Two recent studies found that improving hamstring flexibility through stretching exercises can reduce the risk of back strain. The studies showed that tighter hamstrings force the body to bend at the lower back rather than at the hips. Stretching the hamstrings increases hip flexion and allows the pelvis to rotate and take on more of the movement during activities like lifting, reducing strain on the lower back. The workshop then reviewed stretches targeting the hamstrings and related muscles to improve flexibility and encourage bending from the hips rather than lower back.

1. Some interesting research is showing that improvement in hamstring flexibility
will result in better movement strategies and reduced risk of back strain in daily
life.

2. Here's a link to the research papers:
http://goo.gl/IixTFF
http://goo.gl/HNZvZq
What the research found:
The results of both studies were interesting, but unsurprising: “After
hamstring stretching exercises, there was a significant increase in hip
flexion and decreases in both lumbar flexion and the lumbar/hip flexion
ratio during the preparation phase of stoop lifting." To simplify- in flexible
subjects, pelvis movement/rotation, the preferred means of movement,
was dominant. In conclusion, improving tight hamstrings may reduce
lumbar loading/flexion thereby reducing low back pain.
Two recent studies looked at what is called “lumbo-pelvic-rhythm.” The first
looked at lumbo-pelvic-rhythm in relation to forward bending, the second in
relation to lifting. Lumbo-pelvic rhythm is essentially how the pelvis and
lumbar spine move in relation to each other. We, i.e. the body, usually
employ one of two patterns, particularly when forward bending and
lifting—lumbar dominant and pelvis dominant. In lumbar dominance, a
forward bend is achieved through flexion of the lumbar spine. In pelvis
dominance, a forward bend is achieved through pelvic rotation i.e.
increased hip flexion, with less loss of neutral spine position.

3. In the first part of this workshop we will look at how to stretch the Hamstrings and Adductor Magnus. In the second
part we will focus on Gluteus Maximus, the lateral hamstrings and Piriformis. Our goal will be to improve their flexibility
and as a result facilitate a forward bend that is achieved through pelvic rotation instead of lumbar flexion.
First, lets look at the anatomy. Images are taken from Innovations in Pilates-Therapeutic Muscles Stretching on the
Pilates Reformer
Can you name the two muscles at the end of the two yellow
lines?
ThetoponeisSemiMembranosus,andloweroneistheshort
headofBicepsfemoris

4. On top of the previous muscles are a second layer, said to
be more “superficial” Can you name the muscle at the
end of the first line, and then the muscles at the end of
the bottom two lines?
ThetoponeisPiriformis,thesecondbottomisthelong
headofBicepsFemoris,andthebottomoneistheSemi
Tendinosus

5. Can you name the most superficial and largest of the hip
extensors?
GluteusMaximus

6. A very safe and simple way to stretch the hamstring group is on the Pilates reformer. Start with medium resistance,
enough to move the carriage away and stretch the muscles without pulling the hip into too much flexion. This will cause
the stretchee to contract the very muscles we are trying to stretch. If the other leg is kept horizontal, it will hold the pelvis
in a neutral position via hip flexor tension.

7. This close up makes it easy for you to see the Gluteus Maximus, the short head and long head of Biceps
Femoris as well as Semi Tendinosus and Membranosis. If you dorsi flex your foot, i.e. point your toes toward
your face, you can see that the Gastrocnemius will be stretched more also. This part of the stretch is more
intense in the bulk of the hamstring group. In a moment, we will alter the leg position to change the focus
to the lateral band of muscles.

9. Now lets move the stretch more strongly into the Gluteus
Maximus, the Lateral Hamstrings and Piriformis

10. Notice the Piriformis here, underneath the shadow of the Gluteus Maximus. You can also see the long
and short head of the Biceps Femoris, and the lateral head of Gastrocnemius clearly.

11. This slide is a little tricky to make sense of initially. Its a shot looking up from the posterior aspect of the stretchee, as if you
were lying under the carriage. Note the Piriformis, the long head of Biceps Femoris and the Gastrocnemius.

12. Finally, bend your knee and come out of the stretch
slowly. Normal range of motion is said to be 80 to 90
degrees of hip flexion. In my experience though, it is
more common to find about 60 degrees as normal,
especially in males. Recall the research study
information in the first slide in the presentation. To bend
effectively from the hip joints, without flexing the
lumbar spine constantly, at least normal range of
movement is required The absence of this “normal
range” could be one of the major contributing factors to
the high incidence of Low back pain so prevalent
nowadays.
The take home lesson?
Work consistently to ensure you and your clients have at least 90 degrees of hip flexion. Then,
rehearse the safe and effective practice of bending via pelvic rotation instead of lumbar flexion.
If Geoff, our 73 year old client can do it, you can too!

13. Geoff, 73 years of age, practicing one of our Innovations in
Pilates stretches.
The slideshow above represents a brief snapshot of the
Innovations in Pilates material. The material is contained in our
books, and taught in classes and teacher training workshops
around the world. For further information, please go to
www.innovationsinpilates.com.au
The full article that accompanies this slide show can be found
at www.anthonylett.com.au