Knee Pain: Can Tight Hamstrings Cause Knee Pain?

Knee pain results from a complex series of biomechanical interactions. The hamstrings muscle group, located in the back of the leg, helps support the knee. This supporting role makes these muscles a key factor in knee-injury protection and knee-pain prevention.

Malfunctioning hamstrings create faulty movement patterns, which affect the alignment and health of the knees.

Anatomy of the Hamstring

The hamstring muscles in your legs are skeletal muscles. They’re voluntary muscles, which means you have control over how they move and function. At the back of your thigh, you have three hamstring muscles. These muscles are used to walk, climb stairs, squat, and conduct a variety of other leg actions.

 

The hamstring muscles run down the back of your thigh, beginning at the hip and ending at the knee. The tendons that connect your hamstrings to the bones in your pelvis, knee, and lower leg are called hamstring tendons.

The following are the three hamstring muscles:

• Biceps femoris: it is located on the outside of your thigh. It enables you to flex and twist your knee as well as extend your hip. The biceps femoris is a muscle with great length. It starts in the thigh and runs to the fibula bone’s head near the knee.
• Semimembranosus: located in the center of your thigh. This hamstring stretches your knee joint, extends your thigh at the hip, and provides hip and lower leg medial rotation.
• Semitendinosus: the semimembranous and the biceps femoris are located between the semimembranous and the biceps femoris. This hamstring performs the same role as the semimembranosus.

Causes of Hamstring Tightness

In most leg actions, the hamstring muscle is essential. They are an essential muscle group because they counteract the quadriceps’ activities by keeping the spine and pelvis in a neutral position when the legs and hips are moved. The following are the three most prevalent reasons for hamstring tightness:

• Anterior pelvic tilt: the top of the pelvic bone is inclined to face the front of the body in this position. Attached to the front side of the pelvic bone is the quadriceps (pushing the pelvis forward), whereas the hamstrings attach to the rear of the pelvic bone (drawing the pelvis backward, pulling it into the posterior tilt). As a result, when a person has an anterior pelvic tilt, the hamstrings are forced to work especially hard to counteract the forces that cause the anterior tilt. As a result of the hamstrings being overworked, they are always “on” and hence always constricted or “tight.”

• Nerve entrapment: the bicep femoris muscle runs across the sciatic nerve, and the nerve can sometimes become stuck beneath it.

• Lumbar disc herniation: a disc herniation, like nerve entrapment, can cause hamstring tightness. The hamstrings and other muscles in the lower back will go into overdrive if a patient has a disc herniation. This is done to protect the wounded portion of the spine. This is referred to as “protective tension.”

How Do Tight Hamstrings Relate to Knee Pain?

Because the hamstrings are biarticular, they have an impact on the knee, hip, and even the back. Most athletes with tight hamstrings might experience a variety of issues. They won’t be able to descend their hips past 90 degrees when squatting with heavy weight, for example.

This puts them in a safe mid-range zone, but it aggravates the problem since the hamstrings aren’t fully stretched. Then, when it’s time to blast out of the squat, the hamstring muscles aren’t used to their greatest extent. This can become a vicious cycle, resulting in hamstrings that are weak and tight.

The quadriceps will take over from the inefficient hamstrings if the hamstrings are overly tight and do not allow complete hip extension, putting a great load and strain on the knee. All four quadriceps converge above the knee to create a single tendon that connects to the top and sides of the patella before joining the tibial tuberosity through the patellar ligament.

As a result, if the quadriceps group works excessively hard, it will have an impact on the knee.

How to Treat Tight Hamstrings?

The simple answer to eliminate hamstring tightness is to loosen them through exercises including stretching. There are many helpful stretches for the lower body to prevent tightness that attributes to knee pain. Some more specific and effective stretches include:

Lunging hip flexor stretch:

• Kneel on one knee. Take the front thigh parallel to the ground, place the opposing foot flat in front of you.
• Lean forward, stretching the hip toward the ground.
• Tighten the butt; to allow a deeper stretch.
• Reach up with the arm on the same side as the knee on the ground. This will help deepen the stretch.
• Repeat on the other side.

Figure 4 stretch:

• Lie down on your back.
• Cross the left foot over the right quad, and bend the right knee.
• Hold the back of the right leg and gently pull it toward the chest.
• Repeat on the other side.

Standing hamstring stretch:

• Stand on the right foot with the left foot in front, heel on the ground, toes up.
• Hinge forward at the hips and bend the right knee sitting back a bit.
• Bend the right leg, keep the left leg completely straight with the weight on the edge of the heel.
• This stretches the hamstring of the straightened leg.
• Repeat on the other side.

Side lunge:

• Lunge out to one side, bending the knee and keeping the opposite leg straight.
• Try to keep the foot of the straight leg on the ground.
• Place fingertips on the ground in front to balance.
• This stretches the hips and inner thighs.
• Repeat on the other side.

Calf stretch:

• Stand in front of a wall with one leg straight behind and the other in front, slightly bent.
• Place hands on the wall and push against it.
• Keep your back leg straight, heel planted on the ground.
• Repeat on the other side.

Quad stretch:

• Lie on one side.
• Keep the bottom leg straight and bend the top knee towards the butt.
• Hold the top foot with a hand, pulling it toward the butt.
• Keep the hips stable.
• Repeat on the other side.

Stretching is effective, but there are also dangers of hyper-flexibility. Joint integrity should never be compromised in favor of excessive flexibility. Overstretching the hamstrings may affect joint stability, leaving the knees vulnerable to pain.

Tightness prevention

There are a few things that can stop tightness before it starts. Recommended activities include:

• Warm-up before engaging in different sports or other intense activities. Walking, mild jogging or simple exercises for at least 10 minutes can help avoid hamstring strain.
• Regular hamstring stretches before and after activities may also help prevent tightness. Try to take 3-5 minutes before and after sports or activities to stretch.
• An overall strong and fit body.
• Eat a healthy diet, and drink plenty of water to fuel and replenish muscles.

Alternative Treatments

Stretching can be a cure for most situations involving knee pain. However, in extreme cases,  it may not be enough. Surgery is an option but is rather invasive and expensive.

Regenerative cell therapy allows patients to use their own cells and growth factors to help repair and regenerate damaged cells and tissues in their knees. The two regenerative therapies offered at CELLAXYS are:

Cell-based therapies

This treatment is also known as stem-cell therapy. It includes extracting healthy cells from the patient’s body, processing them, and reinjecting them into the injury site to promote healing. Depending on your knee condition, the doctor may recommend you one of the two types of cell-based therapies:

• Minimally Manipulated Adipose Tissue (MMAT) transplant. It removes healthy cells from your adipose (fat) tissue and reinjects them into the injury site. One advantage of MMAT is that the doctor can perform it in multiple locations of your knee if needed.
• Bone Marrow Concentrate (BMAC). This procedure extracts highly concentrated cells from your bone marrow and reinjects them into the injury site.

Both cell-based therapies take about 1.5 to 2 hours to complete. These are outpatient procedures, which means you can go home right after the process. The doctor will put you under anesthesia, so you will feel minimal pain. They may use live X-rays and ultrasound to detect the exact location of the injury.

Platelet-rich plasma (PRP) therapy

PRP therapy isolates platelets from the patient’s blood plasma, processes them, and re-injects them into the injury sites. Platelets are the healing components of your body, containing 10 Growth Factors to promote the growth of tissues. They also release chemical signals to attract healing cells from the blood and produce a web-like sticky structure called fibrin that supports the development of new tissues.

Inserting platelets into the injury site accelerates the healing process. The procedure takes about 45 minutes to complete and is a popular treatment for orthopedic, spine, and sports injuries.