Great Post! Lumbar Spine Mobilization for Hamstring Strains | Modern Manual Therapy Blog

Great Post! Lumbar Spine Mobilization for Hamstring Strains

Another great post by the Sports Physiotherapist. I had recently used this article in a class I taught and was going to blog about it, but he did first, so I'll just link back to his site. 

You can screen apparent hamstring "strains" very quickly with a repeated motion exam. If unilateral, I would recommend checking repeated sidegliding toward the involved side to check for obstruction. Neurodynamics of the sciatic nerve should also be checked along. Assessment and treatment of the neural container should include

  • lumbar spine PIVM and mob/manip, plus applicable repeated motions for treatment
  • QL, psoas, piriformis, hamstring/gluteal junctional zone, gastroc/soleus STM
  • hip ROM and mobilizations
  • talocrural and subtalar joint accessory motion and mobilizations
  • neurodynamic tensioners/sliders


  1. I don't see patients with hamstring strains, but it'd be interesting to see how unilateral PA's would compare to a thrust manipulation. Certainly PA's are likely creating a neurological effect and likely mobilizing nervous tissue locally through slackening the nerve roots (Paris cites this with backward bending) versus a thrust which would possibly create a more resound neurophysiological effect and take a shorter amount of time for treatment.

  2. I'm sure thrust manipulation would have a similar effect. Not sure if the P/A are mechanical, however as in nerve root slacking b/c that effect would only be temporary. It is most likely neurophysiologic either way. Remember that type III mechanoreceptors are fired when a joint reaches end range, thus inhibiting surrounding musculature.

    Dunning showed that thrust manip to C5 inhibited biceps, so I'm sure the effect would be similar and certainly would be shorter. Just like Hartman states, thrust manip is a shortcut compared to minutes of mobilization.