“Tight hamstrings lead to low back pain.”

This is a common assumptive prediction offered by the medical and rehab communities. While someone complaining of back pain may present with “limited hamstring flexibility”, why do we assume a specific relationship?

It is true that these often correlate, but we MUST reconsider the assumption of causation… at least the relationship of causation historically presented.

Over the decades many athletes have trained at my facilities (combining conditioning and rehab). Over the years several individuals incurred injuries such as ACL tears during Friday evening football game or a Saturday afternoon soccer. While presenting with “normal hamstring flexibility” (a phrase like the above, so wrought with misstatement that it’s painful to write) the day before the game, they unanimously displayed dramatically limited hip flexion when assessed while concurrently in knee as close to full extension as currently available, what the world labels as “tight hamstrings”. So we must assume that one of the body’s responses to the ACL tear is to increase tension in the musculature that would appropriately limit post injury knee motion.

So what about back pain? I’ve seen the same scenario. Now this doesn’t qualify as research, merely observation. But it is a scenario to which virtually zero physicians and PT’s are privy… because they never see the individual until after the injury occurs! They have no opportunity for pre-injury assessment in order to make a remotely reasonable conclusion of much less prediction that “hamstring” tension leading to back pain.