Something really interesting happened to me the other night at the gym during practice, and I wanted to share the story. One of my level 8’s told me that she has “really tight hamstrings” and that for some reason no matter how much she stretches her splits or pikes they never get better. I know this gymnast personally, and I know that she is one of the most flexible/hyper mobile girls on our team. So naturally I was thinking there had to be more to this. I decided to take a few minutes to break it down and figure out if it was really a hamstring mobility problem based on a lot of the PT information I’ve been reading/listening to lately. What ended up looking light tight hamstrings and a restricted pike stretch was really a core control /stability problem, and by doing some corrective work I was able to fix what looked like tight hamstrings in about 5 minutes. It all started out with her showing me a pike stretch, where she said she felt a lot of pulling in the back of her legs because of her hamstrings and she could not reach her hands to the floor.
Pre-Test Pike Stretch Suggesting Some “Tightness”
Here is how the rest of the process went down. The first thing I did was look at her hamstring flexibility with a passive straight leg test. This is commonly how gymnasts stretch their hamstrings with a partner. The gymnast lays on their back, straightens their knee as much as they can, brings their toes up toward their head while making sure the other leg stays on the ground. I had a coach brings their leg up as far as it will go until she felt a stretch in the hamstrings, to really see what her flexibility was. Here is what it looked like
Passive Straight Leg Raise Right Assessing Hamstring Mobility
Passive Straight Leg Raise Left Assessing Hamstring Mobility
I then had her stand up and do a pike stretch with one leg up on a block, slowly reaching down, to look at the pike with each side working one at a time.
Standing Left Sided Pike Test for Hamstring Flexibility
Standing Right Sided Pike Test for Hamstring Flexibility
When offloaded and reaching slowly down to one side, she was able to touch the floor easily with no reports of pulling in her hamstrings. Clearly from these pictures above, she seems to have some good hamstring flexibility available. Then, to see if it was a problem related to her reflexive core/spine engagement, I had her lay back down to do a straight leg raise the same way, but on her own. This looks to see if the gymnast can first stabilize their core and spine before they raise their leg. Here is what this looked like.
Active Straight Leg Raise Right Assessing Reflexive Core Stabilization While Lifting Leg
Active Straight Leg Raise Left Assessing Reflexive Core Stabilization While Lifting Leg
From looking at the passive motion (hamstring mobility) to the active motion (core stabilization with lifting leg pattern), there is a pretty large difference between the two. This suggests that the core is really the problem, and not “tight hamstrings”. During the pike stretch to the floor and the active straight leg test above, the brain is not firing in good sequence to set the core THEN move into the motion. This gymnast simply kept their core in the arch back posture or anterior pelvic tilt she chronically has problems with. This actually causes the hamstrings to go on more stretch as well due to them attaching on the bottom of the pelvis bone. Due to the core/spine not having good reflexive or automatic core stabilization, the brain subconsciously puts a stop to how far the leg will go or how far the pike stretch will go because it is trying to protect the back.
So to keep looking at the problem, I had the gymnast do a drill that looks at what the legs can do when the core is properly engaged. To do this I asked a coach put her arm up, and then had the gymnast push down into it. This motion engages the core musculature. I then asked the gymnast to raise her legs again, and you might be amazed at what the difference was.
Core Engaged Active Straight Leg Test L
Core Engaged Active Straight Leg Test L
Although it was not as much as her passive hamstring testing, there was a huge difference in how far she could raise her leg up. This further points to the fact that this is not a hamstring mobility problem, this is a core stability problem. So, based off of a lot of literature I have been reading, the authors of these texts suggest that you should look at the way some one rolls  to identify if the person is having a problem activating the core musculature. These are called developmental rolling patterns, and although they require some specialty education to learn about I had her do some of these along with the drill above to look at/work on her core engagement.
Upper Body Rolling Pattern Drill
Upper Body Rolling Drill
Lower Body Rolling Drill
Lower Body Rolling Drill
You would be amazed at how challenging some of these were for this gymnast. There were patterns she simply did not know how to do, and it looked as if she was “stuck” during some of the upper body ones. This is where things got really cool. After 5 minutes of rolling and basic core stability work like the drill above when she pushed down into the coaches arms, I had her stand up and re-test her pike stretch. Lone behold, this is what it looked like.
Post Test Pike Stretch Following Core Stability Drills
She, the other girls in the gym, and the coaches were blown away with how far she could reach. To be honest, I was too a little bit because I had never seen such a drastic increase in such short time. She was able to touch the floor with ease, saying she felt no stretch in her “tight hamstrings” what so ever any more. Everyone asked what kind of magic trick I did. Truth be told, it wasn’t a magic trick at all, it was just looking at the pieces of the system and teasing apart if the issue was a mobility or stability problem. This morning after this all was buzzing in my head, I sent the story over to Dr. Josh Eldridge, and here is what he thought about it.Â
“Dave….this is wild and I love it! I’ve been saying core is the issue with shoulder flexibility for a long time, and when people tell me their gymnasts hamstrings are tight, I knew there was something not right about it, but this really puts the problem in perspective.Â
This goes to the problem we’ve been talking about for 3 years, and with examples like this, we’ll get real traction I hope. Core control is the problem in gymnastics, not flexibility (and not strength to a point). Even here, she has the strength, but she has no clue how to access it.Â
This is even a great case study that you should write up and submit to a journal.Â
Well done my friend and keep up the great work. I really enjoy your perspective on this. Your innovating and that is what has to be done!
Josh”
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Again, a huge thanks to Dr. Josh Eldridge and Dr. Perry Nickelston for letting me bounce these ideas off them and develop this post.
Why This Matters
The reason that I posted this story and wanted to tell people about it definitely isn’t to confuse or show some wild type of PT work. The reason I want to show this is because it is a perfect example of the difference between a mobility (hamstrings being “tight”) and a stability (core not reflexive stabilizing) problem. Basic core stability and core control is a huge issue in gymnastics, and although gymnasts have strong muscles they often times don’t know how to use them during practice and skill work. This a concept Dr. Josh Eldridge harps on with his website, and this is an example of it coming into play. Â I heard a really cool analogy when listening to a podcast from Dr. Dan Pope’s website. They said that it is like trying to fire a big powerful cannon off a boat in the middle of a lake. It doesn’t matter how strong the cannon (arms, legs, muscle etc.) is, because the cannon is on an unstable base of water (like not having proper core control and core stabilization reflexively). We have to put the cannon on a stable surface like the ground to really see the cannons potential. This translates to first developing a strong basic core for all motions, then working on building strength and power on top of this.
Unfortunately, I think many coaches would see this gymnast doing a pike stretch and assuming they have “tight hamstrings” and start hammering away on her flexibility. This can be an explanation to someone getting confused as to why no matter how much they stretch or do flexibility it doesn’t get better. Doing ton’s of flexibility for this gymnast isn’t going to help, and actually it may make it worse. The hamstrings attach at the bottom of the pelvis the more lengthened they get, the more a gymnast is allowed to move into the arch back or anterior tilt that so many gymnasts have. This is a very dangerous position for their lower back, can lead to overuse injuries, increases the risk of traumatic jarring of the back because the back rests in this posture, is decreasing their core engagement capabilities, and most likely is affecting their gymnastics skill work. Today I did the same type of work with some of the other girls out of curiosity and found a lot of the same problem.
Now, I’m not saying that everyone should make their girls lay on the floor rolling back and forth to try and get their pike and core better. Also, there are definitely times when hamstring mobility is limited in an athlete, and it does simply come down to doing more mobility work (although simply stretching someone to their limit may not be the only way). This is not always the simple fix, there are other theories that authors talk about. These are related to joint centralization (this hip joint not sitting in an ideal position), other lower back and pelvis joints, and nerves/muscles deep in the hip that may also be a factor. This process is something that takes an educated/trained eye to pick up and when done on a whim by someone without the training can cause a problem. This is a time when a gymnast needs the help of a trained medical professional who understands these problems in depth and knows how the system works based on mobility/stability, and so on.
This post is simply to get people to think about some of the issues we are seeing in gymnastics related to injury and decreased skill performance. This concept has parallels to a lot of other issues that may be going on in gymnastics. I actually applied the same concept to someone who had very “tight shoulders” despite stretching all the time, and found similar results. Once I become more familiar with that process of evaluation I will post what I found in another article.  I think there is a huge amount of work to be done in discussing the issues we see in gymnasts, and maybe that we need to start integrating these concepts regarding why gymnasts have some common issues in our gymnastics practices.  I by no means have the answers to all of the problems, and I am definitely not an expert at this type of work just yet. However, I think this story serves as the perfect catalyst to opening the door to some of these schools of thought.  I hope everyone found this as cool as I did. That’s all for now,
Dave
References
- Cook G., et al. Movement –  Functional Movement Systems: Screening, Assessment, Corrective Strategies.  First Edition. On Target Publications, 2010.
- Dr. Perry Nickelston, DC, FMS, SFMA – http://www.stopchasingpain.com
- Dr. Dan Pope PT, DPT – http://www.fitnesspainfree.com
I'm a Physical Therapist at Bay State Physical Therapy in Salem MA, a women's optional gymnastics coach for North Shore Wildcat's in Beverly MA, and was also a competitive gymnast for the majority of my life. I received my doctorate in Physical Therapy along with my minor in Psychology in 2013, and look to obtain my Certified Strength and Conditioning title in the upcoming year. I created The Hybrid Perspective to offer my opinions/thoughts on the benefits of connecting Physical Therapy and Gymnastics. I look to address common patterns of dysfunction and injury/pain for gymnasts, educate people about gymnastics based pre-hab to possibly reduce injury, help maximize gymnast's performance, and gain knowledge myself from those involved in the sport. Feel free to share, comment, and offer your experiences through the site. 
The Hybrid Perspective : Linking Gymnastics & Physical Therapy 
Interesting how this possibly relates also to lower leg injury, ie., knees, Achilles and ankle during explosive take offs and landings?
Hi Angela,
Your have that right on target. This concept is huge in relation to those injuries, both progressive injuries and traumatic. If the core stability and control is not automatically working at its finest, big problems can come up. It sets the lower body structure up for excessive forces, poor alignment, and learning faulty movement patterns that contribute to those types of injuries and more for gymnasts. A fully working base in the core, as well as proper stabilization in the hips/shoulders is crucial. It’s why it’s so important to recognize it, and take pro active steps during training to prevent it. Great thought, thanks for reading!
Dave