If the diagnosis is a structural problem, then the location of pain is almost always where the structural lesion is. Structural lesions with bones, muscles, tendons, ligaments, discs, cartilage, and menisci create local symptoms. The main exception is when structural lesions occur with nerves, in which case symptoms can travel along the nerve. So if what you suppose is a problem in a structure changes location, it’s more likely that instead of there being a problem with the structure, there’s a problem with how things are functioning - which is the majority of problems. With functional problems (that is, something is not working well instead of a structure actually being broken), it's common for pain to change location. Muscle strain, tear, pull pain doesn't move. It's where the strain, tear, pull is. -- Laura
Hamstring pain is posterior thigh pain. Quadriceps pain is anterior thigh pain. IT band pain is lateral thigh pain. Adductor pain is groin pain.
Of course it fits that people who aren’t clinicians would label pain using structures they know. And it’s obvious most people can name big muscle groups! My issue is when clinicians inappropriately do it.
If the patient uses this language, in an effort to create rapport, I may use it with interactions with that patient as well. Mimicing language can be a nice therapeutic tool that is easy to implement. (I typically will adopt the patient’s word for describing his or her own symptoms, for example; my favorite instance being my patient who referred to his radiating leg pain as his “lightning bolt.”) I’d prefer, however, to use the correct language if possible since accurate patient education regarding his or her problem is key to a successful outcome.
I do not use these terms to refer to these parts of the body outside of that specific patient context, though. Yes, if the patient has true hamstring, quad, ITB, or adductor pathology, these words are clearly apropos. But those patients (especially among non-athletes) are rare. In most cases a patient’s posterior, anterior, or lateral thigh pain or groin pain is referred pain from the spine or hip. --Laura
When reaching hard enough, will you feel pulling in your hamstrings? It’s likely. Tendons and muscles (unlike other structures) will usually allow you to eek out another centimeter in pursuit of your toes, which you’ll feel. But “feeling it there” does NOT mean that is necessarily the limiting factor. To touch your toes you’ll need sufficient hip mobility, low back mobility, and sciatic nerve length for starters, not to mention mid back mobility and even arm length! Whereas so many (I want to say most) fitness professionals and medical clinicians alike make assumptions such as this, I critically assess why someone cannot do something. We move your body in various ways repeatedly to understand the source of a complaint or functional deficit. And by the way: it’s usually not your hamstrings.
Many, many bodily joints and tissues need to function well to be able to fully bend forward. Poor hamstrings, though … they always get blamed!
To regain forward bending ability, I hardly ever loosen patients’ hamstrings. However, say a patient did simply need looser hamstrings - then clinical care is hardly needed. (Stretching is not rocket science!) With consistent home stretching, hamstring length better consistently improve.
In almost all cases, forward bending is limited because lumbar structures are moving improperly. Usually it’s that the joints themselves are misaligned. In other cases, compressed/adhered/trapped nerves create nerve tension that limits this movement (with or without contemporary joint malalignment).
Forward bending (lumbar flexion) is usually restored once we get the patients’ lumbar structures moving properly again. Importantly, using forward bending to achieve this is beneficial in only a small group of patients. More commonly I utilize lumbar extension or sidegliding.
So why do people say they “feel it” in their hamstrings? It’s either that they’re actually feeling the sciatic nerve(s) pull or that, in attempting to bend further, their body eeeks out more motion in the only structures it can – muscles and tendons – so they “feel it” there. Expert mechanical clinicians know better. --Laura
Learn more about the world of diagnosing and treating orthopedics here!