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need help with adolescent hamstring tightness

 
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need help with adolescent hamstring tightness - January 21, 2008 1:09:34 AM   
strut

 

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Hi, I am an out of practice PT(doing the mom thing for a while) trying to help some kids gain some flexibility with their leg muscles in order to attain full splits in their martial arts program. I have one 10 yo child who has extremely tight hamstrings (only), (can only achieve about 45 d hip flex with knee ext (SLR). This child has no c/o of pain or problems except when being stretched; Is very athletic and active. Does have a 2x history as a toddler of sudden unexplained cessation of ambulation, with spontaneous resolution after ~2-3 days per mom's recollection. Med. records not yet available. After several sessions of rigorous traditional stretching and with use of MET post isometric relaxation, and given daily HEP to follow over ~3 weeks, he made little to no gains in his hams. flexibility. I have asked the mom to request an xray of LB to r/o developmental spondylolysis, but am otherwise stumped. Given my own rustiness as well as my general lack of pediatric ortho experience, does anyone have any ideas? Is adolescent hamstring tightness of this nature, in an otherwise flexible child, more common than I am aware? Any ideas for stretching that will help him to reach his mandatory goal of "palms flat to floor" when doing the standing hamstring stretch? (He's a good 8" away from tips to floor now!) Thanks for your help! This young man wants to continue training for his 2nd degree black belt, but without this goal achieved, he is unable and will have to wait until he is 13 as required by the organization.
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RE: need help with adolescent hamstring tightness - January 21, 2008 10:30:58 PM   
Sebastian Asselbergs

 

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From: Barrie, Canada
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Only case of similar stubborn hams tightness i can remember, is one where the kid had a tethered cord - no other symptoms, just ongoing trouble with hams staying tight.
At this young age, when tissues are normally rather malleable, this type of isolated tightness (NOT common) is clearly neurologically driven, rather than a potential disease, or "just tightness".  I think the x-rays are a good start.

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Mundi vult decipi

(in reply to strut)
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RE: need help with adolescent hamstring tightness - January 22, 2008 2:04:54 AM   
strut

 

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Thanks for the input--I'll look into this. Do you remember the outcome with your case? How much, if any, progress can be made if this is the case?

(in reply to Sebastian Asselbergs)
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RE: need help with adolescent hamstring tightness - January 22, 2008 9:41:23 PM   
Sebastian Asselbergs

 

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Joined: September 30, 1999
From: Barrie, Canada
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Yeah, the kid actually was told that there was a choice: surgery, or wait and see how his development would progress. He waited, and needed surgery within 2 years, due to progressive tightening. Has artroscopic spinal laser surgery, and ended up with about 75 degrees of SLR after his rehab, and no other problems.
Nice, but it IS one case only......

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