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Updated: May 5, 2026

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
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The Association Between Hamstring Tightness and Chronic Low Back Pain: A Comparative Study.

Amit Hegde1, Atul Sareen2, Ravi Shankar2

  • 1Orthopaedics, Safdarjung Hospital, New Delhi, IND.

Cureus
|May 4, 2026
PubMed
Summary

Individuals with chronic low back pain (CLBP) exhibit significantly reduced hamstring flexibility compared to healthy controls. This study found a strong association between hamstring tightness and CLBP, suggesting a potential link for targeted interventions.

Keywords:
active knee extension test(ake)bmihamstring flexibilityheightlumbar lordosispassive straight leg raising test(pslrt)

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Area of Science:

  • Orthopedics
  • Physical Therapy
  • Biomechanical Research

Background:

  • Chronic low back pain (CLBP) is a prevalent musculoskeletal condition causing functional impairment, particularly in young adults.
  • Hamstring flexibility is crucial, as tight hamstrings can restrict pelvic mobility and lumbar spine movement, potentially contributing to back pain.
  • A biomechanical relationship is hypothesized between hamstring muscles, lumbar extensors, and the pelvis, influencing low back pain development.

Purpose of the Study:

  • To investigate the association between hamstring tightness and chronic low back pain (CLBP).
  • To compare hamstring flexibility in individuals with CLBP versus healthy controls.
  • To explore potential correlations between anthropometric parameters and hamstring tightness.

Main Methods:

  • A cross-sectional study involving 40 CLBP patients and 40 age-matched healthy controls.
  • Hamstring flexibility assessed using the active knee extension (AKE) test and passive straight leg raising test (PSLRT).
  • Statistical analysis included chi-square tests and Pearson's correlation coefficient (p < 0.05 significance).

Main Results:

  • Significantly higher prevalence of abnormal PSLRT results in the CLBP group (87.5% right, 80% left) compared to controls (12.5%).
  • AKE test confirmed significantly reduced hamstring flexibility in CLBP patients (87.5% right, 82.5% left) versus controls (12.5%, 17.5%).
  • A positive correlation was observed between increased height and hamstring tightness in both groups.

Conclusions:

  • Individuals with CLBP demonstrate significantly decreased hamstring flexibility compared to healthy individuals.
  • Hamstring tightness is strongly associated with chronic low back pain.
  • Increased height may be linked to greater hamstring tightness, warranting further investigation.