This article aims to provide an in-depth yet accessible understanding of the hamstrings through the lens of Motion Specific Release (MSR) techniques. Designed to benefit healthcare practitioners and their patients, we will explore the anatomy, biomechanics, and MSR-specific approaches to hamstring functionality and functional exercises, all underpinned by evidence-based research.
This blog offers practical insights into hamstring function, walking you through specialized MSR techniques, best practices, and the biomechanical implications of hamstring function in the context of both performance care and injuries.
Article Index
Introduction
Motion Specific Release
Exercise
Conclusion & References
Anatomy and Biomechanics
The hamstring complex plays pivotal roles in human locomotion, postural stability, and athletic performance. Comprising three distinct muscles—Biceps Femoris, Semitendinosus, and Semimembranosus.
Biceps Femoris
The Biceps Femoris serves as a key contributor to knee flexion and hip extension. It also facilitates external rotation of the knee when flexed.
Origin and Insertion
Proximally, it originates from the ischial tuberosity (long head) and the linea aspera of the femur (short head). It inserts distally into the head of the fibula and lateral tibial condyle.
Innervation
Innervated by the tibial division of the sciatic nerve (long head) and the common fibular division (short head).
Semitendinosus
Engages primarily in knee flexion, hip extension, and internal knee rotation.
Origin and Insertion
Its origin point is the ischial tuberosity, and it inserts medially onto the superior part of the tibia, below the medial tibial condyle.
Innervation
Innervated by the tibial division of the sciatic nerve.
Semimembranosus
This muscle also contributes to knee flexion and hip extension, with additional roles in internal rotation and knee stability.
Origin and Insertion:
Originates from the ischial tuberosity and inserts into the posterior surface of the medial tibial condyle.
Innervation:
Like Semitendinosus, Semimembranosus is innervated by the tibial division of the sciatic nerve.
Clinical Significance
All three muscles are essential for explosive activities like sprinting and jumping. Their synergistic action is particularly crucial in eccentric control during dynamic movements' deceleration and landing phases, thereby preventing hamstring strains and anterior cruciate ligament (ACL) injuries.
Visual Cues of Dysfunction
Clinical indicators of hamstring dysfunction are multifold: asymmetry in running gait, premature fatigue, and localized posterior thigh discomfort. Such signs should prompt a detailed biomechanical evaluation and possibly electromyographic studies for further assessment.
Hamstring Release (MSR) Procedures
Step-by-step Instructions
These MSR procedures are demonstrated in the accompanying video.
Initial Setup: The patient lies in a supine position, the knee being treated in a flexed position.
Technique:
Treatment Hand: Employing the Metacarpal-Phalangeal Compression Technique. The practitioner initially shapes their hand into a relaxed fist. They then extend the hand to a 90-degree angle, flattening the metacarpals and phalanges. Subsequently, targeted pressure is applied using the dorsal surface of the hand, accompanied by slight rotational movements, to address specific treatment areas on the patient.
Support Hand: Holds the lower part of the leg being treated. This hand is used to bring the patients.
Synchronization: Both the treatment hand and the support hand move in unison. Providing both treatment motions and movements of circumduction.
Pressure: Employ moderate compression. Too much pressure will inhibit your ability to feel different layers of tissue moving over one another.
Focus Area: When the practitioner encounters a restriction, slow down and spend adequate time on it until a release is felt.
Advanced Maneuver: Incorporate circumduction to induce shear stress, assisting in myofascial release.
Fiber Orientation: The semitendinosus and the long head of the biceps femoris primarily feature parallel, longitudinal fibers. The semimembranosus also has parallel fibers but is broader and more flattened. The short head of the biceps femoris exhibits parallel, longitudinal fibers as well but is specialized to the knee as it doesn't cross the hip joint.
MSR Demonstration Video
In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures for releasing the hamstring muscles.
Best Practices
Time Factor: Take your time with these procedures. The process of releasing myofascial restrictions cannot be rushed.
Circumduction Benefits: Employing circumduction in your MSR procedures offers neurophysiological advantages such as modulating nociceptive signals and fostering muscle relaxation. Furthermore, it has the added benefit of system-wide therapeutic intervention, aligning well with MSR's comprehensive treatment philosophy.
Kinetic Chains: Always consider the effects of a larger kinetic chain on the primary structures.
Precautions
Manual therapy on any structure requires careful consideration of underlying medical conditions, the patient's history, and current symptoms.
Precautions include avoiding therapy on inflamed or ruptured tissues, contraindicated medical conditions, and post-surgical cases without clearance.
Proper assessment, consent, and technique are crucial to minimize risks.
Hamstring Functional Kinetic Chains
Understanding kinetic chains is essential for MSK practitioners, offering a nuanced framework for precise diagnosis, effective treatment, and targeted rehabilitation through techniques like MSR. The framework includes:
Direct Myofascial Connections
Synergists
Stabilizers
Antagonists
Direct Myofascial Connections
These fibrous networks allow force to be transmitted across muscles, linking them in a continuous chain. A disruption in these connections can lead to impaired force transmission, affecting overall biomechanical efficiency.
Gluteal Muscles: Shares fascial connections that impact hip extension and posterior pelvic tilt.
Adductor Magnus: Connected via the fascial network in the inner thigh region, playing a role in hip stabilization.
Gastrocnemius: Interconnected through the posterior fascial chain, impacting knee flexion and ankle movement.
Sacrotuberous Ligament: Fascial connections here play a role in stabilizing the pelvis.
Erector Spinae: Some fascial continuity exists, affecting lumbar stability.
Synergists
These muscles work together to facilitate specific movements, serving as the action's active agents. Synergistic dysfunction often leads to compensatory patterns, affecting the muscle group's overall performance.
Gluteus Maximus: Assists in hip extension and external rotation.
Adductor Magnus: Helps in hip extension.
Gastrocnemius: Works in tandem during knee flexion.
Stabilizers
These muscles provide the foundational support during movement, ensuring efficiency and safety. Weak or inhibited stabilizers can compromise joint integrity, making movements less efficient and more prone to injury.
Quadriceps: Anterior thigh muscles that stabilize the knee during hamstring activity.
Core Musculature: Provide overall stability to the pelvis and trunk during hamstring movements.
Antagonists
Working in opposition to the primary muscle's action, antagonists play a vital neurological role in both concentric and eccentric muscle contractions through reciprocal inhibition. This process ensures that when one muscle contracts, its antagonist receives a neurological signal to relax, facilitating smoother and more efficient movement. When antagonistic muscles are dysfunctional, they may fail to properly inhibit, which can lead to decreased strength, muscle imbalances, and reduced range of motion, posing a risk for injury.
Quadriceps: Work in opposition, especially during activities like running and jumping, which require rapid changes in knee position.
By examining these components, you gain a multi-dimensional understanding of the hamstring’s role in movement and stabilization, which could be invaluable for targeted treatments and interventions.
Mobility Exercises
Mobility is the cornerstone of effective muscular function, especially for muscles as central to movement and stability as the hamstrings. Proper mobility allows for an optimal range of motion and is often a preliminary step to more complex MSR techniques. Below, we delve into specific exercises for the hamstrings.
Dynamic Leg Swings
Phase 1: Anterior-Posterior Direction
Stand upright while holding onto a stable surface with one hand.
Engage your core and stabilize the standing leg.
Swing the opposite leg forwards and backwards in a controlled motion.
Execute 10 swings, then switch to the other leg.
Phase 2: Medial-Lateral Direction
Stand upright, holding a stable surface for support.
Again, engage the core and establish balance on the standing leg.
Swing the free leg from side to side across your body in a controlled manner.
Perform 10 swings, then change to the opposite leg.
Sets: 2 to 3 sets per leg, for both anterior-posterior and medial-lateral directions.
Eccentrically Loaded Bridges
Starting Position:
Lie on your back with feet flat on the ground, hip-width apart, and knees bent at approximately 90 degrees.
Place your arms beside you, palms down for stability.
Execution Phase:
Contract the core and glutes to lift your hips toward the ceiling.
Hold the bridge position momentarily.
Slowly lower your hips back to the starting position, emphasizing a slower eccentric phase.
Repetitions and Sets:
Three sets of 10 repetitions, focus on the slow descent to emphasize eccentric loading on the hamstrings.
Strengthening Exercises
Strength is integral to functional anatomy; it's not just about muscle size, but about the capability of muscle and tendon systems to produce force. This is particularly crucial in a biomechanical context, where muscle imbalances can significantly affect postural equilibrium and joint stability. Given the Rectus Abdominis and Obliques' role in core stability, strength training exercises are essential, especially when considering MSR techniques that can release restrictions and optimize function.
Romanian Deadlifts
Starting Position:
Stand upright with feet hip-width apart, holding a barbell in front of you with a pronated (overhand) grip.
Execution Phase:
With a slight bend in the knees, hinge at the hips to lower the barbell toward the ground.
Keep your back straight and core engaged throughout the movement.
Return to the starting position by contracting the hamstrings and glutes, pulling the hips forward.
Repetitions and Sets:
Four sets of 8 repetitions, using a load corresponding to 70-80% of your one-repetition maximum (1RM).
Cable Hamstring Curls
Starting Position:
Attach an ankle strap to the low pulley on the cable machine.
Strap the ankle strap securely around one ankle.
Stand facing the machine, holding onto it for support, with the strapped leg extended backward.
Execution Phase:
Flex your knee to curl the lower leg towards the glutes.
Ensure a controlled movement throughout the phase, avoiding any jerky motions.
Slowly extend your knee to return to the starting position.
Repetitions and Sets:
Complete 3 sets of 10 repetitions for each leg.
Nordic Hamstring Curls
Starting Position:
Kneel upright on a padded surface with your heels secured under an immovable object or a partner's hands.
Keep your hips extended and your torso upright.
Execution Phase:
Slowly lower your torso forward towards the ground, controlling the descent through the hamstrings.
Upon reaching near-horizontal, push yourself back up to the starting position using your hands for slight assistance.
Repetitions and Sets:
Perform 3 sets of 5-6 repetitions.
Precautions
When performing Nordic Hamstring Curls, it's crucial to be mindful of knee joint stress, especially for those with existing knee conditions. Proper technique is paramount to avoid hamstring strains and neuromuscular fatigue, which increase the risk of injury. Always start with a comprehensive warm-up, and consider using assisted variations or consulting a healthcare provider if you're new to the exercise or have underlying medical conditions.
Conclusion
In summary, this article provides an evidence-based exploration into the intricacies of hamstring anatomy, biomechanics, and treatment using Motion Specific Release (MSR) techniques. We dissected the anatomy of the three principal hamstring muscles—Biceps Femoris, Semitendinosus, and Semimembranosus—and discussed their roles in locomotion, postural stability, and athletic performance. Crucially, we delved into the clinical significance of these muscles, visual cues for dysfunction, and practical MSR procedures designed to improve hamstring functionality.
The article also presented an integrated understanding of hamstring function within larger kinetic chains, emphasizing the importance of considering synergists, stabilizers, and antagonists in diagnosis and treatment. To round out this comprehensive view, mobility and strength exercises were examined as essential complements to MSR procedures.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson's approach in musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the developer of the Motion Specific Release (MSR) Treatment Systems, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.
Elevate Your Practice Through the Multifaceted Approach of Motion Specific Release (MSR)
MSR isn't just another treatment system; it's a paradigm shift in musculoskeletal care that synthesizes diverse therapeutic modalities. This well-rounded approach addresses not just symptoms but the root causes of musculoskeletal conditions, providing more enduring and effective patient outcomes.
Immerse yourself in our courses to gain a rich array of both soft-tissue and osseous techniques that can be effortlessly integrated into your existing practice. Our curriculum is designed to bridge the gap between traditional medical science and innovative, evidence-based therapeutic methods, offering a holistic lens through which to view musculoskeletal diagnosis and treatment.
From orthopedic and neurological assessments to myofascial interventions and osseous manipulations, from acupressure techniques to kinetic chain evaluations, and functional exercise plans—MSR provides an all-encompassing toolkit for musculoskeletal care. By adopting the MSR system, you'll not only enhance your practice's clinical outcomes but also become a magnet for patient referrals. Take the leap into the next era of musculoskeletal therapy with our MSR courses and memberships.
References
Abelson, B., Abelson, K., & Mylonas, E. (2018, February). A Practitioner's Guide to Motion Specific Release, Functional, Successful, Easy to Implement Techniques for Musculoskeletal Injuries (1st edition). Rowan Tree Books.
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Garrett, W. E. (1996). Muscle strain injuries: Clinical and basic aspects. Medicine & Science in Sports & Exercise, 28(5), 1-8.
Heiderscheit, B. C., Hoerth, D. M., Chumanov, E. S., Swanson, S. C., Thelen, B. J., & Thelen, D. G. (2005). Identifying the time of occurrence of a hamstring strain injury during treadmill running: a case study. Clinical Biomechanics, 20(10), 1072-1078.
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Opar, D. A., Williams, M. D., & Shield, A. J. (2012). Hamstring Strain Injuries: Factors that Lead to Injury and Re-injury. Sports Medicine, 42(3), 209-226.
Orchard, J., Marsden, J., Lord, S., & Garlick, D. (1997). Preseason Hamstring Muscle Weakness Associated with Hamstring Muscle Injury in Australian Footballers. The American Journal of Sports Medicine, 25(1), 81-85.
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Witvrouw, E., Danneels, L., Asselman, P., D’Have, T., & Cambier, D. (2003). Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players: A prospective study. The American Journal of Sports Medicine, 31(1), 41-46.
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