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Identifying the Real Source of Hamstring Pain

Stretching may temporarily relieve tight hamstrings, but the origin of the discomfort could be found elsewhere in the body.

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Pain and Anatomy Advisor

A reader named K.C. recently wrote the site saying he/she was having terrible struggles with his/her hamstrings. K.C. said that he/she stretched them every day but still endured terrible pain and asked if I had any recommendations or advice. Well, I do. This one’s for you, K.C., and anyone else whose hamstrings are causing pain or constantly feel tight.

In all cases of chronic stiffness or tightness, the stiff, tight muscle is not the issue. Rather, it’s the signal that the balance of the muscle action has been compromised and compensated for, probably for a prolonged period of time, and the problem is actually elsewhere. In the case of stiff hamstrings, the problem is about the load-bearing joints, the shoulders and ankles, yes, but primarily the hips and knees.

First, a brief anatomy lesson. The hamstring is actually comprised of three muscles: the biceps femoris, the semitendinosus, and the semimembranosus. All three cross both the hips and knees, engaging both joints, but the latter two muscles are also involved in the rotation of the knee.

All muscles respond to stimulus, so if the hamstring is tight, it’s because of the stimulus, or information, it is receiving from the hip and knee joints. In other words, if you have chronically stiff hamstrings, there’s nothing wrong with your hamstrings. They’re doing only what the hips and knees tell them to do. The problem lies with the hips and knees, and the upshot is that they are not balanced.

Related: Do you have a question for Sonima’s experts? Submit it here!

Here are a couple of tests you can try to see that these joints aren’t balanced. First, grab a pair of shoes, any pair that you wear often—could be office shoes, running shoes, tennis shoes, whatever. Place them together, sole to sole, and see if the wear patterns mesh together. If you’re balanced, they will mesh, but my hunch is they don’t.

Another test: throw on a pair of shorts and stand in front of a mirror. Look at your knees. You’ll most likely see that one or even both of your knees don’t point straight at the mirror; they’re turned to the side. Or you’ll notice that one or both aren’t lined up with the feet, meaning your foot and knee aren’t pointing in the same direction. For instance, your foot might be angling out to the right while your knee still points straight forward.

Again, the problem is not the hamstring. The problem is the joints being out of position, so much so that the body thinks the hamstring needs to be shortened, which is why the hamstring is shortening and causing stiffness. (Which is also why just stretching the hamstring isn’t going to bring relief; stretching doesn’t engage or adjust the joints, where the problem is.)

Or the problem could be something else.

All muscular-skeletal muscles are activated by nerves. The hamstrings are activated by the sciatic nerve, which originates in the lumbar spine, or lower back. With the pelvis out of position, there’s an impingement on the signal of the sciatic nerve activity, which means the pain you feel in your hamstrings could really be about pain you’re feeling from your sciatic nerve.
Either way, you need to reposition and rebalance the load-bearing joints, not only the hip and knee joints but also the shoulder and ankle joints. The body is one unit, and the joints all talk to each other. The impinged sciatic nerve is just as much about the shoulders as it is the pelvis, so we need to loosen up the mid and upper back, and it’s just as much about the ankles as it is the knees. Remember that test with the shoes?

So anyone having problems with hamstrings, it’s probably not your hamstrings. It’s your joints, and your solution isn’t stretching your hamstrings. Your solution is balancing your body and realigning your joints so that your body performs as a single unit.

Known as the Father of Postural Therapy, Pete Egoscue has helped relieve thousands of people from their chronic pain, including many of the world’s leading athletes. For more information on Pete and any of his 25 clinics worldwide, go to



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