrings specifically, but including many muscle groups is likely to help your position as well (hip flexors, quadriceps, iliotibial bands, calves, etc). If performing static stretching, the preferred time would be after a workout or warm-up given the aforementioned controversies. In general, stretch and hold for 10-30 seconds per stretch and perform each stretch 2-3 times. A basic hamstring stretch could be sitting on the ground and leaning forward to stretch both legs at once or by isolating one leg at a time, by standing and bending over to try to touch your toes, or by lifting one leg up onto something and bending forward to stretch. Incorporating other standard stretches for the calves, quadriceps, iliotibial bands, hip flexors, shoulders, chest, and any other muscles particularly tight would also be a good idea. Dynamic stretching on the other hand could be performed before or after workouts. Particularly good ones include lunges, skips, leg swings and most yoga stretches.

Again, the important thing here is something that is practical and that you are willing to do on a regular basis. The last thing to consider, if you have not already, is a professional bike fit. Many bike shops have someone who can do this, and even some people have special certifications/qualifications for their bike fitting. Even if you have done this before, it would be a good idea to do again after you have improved your flexibility to try to get into an even more comfortable and aerodynamic position. Hope this is helpful and best of luck to you out on the road!

Stuart Lisle, MD
University of New Mexico Primary Care Sports Medicine Fellow

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date: July 24, 2014

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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