Hi Laurie,
Can I please have your thoughts on bilaterally tight hamstrings? 2yo F sporting bred BC who has had tight hamstrings since I got her at 6m. She hates me stretching them and they do appear mildly uncomfortable on palpation. They are moderately muscled, possibly nit as much as they should be for what she gets. She is v difficult to condition as won't eat, I do sit-stands with front end elevated and she's reluctant. Not lame, has regular needling a d chiro, chiro regularly mutters about her pubic bone being unhappy and has had other intermittent issues with her pelvis that have been corrected, SIJ OK.
She gets regular equissage, PEMF etc. Unsure if I should be stretching them more (generally once/week) or whether they are compensating for something else, not sure what. Chiro said in ppl tight hamstrings are something to do with the head?
Thanks
Kriszty
Tight hamstrings
Re: Tight hamstrings
Hey Kriszty,
My goodness... you have quite the collection of 'head scratching' dogs!
Okay, so, maybe it's just me, but I don't see tight hamstrings in dogs. The don't make sense.
Simply walking causing the hamstrings to stretch. Standing and bending down to drink water would stretch them a little as well. Scratching behind the head, side of head or shoulder is a hamstring stretch.
In people, tight hamstrings are a sign of an issue elsewhere, I agree. However, I have usually linked it to weak glutes and an overuse of hamstrings as a hip extensor muscle.
So, I would say, I'd look at:
. The SIJ
. Lumbosacral disc disease
. An abnormality of the L-S region (sacralization of L7 or lumbarization of S1)
Basically check the back.
And check sciatic nerve.
For the latter, try doing a sciatic nerve stretch (i.e. just like hamstrings). 1) note how far you go. 2) now have someone pull the tail (tail pull traction) and then repeat the stretch simultaneously. Does the leg go farther? Is the dog more comfortable?
Odd ball differential: Tethered Cord Syndrome (I have one patient dx with this)
Those are my thoughts. Again, I wish you lived closer!!!!
Best of luck!
Cheers,
Laurie
My goodness... you have quite the collection of 'head scratching' dogs!
Okay, so, maybe it's just me, but I don't see tight hamstrings in dogs. The don't make sense.
Simply walking causing the hamstrings to stretch. Standing and bending down to drink water would stretch them a little as well. Scratching behind the head, side of head or shoulder is a hamstring stretch.
In people, tight hamstrings are a sign of an issue elsewhere, I agree. However, I have usually linked it to weak glutes and an overuse of hamstrings as a hip extensor muscle.
So, I would say, I'd look at:
. The SIJ
. Lumbosacral disc disease
. An abnormality of the L-S region (sacralization of L7 or lumbarization of S1)
Basically check the back.
And check sciatic nerve.
For the latter, try doing a sciatic nerve stretch (i.e. just like hamstrings). 1) note how far you go. 2) now have someone pull the tail (tail pull traction) and then repeat the stretch simultaneously. Does the leg go farther? Is the dog more comfortable?
Odd ball differential: Tethered Cord Syndrome (I have one patient dx with this)
Those are my thoughts. Again, I wish you lived closer!!!!
Best of luck!
Cheers,
Laurie
LAURIE EDGE-HUGHES
Re: Tight hamstrings
Thanks, Laurie.
I will go through the list with her chiro on Thurs. Thinking about getting her spine CTd too, everything else has been xrayed. She will sometimes off weight her LH when standing too.
This is the only view I've got of her spine, taken during her pennhip evaluation.
I wish I was closer too, I'd be your most annnoying client! Ha.
I will go through the list with her chiro on Thurs. Thinking about getting her spine CTd too, everything else has been xrayed. She will sometimes off weight her LH when standing too.
This is the only view I've got of her spine, taken during her pennhip evaluation.
I wish I was closer too, I'd be your most annnoying client! Ha.
- TAMMY_Kelly Pelvis VD 4.jpg (371.8 KiB) Viewed 2073 times
Re: Tight hamstrings
Ok so the chiro reviewed her and she was definitely able to stretch substantially more with tail pull traction.
She felt she was mildly reactive in her lumbar spine and painful on palpation of her ischial tuberosities bilat. And not that happy to extend her hip LHS.
I will send her in for CT lumbar spine and pelvis, but would be interested in your thoughts re the sciatic nerve test that you said to check.
Thanks!
She felt she was mildly reactive in her lumbar spine and painful on palpation of her ischial tuberosities bilat. And not that happy to extend her hip LHS.
I will send her in for CT lumbar spine and pelvis, but would be interested in your thoughts re the sciatic nerve test that you said to check.
Thanks!
Re: Tight hamstrings
MRI’d today from lumbar spine to stifles. And all NAD, so that’s something..
Re: Tight hamstrings
Okay...
So, no MRI findings is good. Nothing majorly structural.
The Sciatic nerve glide test however, could indicate that there is some dynamic component in the L-S junction and/or inflammation somewhere along the sciatic nerve.
So, if she were my case, I would prescribe the following as a TRIAL to see if you can improve things:
1. Tail Pull Traction
2. Dural mobilizations for the Sciatic nerve (look at the A"dverse Neural Tension Testing" Videos) and I believe I did a recent blog on the topic or was it a FourLeg Video... (It was a blog - I just checked)... (Feb 18th, 2023)
3. The pelvic Tilt exercise (It's a video - 187, and a FourLeg Minute - Lumbo-Sacral Pelvic Tilt & Tail Traction)
4. And flexion mobs for the lumbar spine - (Video Training 82 & 83)
And then see what you get!
Best of luck!
Laurie
So, no MRI findings is good. Nothing majorly structural.
The Sciatic nerve glide test however, could indicate that there is some dynamic component in the L-S junction and/or inflammation somewhere along the sciatic nerve.
So, if she were my case, I would prescribe the following as a TRIAL to see if you can improve things:
1. Tail Pull Traction
2. Dural mobilizations for the Sciatic nerve (look at the A"dverse Neural Tension Testing" Videos) and I believe I did a recent blog on the topic or was it a FourLeg Video... (It was a blog - I just checked)... (Feb 18th, 2023)
3. The pelvic Tilt exercise (It's a video - 187, and a FourLeg Minute - Lumbo-Sacral Pelvic Tilt & Tail Traction)
4. And flexion mobs for the lumbar spine - (Video Training 82 & 83)
And then see what you get!
Best of luck!
Laurie
LAURIE EDGE-HUGHES
Re: Tight hamstrings
Thank you very much Laurie, much appreciated as always!! Will let you know how we go.
Re: Tight hamstrings
Hi again Laurie (sorry!)
So, Tammy is getting worse. I was fairly horrified at this vid of her jumping taken from the last trial : https://youtu.be/xDEMaq0PBVA
And her offweighting LH was more marked. So I’ve pulled her from agility and high impact activity for now and asked for her MRI to be re-reviewed. Findings attached : mild hypertrophy of the dorsal ligament at LS producing decrease size of the ventral epidural fat but no cauda equina compression. No obvious stenosis of the foramina or radicular thickening.
I queried this with the radiologist as I read this as L-S disease (mild). She said this is NOT L-S disease and is an incidental finding (?)
Anyway, I have a symptomatic dog so I’ve started treating her with shockwave (had the 1st tx 3 to go), basically shocked the L-S , dorsal LHS of the hip and both hamstrings (anywhere she seemed sore). I will start a targeted core conditioning program but would love your thoughts on this and your thoughts on the case in general. Poor dog she’s really had a rough ride (O died, severe IBD, behaviour problems now this!)
Thanks again
So, Tammy is getting worse. I was fairly horrified at this vid of her jumping taken from the last trial : https://youtu.be/xDEMaq0PBVA
And her offweighting LH was more marked. So I’ve pulled her from agility and high impact activity for now and asked for her MRI to be re-reviewed. Findings attached : mild hypertrophy of the dorsal ligament at LS producing decrease size of the ventral epidural fat but no cauda equina compression. No obvious stenosis of the foramina or radicular thickening.
I queried this with the radiologist as I read this as L-S disease (mild). She said this is NOT L-S disease and is an incidental finding (?)
Anyway, I have a symptomatic dog so I’ve started treating her with shockwave (had the 1st tx 3 to go), basically shocked the L-S , dorsal LHS of the hip and both hamstrings (anywhere she seemed sore). I will start a targeted core conditioning program but would love your thoughts on this and your thoughts on the case in general. Poor dog she’s really had a rough ride (O died, severe IBD, behaviour problems now this!)
Thanks again
- Attachments
-
- Mail - Kriszty Kelly - Outlook.png (632.96 KiB) Viewed 1589 times
Re: Tight hamstrings
Well dang! I have to say that I couldn't really ascertain the issues with jumping based on the video. I tried to zoom in - but then it was grainy. I tried to slow it down... but couldn't do that when I was zoomed in.
All I could presume to be seeing was a bit of a roundedness in the lumbar spine - but I couldn't actually see landings / push offs very well.
Okay...
Keeping in the thought process of spine / nerve:
Dynamic L-S disc disease?
Outside the box:
Gastroc's disease? (But didn't we already think about that - of was that a different dog?)
Any other thoughts I'm having are WAAAY outside the box, and honestly shots in the dark!
I'm hoping David Lane jumps into the thinking mix here. Because I'm not sure where else you look 'orthopaedically'.
What all have you tried with her?
Did you try the Adverse Neural Tensioning Techniques?
Any tendering / irritation up at C1 / Subocc / behind the ears?
You say she's a fussy eater, but are her stools normal?
Where have you found pain in her when she's off loading?
Hmmmmm
Laurie
All I could presume to be seeing was a bit of a roundedness in the lumbar spine - but I couldn't actually see landings / push offs very well.
Okay...
Keeping in the thought process of spine / nerve:
Dynamic L-S disc disease?
Outside the box:
Gastroc's disease? (But didn't we already think about that - of was that a different dog?)
Any other thoughts I'm having are WAAAY outside the box, and honestly shots in the dark!
I'm hoping David Lane jumps into the thinking mix here. Because I'm not sure where else you look 'orthopaedically'.
What all have you tried with her?
Did you try the Adverse Neural Tensioning Techniques?
Any tendering / irritation up at C1 / Subocc / behind the ears?
You say she's a fussy eater, but are her stools normal?
Where have you found pain in her when she's off loading?
Hmmmmm
Laurie
LAURIE EDGE-HUGHES
Re: Tight hamstrings
She is briefly hesitating before each jump on the vid, plus lots of short little strides rather than longer ones, and v slow. Here is an earlier vid to compare https://youtu.be/bjH3GCTK-hU
I guess dynamic L-S disease is an option as I suspect her MRI was just done in neutral. Do you not feel that the MR changes she has already say she has L-S disease ?( I am confused as the radiologist called them incidental and was going round in circles with her).
She really didn’t like the adverse neural tensioning and didn’t let me do it. She frequently turns round to look at her LH foot, esp after training so I am wondering about nerve pain.
Couldn’t find anything much sore when she offweights apart from hamstrings/hamstring origin intermittently.
She has frequent soft/d# faeces due to the IBD and sometimes scoots (anal glands normal). Do you think that could be related?
Thanks again heaps!
Kriszty
I guess dynamic L-S disease is an option as I suspect her MRI was just done in neutral. Do you not feel that the MR changes she has already say she has L-S disease ?( I am confused as the radiologist called them incidental and was going round in circles with her).
She really didn’t like the adverse neural tensioning and didn’t let me do it. She frequently turns round to look at her LH foot, esp after training so I am wondering about nerve pain.
Couldn’t find anything much sore when she offweights apart from hamstrings/hamstring origin intermittently.
She has frequent soft/d# faeces due to the IBD and sometimes scoots (anal glands normal). Do you think that could be related?
Thanks again heaps!
Kriszty