Why Are My Child’s Hamstrings So Tight!?

Hamstring Exercise

Hamstring Exercise

If you are a parent that is wondering why your child’s hamstrings are so dang tight then trust me you are not alone. This is absolutely one of the the most frequently asked questions we get here. So I am going to try and help you all understand a little bit more about this topic. Let me start by explaining a few key terms that I know you’ve all heard before, such as “tone” “spasticity” and “contracture.” So muscle tone is basically just the right amount of tension a muscle has at rest and its ability to respond on command. For example, if you are just sitting there and want to reach for your fork to eat dinner, your resting muscle tone allows you to reach at the right speed and distance without any effort required. For children with neurological diagnoses the resting tone of their muscles is higher than those of typically developing children which means there is too much tension in their muscles at rest. From this previous example, for a child with let’s say Cerebral palsy, they would have to concentrate 10x as hard and overcome the tension in his/her muscles in the arm in order to reach and grab the fork. With high tone or “hypertonicity” movements are often jerky and uncontrolled which makes it super hard for these kiddos to perform everyday activities.

Next, we have spasticity- spasticity is an abnormal increase in that muscle tone that we discussed before. So, for example if you go to stretch your child’s leg and it suddenly stiffens up and it feels like you can’t move it that is what spasticity is. Did I lose you guys yet?! Now we can start talking a little bit about how all of this stuff contributes to your child’s muscle tightness. You know that feeling when you feel your muscles tightening to lift a weight at the gym? For example, when we do a bicep curl our muscle has to shorten in order to contract and allow us to lift that weight. Imagine that feeling constantly 24/7, without you even doing anything your muscles are just tight and contracting. That is how your kids feel, their muscles are always at this heightened state and they are unable to relax. So, because of this increased tone and spasticity and all the fancy terms we learned about before, their muscles are constantly in this shortened contracted state which overtime can lead to their inability to move and decrease the flexibility that they have.

Now we have these poor hamstring muscles that are just constantly tense and short and becoming shorter and shorter as time goes on and this is what can lead to a contracture. A contracture is a condition where the muscles are now at a permanent shortened and hardened state and even with stretching, they are unable to move any further. This is what we want to avoid people! And why physical therapy is SO important for these kids!

Now that we understand a little bit more about the reasons behind the tightness let’s talk about how to avoid that dreaded “contracture” word. There are a variety of ways you can prevent contractures including stretching and night splints/immobilizers. Stretching these muscles is effective but it needs to be consistent. In order to see true change in muscles they need to be continuously stretched daily. Let’s take a rubber band for example. If you pull on it, it stretches right? But once you let go it goes back to its original size. It’s the same thing with your muscles, if you don’t continuously stretch those tissues, they won’t gain that new range. Another great way to maintain the length of those muscles is using night splints or immobilizers. These braces keep these hamstring muscles in that lengthened position for a prolonged period of time which can help maintain their current mobility and overtime may contribute to increased available movement. But most importantly, I’m going to throw out two lovely words that will be sure to help… Physical. Therapy. I am sure you are thinking well can’t I just learn a few hamstring stretches off of YouTube and we’ll be good to go? Yes and no. Yes, continuous stretching is a big component of preventing these contractures but it’s not the only thing these kids need. Strengthening and being able to work these muscles in certain functional positions is what is going to help long term prevention. If we are able to break through some of that tone and start building true underlying strength in these muscles, we can help improve mobility, positioning, and posture which all contributes to contracture prevention. Stretching, bracing, and splinting are all awesome components that can and should be used for maintaining that flexibility and range of motion in these muscles but trust me when we say, your kid needs more than just that!

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Christine Astarita