I recently had a post-op ACL patient who complained of hamstring tightness. While this is a common problem following ACL surgery, there is often other reasons for the hamstrings presenting as "tight". Once swelling is under control it is important to look at the underlying causes of what can make hamstrings seem tight or overactive.
Usually there are 1 or 2 causes for this:
- Stiffness of the hips (primarily hip flexors, TFL)
- Poor lumbopelvic control
Lets assume that the hip flexors and TFL are overactive, which is a common problem these days. If we respect the anatomy and the pull it has on the pelvis then we can understand how an anterior pelvic tilt can cause the hamstrings to be overactive. Treating this is easy, either work on the flexibility of the hips flexors if it is a true length problem, or work on the soft tissue mobility if it is a tone problem.
However, sometimes the problem is the lumbopelvic control. If the core is unable to control the pelvis then one can fall into an APT. Being sure to address motor control of the core (hips/TA) is important to re-establish normality of the pelvis. This being said, be sure to also address diaphragmatic breathing and good lat tone to ensure you are not missing any components!
- Brian Schwabe
Board Certified Sports Clinical Specialist in Physical Therapy/Strength & Conditioning Coach/Fitness & Medical Writer
Sports Physical Therapist in Los Angeles, CA