What You are Missing with Hamstring Strains
Are hamstring strains really as straightforward as they seem? In this episode I dive into some of the less known complexities of this common injury, sharing the top three aspects that often get overlooked in treatment. By sharing a case from my own practice - a professional football player with recurrent hamstring strains - l explore the distinction between true muscle weakness and neurological changes, and how our language and what we say matters.
Look beyond the muscles and musculoskeletal system to examine the hidden causes of hamstring strains such as nerve tension and entrapment. This tension can be in surprising places - not just the peripheral nervous system, but also centrally in the spine or cranium. You'll learn about the key role of visceral connections and how a protective pattern can not just change mobility and muscle performance but also change the dynamic alignment that is often seen with hamstring issues.
This is more than just another conversation about movement. This is an exploration into the body's intricate network of connections, where I hope you will gain valuable insights to benefit your athletes and clients.
Resources mentioned in this episode:
Sciatic Secrets- Unreal Results Episode- https://www.movementrev.com/podcast/season-1-episode-27-sciatica-secrets
Long Sit Pelvic Walking- https://vimeo.com/manage/videos/473618587/a6b7ba4c2e
Forward Fold Hamstring Stretch- https://vimeo.com/448660986/0f8583e206
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Hey there, and welcome. I'm Anna Hartman, and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain, and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello, hello, I am back with another episode of the Unreal Results Podcast. Um, yeah, so... This week, I teased it out a little bit already on Instagram, but this week I'm gonna talk about hamstring strains. So gonna share the top three things that you're probably missing when you're doing someone's hamstring.
Rehab or taking care of someone with a hamstring strain, tell you a story, talk a little bit about hamstring strains in general, and then, um, kind of go over some common mistakes too, which you know. I'll try to keep it organized, but that's just not how my brain works. Um, so How to start it out. So I think we've all Probably encountered the athlete or patient that comes to us and is like I've had a hamstring strain for Months and I'm like month like multiple months or there and it was like maybe it started as like a low level Grade one strain or like maybe they didn't get an MRI Whatever it is, it was never really bad, right?
Maybe there was barely any limping, only a couple days of soreness, um, Or, perhaps even it was worse, right? Maybe it was more of a higher grade strain. Um, but it's just not, they're not getting over the hump. Um, I hear this from people a lot, like a lot, a lot.
Why I decided to do this podcast episode is recently I had a football player that came to see me Who had strained his hamstring again for like the I don't even know fifth year in a row or the third year in a row and He was pretty frustrated that it happened again and, um, he was like, you know, Anna, I would like, he's like, you know, treatment seems to be going pretty good with the team.
He's like, we're doing the standard things and I was like, let me guess, like a bunch of glute exercises and modalities and he laughed. He's like, yes, he's like, but. I can't, he's like, I'm still not 100 percent and he's like, and most, most of all, I'm fearful that it's going to happen again and frustrated that it keeps happening.
And he's like, so I'm hoping that not only can you help me. Get to 100%, but can you give me some insight on what I'm missing and what to do to prevent future ones? And I was like, yeah, absolutely. Like I'm pretty confident that, um, you should leave this appointment, uh, feeling better and not having the symptoms that you're still having.
And also with some clarity on what's going on and that clarity, including that. I doubt a professional football player who works out all the time has weak glutes. So, you know, in that, I've talked about that probably on other podcasts and definitely on Instagram, but unpopular opinion, um, in this patient population, you only see weaknesses like true muscle weakness after a mobilization.
period or neurological injury. But then it's like, is it really true muscle weakness then? Yes and no. Um, because what you'll see is a lot of times it's more of a neurologic thing for people than strength. And we know this. Fundamentally, I think as physical therapists and athletic trainers, strength coaches, like, we know this, right?
We all know the research that it takes, you know, eight weeks to create hypertrophy, like physiological hypertrophy. And strength gains in a muscle, you know, we know the first six to eight weeks of exercises is are all neurological gains, yet we keep labeling people in the in this world as having like weak glutes, weak, whatever's weak hip flexors, doing four weeks of exercises and being like, Oh, look at that, they're stronger.
And that's not, it's just not true. Like, are they stronger meaning like, as neurologically they improve their motor pattern, um, or get nerves to fire better, that they can move more mass or go through a greater range of motion? Absolutely. Is that the same thing as strength, physiologically? A little different, right?
And part of, so I think part of the problem is like, we don't have the right words to put around things. Um, and you know, I hate like telling people things are inhibited or turned off or turn on that kind of thing. So you know, it's like getting away from that as well. But um, so I don't think it's like, you know, when it, I don't think if somebody really stopped to think about it, they wouldn't realize what they're saying is probably not correct.
But what the athlete hears, we care about, right? Because then they get this like idea in their head. So Um, my top three things when it comes to hamstring strains, really any, well, not really any strains, but some of this will be applied to any strains and some is very specific to the hamstring. But the top thing, things that I see that are being ignored are hip flexion mobility, not related to the tension on the back of the leg, which, you know, quote, unquote, Hamstring tightness or nerve tension, not the posterior limiters of hip flexion, but hip flexion mobility that is limited by a hip not wanting to sink in the socket or crease, fold over the inguinal ligament.
And you feel that when you Get better at paying attention to what you're feeling with your hands as opposed to just test randomly not randomly But just testing range of motion Flippantly like not paying attention to what you feeling and what I mean by that is when you're testing Let's say supine passive hip flexion when I do it.
I have one hand monitoring the ASIS So I'm monitoring the pelvis and the other hand is on the femur and I'm passively moving it
I want to see, I want to notice, is the femur moving independently, right, dissociated movement, femur on pelvis, where does the pelvis start to move, and then also, What is the quality of movement? Does it feel like the femur wants to go, wants to go into hip flexion or does it feel like it's avoiding a certain direction?
And when, when athletes are limited in hip flexion from an anterior problem, what you'll see is it'll just stop and the pelvis will go. Or you'll feel like this tendency towards wanting to avoid a certain area of the front of the hip. So you might even feel like the femur wants to track laterally to avoid, or maybe even it starts to externally rotate or internally rotate, right?
So you're monitoring the femur and you're going slow enough and you're paying attention to these little subtleties of like, does the femur want to fold at that hip joint? And then from a resistance or lag feeling, it doesn't feel like it's lagging from behind, right? We're not feeling this posterior tension, we're feeling this avoidance.
of the hip flexion on the front, and this is very important. Now, you know, obviously, sometimes when you're testing this, you're gonna feel a posterior leg and some posterior tightness. That still can exist, um, and sometimes it is the limiting factor of hip flexion. So, you know, fundamentally, this piece is like, let's see where their hip flexion limitation is really coming from.
And what I often see and what is often missed is this. Is this resistance to, or this avoidance of, folding over the front of the hip? And, um, we'll talk about two things. One, why does it matter? And then two, what could it be coming from? So, why does it matter? Like, why is hip flexion important? Obviously, um, a lot of the times the hamstrings are getting strained in a mechanism of eccentric.
So, And so that would be hip flexion, hip flexion and knee extension to be exact. Right. So, so restoring hip flexion is an important part of it, like a hip hinge, right? Um, And this also gives you some insight into if you're looking at their hip hinge quality and pattern, like why they might not be hip hinging very well.
It would make sense that the hip hinge doesn't look, doesn't look like good quality if they're avoiding the front of their hip. And the other thing is when we look at like the other mechanism that hamstring strains come with a lot, especially in running sports, is that they tend to happen with the athlete gets into a.
mechanic, a running mechanic of what's called casting. And it's basically when their knee starts to, the knee flexion angle starts to increase, right? Get more towards extension. And the person is running by their foot being too far in out in front of them. And it's like they're pulling their body forward with their hamstring instead of Striking the ground underneath them and pushing it away, right?
So this, this is commonly called casting in the world of, um, running mechanics. And so how you fix it besides cleaning up running drills is sometimes as simple as identifying that when the hip has a hard time moving into hip flexion. The SOAs can't do its job as the primary hip flexor and, and, and move the thigh into hip flexion.
And so the synergistic muscles, the other hip flexor muscles, right, the other hip flexor muscles are also knee extenders. And so in. In effort to get good hip separation in a running mechanic, the athlete tries harder to bring their leg up into hip flexion, and it does that at the expense of knee flexion, right?
Because it's, they're trying to utilize all of their hip flexors, and some of those hip flexors are knee extenders. And so every time they go into hip flexion, they also go into a little bit more knee extension. That sets them up for that casting pattern. And you can do all the running drills in the world, and as soon as you have that athlete open up and they try to maximize that hip separation, same scenario happens.
So, part of this is cleaning up this hip flexion, and it can't just be beating them over the head telling them to activate their psoas. And keep their knee bent. Sometimes you have to go a layer deeper and realize like why they're not moving in the hip joint. And so many times this avoidance pattern that I see with a supine passive hip flexion test is in avoiding the neurovascular structures on the front of the leg, avoiding.
over compressing them. And we see that when they're already under quite a bit of compression, given a position of the pelvis, right? If the position of the pelvis has a relative out flare to it, perhaps because someone has A tight ass, right? A posterior pelvic tilt. It puts tension across the inguinal ligament which puts compression on the neurovascular structures under the inguinal ligament.
So when you go to passively, um, flex the femur, it doesn't want to add to that compression because remember neurovascular structures hate over stretching and they hate compression. Also, one of the things that can happen is underneath the inguinal ligament you have another structure of fascia that sort of maintains this, this space under the inguinal ligament called the iliopectinial ligament and sometimes that iliopectinial ligament Can be what's the right word for it?
Maybe like the tissue can just be a little bit dehydrated and when fascia is dehydrated It's just not as good as maintaining. It's it's it's microvacuole like space so um Doing treatment sometimes on this iliopectineal ligament, um, can be very good to restore the space underneath the inguinal ligament and free up the hip joint and allow it to, to move into hip flexion without avoiding that.
Another component of this. is actually from the posterior and that is that part of this posterior pelvic tilt tendency in this protection pattern is perhaps a femur that doesn't sink very well in the hip socket. I see that quite a bit too, um, and that strategy to fix that is a little bit different, but um, again, it all fundamentally comes down to noticing when you're doing a passive hip flexion assessment, when the range of motion really runs out in the, in the true hip joint versus in the just general hip motion.
So often athletes will come to me and somebody will have evaluated them first and be like, yeah, their hip flexions within normal limits. And I look at it and I'm like, Oh my gosh, it's barely like 80 degrees before the pelvis starts moving. In a perfect scenario, I would love for an athlete to get 100 to 120 degrees of hip flexion before the pelvis moves.
I am not too concerned if they can at least get to 90. So, and I've seen athletes come in anywhere between 55 degrees of hip flexion before the pelvis starts moving, and 120 degrees. And so, um, paying attention to that is key to catch a lot of things. So another important spot to consider is a neural tension and the neural tension component of it.
This is often the case. And actually too, like let's even take a few steps back and before I even like continue more on this, like top 30 things you're missing. Let's talk about this concept of like when we're living in this lens of view that the, Um, viscera is the most important thing to the body. We have to look at soft tissue injuries in the limbs as something like, why was the musculoskeletal system protecting it?
Because the body would rather tear a muscle, or fascia even for that matter, before it tears a nerve or vascular structure. Right? Muscles regenerate, fascia regenerates very quickly, muscles especially. And so, um, going back to that casting. Type of mechanic right if someone is running with that pattern because they're avoiding that hip flexion and they're casting out now What that casting does too as the knee starts to open up into more extension it starts to add on this the elongation or the stretch or glide needed in the Tibial nerve and the posterior Branch of the operator nerve and the common peroneal nerve, right?
All of those nerves on the posterior leg start to elongate and if there is some sort of neural tension or compression happening within the nervous system anywhere from central nervous system to peripheral nervous system. And we don't have the ability for that peripheral nerve to lengthen in the tissue.
What does the body do? It's like, Oh my gosh, the nerve is in a position or the nerve vascular structure is in a position where they might tear. So, Immediately send a message to the hamstring to check that range of motion. So what happens is you start to feel the little pull from the from the nerves of the back of the leg, you know, which often feels like hamstring tightness and then all of a sudden the body grabs.
And often that grab is that that message from the body of like oh shit. Contract the muscles as much as we can to reflex the knee to protect tearing the nerves. Alright, so this is also why hamstring hamstring tears and hamstring strains tend to be in very similar specific spots. And then it's often right where a peripheral nerve is like supposed to be like gliding easily through the fascia.
So, so that's, you know, why we need to take a step back too, because understanding that this neural tension piece not only can mimic a hamstring strain that a grade one hamstring strain that It doesn't ever really go away, right? Because we get that a lot. I have so many athletes come to me with that.
Like, I've had a hamstring frame for six years. No, you haven't. Right? So, not only can the neural tension create the scenario of the symptoms that feel like constant hamstring tightness or constant, like, grabby feeling or, like, the borderline of right before the grabby happens, um, to Creating this, um, scenario that you do actually then tear the hamstring, um, musculo mus, like muscle tissue or myofascial tissue.
So this, these neural tensions, but like I said, can come from anywhere in the system. 'cause just like we talked about in the last podcast, which was on the sciatic nerve, we can have. compression or tension or an area of the nervous system that is not able to slide and glide very well anywhere along the chain and it affects symptoms in the periphery.
So we can have central nervous system. Components up in the cranium itself around the tentorium, which I talked about a lot last week in the areas of the spinal dura in the spinal column where, um, the. vertebral foramen naturally narrows, the dura naturally narrows and provides and adds in a little like pinch point there in the spinal dura, in the spinal cord.
We can have, um, entrapment or compression of the nerve roots as they exit at the disc level. Um, for, you know, from the disc pressing on them, like very central, or we can have it a little bit more periphery at the nerve root where it exits the neural foramen on the lateral side of the spine. So those are all like central nervous system things that could cause entrapments, um, and cause this neural tension, right?
And going back to this casting scenario, right, that can. That can, uh, uh, uh, tension in the tentorium can cause a scenario that when you go into hip flexion and knee extension that you have a limit of how well that nerve can get down there because it's not getting pulled down in the spinal canal, right?
So that cranial. piece can actually create a scenario where the person does pull their hamstring, right? I'm not saying that hamstring pulls don't happen and it's all neural tension. I'm not saying that at all. I'm saying this could be, could be and is often the driver. for the hamstring strain in the first place and you can do all the healing modalities and strengthening the glutes you want and if you never treat that initial cranial piece or central nervous system piece in the spine and you can even do all the peripheral nerve tension glides you it just It sometimes doesn't do anything right.
You stay in the scenario of the hamstring feeling like it has to stay in protective mode and then it is like, feels like it takes forever to get the hamstring better. Right. So, and then two, you can have just true peripheral nerve entrapments that, you know, like we talked about in that sciatic nerve, um, podcast, it can be at the, um, it can be, at the, in the pelvic bowl from a visceral component, which spoiler alert is the third thing you're missing.
Um, it can be at the piriformis and posterior hip. It can be, um, a little bit lower there in the thigh as the sciatic nerve goes, um, down through its like little groove. It can be, um, in the area where the hamstring splits. It can, at the top of the popliteal. popliteal fossa. It can be in the popliteal fossa itself.
It can be within the compartments of the lower leg. There's multiple areas there, or it could be from the other side, right? We talked about with the sciatic nerve last week, this concept of the steering wheel, how one side has to glide up where the other one glides down. So oftentimes the hamstring that got strained, it's actually a compression or an entrapment problem on the other side.
So we have to consider all of those nerve entrapment pieces that we considered last week in the sciatic nerve, um, podcast, which of course I'll link in the show notes for you too. So, um, then the third thing that you, you might be missing and it still kind of relates to the nerves, like I said, is this visceral connection, right?
There is a very strong visceral connection between, um, the liver, the colon, sigmoid colon. Um, even a sending and descending, sending colons, the kidneys, um, on creating a scenario where it's irritating the, the nerves and, you know, again, sending this message of this protection pattern around the hip, um, um, to the nerves in the lower peripheral nerves that creates this same sort of scenario where the body is like.
We're protecting something, so we're going to limit mobility. And when we limit mobility like that, we change the mechanics going back to that casting piece. And again, this could even be like the person who is doing like a yoga pose and over stretches, um, something. Right. So it just, it just. It can be any scenario, but understanding, right, we're always taking this lens of view of the organs are the most important part of the body.
The organs are the most important thing to the whole organism and remembering that the legs of two of the most important organs, the brain and the heart, live in our limbs. So when we get Hamstring pulls or calf pulls or quad pulls like we have to take a step back and consider the the general role of the musculoskeletal system plays as a protector of the viscera.
Okay. So, um, The cool thing is, is when you, when you start to consider all these things, right, because even the hip flexion piece, we talked about how that could be a neurovascular problem, um, a neurovascular entrapment. So when we're, when we're approaching things in this way, we, what you'll see. is then it becomes really clear the common mistakes we make in traditional sports medicine of how we treat hamstrings as a movement impairment syndrome type of scenario.
And what I mean by that is, sure, You might test somebody on the table and look at their hip abduction in sideline and you might be like, look at that. They're weak. You can, you can even see it standing sometimes in their dynamic alignment when they go from two leg support to one leg support and they totally lose control on that leg.
Okay. I, I don't disagree that you're seeing some of these, you know, things that could look like weaknesses, but again, in the absence of immobilization, you know, neurological reasons for weakness or sedentariness, which, you know, again, I, I T I work with athletes. I work with athletes and people who work out on a.
regular or semi regular basis. And so maybe you do work with a population that does nothing and needs some strength, but I gotta tell you, if someone can stand upright. If they can stand and walk, which is a lot of the people who come into your physical therapy or athletic training studio or wherever, or studio, athletic training room.
If they can stand and walk, their glutes are plenty strong. If, if they truly had glute weakness and um,
To the, to the level of which it's described sometimes to the patient of like how their glutes are termed off. Um, glute amnesia. Um, if, if they, if that's happening, they're not able to stand upright. We need our glutes in order to stand up. Anyone that has a spinal cord injury knows this, sees this. Um, this is an aging population who, either has also neurological things from like stroke, or, um, just so much atrophy from aging and weakness, and they, what do they need?
They need a walker, right? So, so let's, again, stop labeling this lack of I don't, again, I don't want to say strength, but like this, this appearance, this assessment that appears that perhaps there's a strength issue or perhaps there is a, um, movement pattern dysfunction. Let's get away from telling people that they're not strong when they are, because what happens is you, you.
So, um, when you deal with some of these areas of entrapment, you get that, you clean up the hip flexion, you clean up the central nervous system piece, and then you retest them, and all of a sudden, they test five of five strengths. Their dynamic alignment looks good from two legs to one leg. So it's like, in that, in that 20 minutes of you touching their body, did they get stronger?
Did physiologically, did the muscle get stronger? No fucking way. No fucking way. Which is why I am like on this soapbox of like, it's not a weakness, right? And, and that, you know, takes us back to remembering that movement. Is an output Movement is an output. So when you do nothing, but give people exercises and cue their output and focus on the output in order to make them feel better, you're making it way harder for yourself.
You're literally banging your head against the wall. And that athlete probably feels like they're banging the head against the wall too, because I got news for you before they came in to see you at the PT clinic or in the outside of training room. They've already worked out. They've been in the weight room for two hours, if not more.
They've been at practice for an hour and a half, if not more. Do you really think they need more exercises? And I'm not saying don't ever work on people's patternings and like doing some exercises and especially like to, to get over that fear piece and let them know they're okay. And if there was truly a soft tissue disruption to progressively load the tissue to allow for the healing and the collagen to realign in the, in the physiological way that, you know, that needs to in order for it to be strong again.
I'm not saying don't do that. I'm just saying that you need to consider some other things. And you gotta stop labeling things as weak when they're not. Um, so another common mistake I see is, um, stretching and stretching when they're still in a protective pattern. And they're either gonna be in a protective pattern because they truly did.
tear soft tissue and probably shouldn't be stretching it, especially very soon. And then because, right, what happens when wound healing, what do we want in wound healing? We want tissue approximation. We want a coming together, a shortening of things.
So that is the opposite of stretching. So the first thing I tell my athletes to do when they Pull something is to not stretch it. Stop stretching that and then also Because oftentimes it's the neural piece and we don't want to be stretching the nerve. That's what got us here in the first place And then to like some people and this is like my yogis that come in with hamstring strains often their strain And, you could argue, maybe a little weakness, is because they're constantly putting the muscle on stretch.
And when a muscle is constantly on a stretch, it adds muscle cells in series, which then tends to weaken it. So, um, but again, if they're standing and upright, They're not that weak. Uh, so then this other concept of when is it okay to stretch the hamstring, it, you can, you know, once you get, get over the first like 12 to 14 days of healing, I'd say it's fine to start stretching the hamstrings cause then we're going into that progressive loading scenario, right?
Because that is part of it, that eccentric lengthening. Um, but understanding that the hamstring attaches to the pelvis and to the tibia. Right, and so we need to get clear at keeping one of those joints steady as the other one moves and stretches it. So my favorite way to actually stretch the hamstrings is a seated long sit because it's taking the pelvis and moving the pelvis away from the other end of the attachment of the hamstring.
or a bent over hamstring stretch and like a forward fold, keeping the knees bent and staying in the same position so that you can one, keep your weight forward on your feet and then two, focus on lifting the pelvis up and forward instead of What is the normal cue for people sending the knees back?
Sending the knees back is the quickest way to tuck your butt under. Which is not lengthening the hamstrings, it's shortening the hamstrings. And, but what is it doing to the nerves? Lengthening the nerves. So the quickest way to feel a nerve stretch in a forward fold is to bend over and slam your knees back.
And so it's understanding what it actually feels like to feel a stretch sensation in the hamstrings, which is actually at the muscle belly. The only way you really feel that is if you can get your pelvis free to move on top of the femur heads. Right? So that's what those two stretches do, and I'll link videos of those in the show notes.
As well as understanding that sometimes your pelvis is bound down, binded, and not allowed to move for two reasons. One is that protective pattern. Normal protective, like, reflex is to tuck your tail and stick your head out. Just like a dog or an animal when it's scared, tucks its tail. We do the same thing.
When we are stressed out, when we are in a protective state, we tuck our tail under and it's really hard to untuck it until you're out of the threat, right? So again, this comes back to like why I'm such a stickler on like doing something like the LTAP, you know, the locator test assessment protocol to figure out where to start treatment.
So you can figure out where the body's protecting, treat there and get the person out of that sympathetic nervous system into a more parasympathetic nervous system. Cause not only is that nervous system state going to help us out in the healing, but it's going to allow us to untuck the butt. And we need that if we're ever going to allow the hamstrings to move in and out of its normal link tension relationship.
Right? Because in order to do that hamstring stretch in the forward fold where the knees stay still and the pelvis lifts up and over the femur heads, I need to let go of the butt tuck because I need my sits bones to open up. I need my tailbone to lift up, right? I need the sacrum to mutate or counter, sorry, counter mutate, right?
Anterior tilt. I need that widening of the pelvic floor. Widening of the pelvic floor is key in order to free the pelvis to allow it to move on top of the femur heads and get this pelvis on femur motion. So, um, Taking a step back sometimes for this means one figuring out where the body needs treatment first to start.
This is also sometimes going to bring you to the central nervous system entrapments or the peripheral nervous system entrapment. So you're kind of fixing two of the things at once. Plus you're getting them out of the posterior pelvic tilt, which means now the hamstrings are going to let go a little bit because They were part of the reason, right?
The hamstrings pulling the pelvis down is part of that protective pattern, too. So, you're finally getting a message to the hamstrings where they don't have to be protecting anymore. And then, um, also, you're setting yourself up for a scenario that you can actually stretch the muscle tissue. And there are a lot of short hamstrings out there.
And it needs to happen. But it's one of the hardest muscles to stretch because it crosses multiple joints and requires a lot of awareness to do it correctly. So, also, um, I said I'd link those stretches. I'm not going to link all the pelvic floor things because then it'll be like a million links. But, um, hopefully that gives you like a little bit of a insight on how I approach the hamstring.
And I want to tell you the story of this athlete who came to me, right? So I started the podcast up with it. I told you he was frustrated. He wanted me to like one, get him better. And then to, um, give him some answers. And so sure enough, when I worked on him, his, um, Locator test assessment protocol directed me to his lumbar spine and sure enough his lumbar spine was Really stiff very stiff didn't really want to go into extension or flexion to be honest But it was very limited in extension like he was had a very flat spine And so I'm like, uh, yeah, no wonder your hamstrings are having recurrent problems is because they are, this cut, this is happening at the nerve root level.
And this was confirmed to me by the double leg neural tension test that I talked about in the sciatic episode. So again, if you missed that episode, you might want to go back because they relate to each other quite a bit. And so then what'd we do? We started treatment there. I started treatment there and that made him feel better.
That changed his range of motion. Then I did another round of the LTAP and that directed me to his cranium because he had a little piece of tension up there too. So then I did treatment in that area and that freed things up even more. And then lastly, I, it directed me to his opposite leg and I, Did some stuff there, and I freed it up, and then I had him recheck what he felt, and the way that he provoked his pain was like this long lever, um, supine bridge, and he tried it and he's like, oh, I don't feel that anymore, and he got up and he bent over and he's like, I don't feel it, it's not tight anymore, and I was like, great, you know, and the next day what did he do?
He went to the training room and he did his exercises and he felt great and was able to progress to, you know, 90, 95, nine, basically 90 percent um, running in practice. And then he was like, back, back in practice two days later. And, um, the most important thing is I was like, I bet you've never considered that it might be coming from your spine.
And he's like, never. I was like, right. So, you know, do or don't do all the glute exercises there. How are you doing? Like, it's not going to hurt you. Um, unless there, unless it's posturally tilting you and then that's another story. But, um, for the most part, like do whatever exercises, it's not going to hurt you, but let's add in some things to address some of this central nervous system tension that is.
Creating problems. And so I gave him ragdoll exercises and, um, like a thoracolumbar sort of massage that facilitated lumbar extension and then segmental cat cow. And that was it. And he's been doing them and. As far as I know, he's feeling good. Well, you know, fingers crossed that it ends up, um, being the, the missing piece, but the important thing is it gave him some hope, and he came to me with pain, and he left without, and I always love that.
So, one treatment, and he was good to go. And, um, I'll keep you posted if that changes, but I really do feel like that led us to the problem and it makes sense when you look at hamstring strains from this point of view. So hopefully that gives you some insight on how I treat on hamstring strains, on common mistakes, things we're missing, and also like a little bit on the movement mechanics.
Because again, remember this is all about restoring people's movement, but in a way that makes sense. Restoring people's movement and understanding that movement is an output. I still care about their movement patterns. I still care about his running mechanics. But I want to set him up so that when he goes and does whatever he needs to from a drill standpoint to improve his movement mechanics that he's not fighting upstream.
That it's easy for him, that he can be in a positive movement experience and get the most out of it. That's when he'll have success in retraining patterns, right? And, uh, if you haven't joined yet, this is the last week.
Uh, this podcast will come out on September 20th. So you have... One, two, three more days to sign up for the free results sheet code and, uh, and then that, that, that starts on the 24th. So I hope you'll join me and, uh, start to see things in a new perspective, new lens of view and, uh, be able to apply some things practically to help your athletes and clients.
So that's it. Have a great day and I'll see you next week.
