Self-Myofascial Release (SMR) - how to treat the Hamstrings

Self-Myofascial Release - Massage Sticks - Spiky Massage Balls

Self-Myofascial Release (SMR) routine for the legs hamstrings

How to Stretch the Hamstrings (Spiky Ball - STR)

There are occasions where treatment using myofascial release techniques may not be suitable or advisable (contraindicated). Contraindications can be global meaning that a method should not be used at all or local, meaning it might be possible to apply a technique to some areas of the body but not others. Before commencing with any fitness or stretching activities and particularly self-myofascial release techniques, one should be sure it is safe. Hence, if one has any contraindications to massage or myofascial release techniques, then self-treatment using the methods listed in the article is not advisable. If in doubt speak to a suitably qualified professional and get advice before commencing with any of these self-treatment methods.

Self-soft tissue release with a spiky ball can be ideal for treating the hamstrings. However, one needs to be careful when applying such techniques, as if too much force is applied, one uses the method too often, or for too long, then one could end up with a pulled hamstring. The technique is precise and so should be used with caution, yet the results can be significant. Soft tissue release or (pin and stretch) effectively involves changing the origin(s) and insertion(s) of muscles (the muscle attachment points). A practitioner trained in soft tissue release will apply a myofascial soft-tissue lock to the tissues under treatment, before applying a gentle stretch, passively or actively. A spiky massage ball can effectively create a soft-tissue lock in a self-treatment context. One can then contract the opposing muscles to those under treatment and thus apply a stretch to the muscles needing treatment. As with the massage stick roller technique, this technique works best when applying the soft-tissue lock to tissues in a relaxed state. Using the method is relatively simple, and like the massage stick roller, can be performed in a seated position. The diagram below illustrates the Hamstring muscles and is a posterior view of a left thigh. The most prominent muscles in the diagram are the hamstrings, Biceps Femoris Long Head (right-hand side), Semitendinosus (the smaller muscle to the left of the Biceps Femoris) and the Semimembranosus (the larger muscle underneath the Semitendinosus). It is possible to effectively access and treat all of these muscles in a self-treatment context with spiky massage ball and soft tissue release.

Image of the Hamstring muscles (left thigh and posterior view)

Image of Hamstring muscles (left thigh) posterior or rear view.

Images produced with kind permission of 3d4medical.com from Essential Anatomy 5

(Copyright © 2018 3D4Medical. All rights reserved.)

One must not use the spiky massage ball in the area behind the knee (popliteal fossa). Ideally, the working area is between the two blue-dotted line boxes, as per the diagram. This example uses an 8cm diameter firm spiky massage ball, as soft spiky balls tend not to produce the required tissue-lock. To perform the technique, one sits on a chair or similar, with the knees bent to around ninety degrees. The author tends to place a towel or similar between the spiky massage ball and chair, bench etc. to prevent the spikes marking furniture. Equally, the spiky ball can leave dents in the skin and wearing clothing while performing the technique or placing a thin towel between the ball and skin works fine. The reason for using a firm spiky ball is because the spikes will act as a means of creating a soft-tissue lock, even through a towel. The soft-tissue lock is essential for performing the technique correctly and effectively changes the origin and insertion of the muscle and soft-tissues under treatment. Position the spiky massage ball as per diagram, by lifting the leg and then placing it on top of the spiky ball. There is no need to apply additional pressure to the limb under treatment, as the combination of gravity and the weight of the leg will create a more than adequate soft-tissue lock (see Step 1).

Spiky Massage Ball - Hamstring Self-Soft Tissue Release

Step 1 - Initial position

This technique is potent, and it is best to air on the side of caution while applying the next steps and actual soft-tissue release. It can be surprisingly easy to overstretch tissues and pull a hamstring if one uses too much force (stretch), applies the stretch for too long or too much stretching is done. Ideally, to complete the next steps, one wants to try and keep the hamstrings relaxed while contracting the quads to extend the knee gradually (see Step 2). There is no need to try and fully extend the leg for the technique to be effective. The state of the tissue under treatment will often affect how far the leg comfortably extends, and even a few degrees is adequate. Hence, extend to leg to the point of just feeling a slight stretch "point of bind" and mild discomfort at worse and certainly not pain. Hold the stretch for 10-12 seconds and don't be tempted to apply further stretch beyond the point that you started to feel the stretch. Then relax the leg and return the original start position.

Step 2 - Apply Soft Tissue Release

Next, lift the leg and move the spiky massage ball 5-10 cm towards the body and away from the knee. Then lower the limb onto the spiky ball again, which changes the position of the soft-tissue lock, but otherwise returns you to the start position in the illustrated in step 1. The Step 3 diagram illustrates how the spiky massage ball has moved and one then just applies the Soft Tissue Release again as per Step 2.

Step 3 - Move the Spiky Massage Ball (soft-tissue lock)

One can then repeat the whole process along the length of the muscle and tissues under treatment, as per the working area highlighted between the two blue-lined boxes. Again, it would be easy to overwork tissues if one repeatedly applied the technique over the same muscle tissues in any one treatment session. The author tends to use the method once and occasionally twice on any specific muscle tissues during a treatment session. For example, the author may perform the technique along the length of Semimembranosus tissues and then go over the same soft-tissues again. Typically, the author will apply this technique in three strips up the back of the hamstrings, lateral (outer part of the thigh), middle and medial (inner part of the thigh). Covering three strips enables one to treat tissues of the Semimembranosus, Semitendinosus and Biceps Femoris.

After treating the Hamstrings, it is worth moving on to the Quadriceps unless one has already treated these before finally addressing the calf muscles starting with the Gastrocnemius.

The article was written by Dr Terry Davis MChiro, DC, BSc (Hons), Adv. Dip. Rem. Massag.,  Cert. WHS.


About the Chiropractor Author

The author possesses an unusual background for a Chiropractor (McTimoney). His education, training and practical experience span over two decades and relate to both physical and mental aspects of health. He has also needed to push his own body and mind to the limits of physical and psychological endurance as part of his time serving in Britain’s elite military forces. His education includes a bachelor of science degree in Business Management, with a specialisation in psychology and mental health in the workplace, an Integrated Masters in Chiropractic, MChiro and a multitude of soft-tissue therapy qualifications. His soft tissue qualifications range from certificate level right through to a BTEC Level 5 Advanced Diploma in Clinical Sports and Remedial Massage Therapy. Terry also has extensive experience in security, work, health and safety and holds relevant certifications. He has also taught at Advanced Diploma level (Myotherapy / Musculoskeletal Therapy) in Australia, both theoretical and practical aspects including advanced Myofascial Release Techniques and has certification in training and assessment. Terry’s combination of knowledge through, education, training, his elite military experience and personal injury history have paid dividends for the patients he sees and has treated. Terry is still extremely active and enjoys distance running, kayaking, mountain biking and endurance-type activities.


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