I saw a patient today who presented with complaints of a tight hamstring. Further investigation revealed that he had bilateral pain, and occasional peripheral pain below the knee in addition to the tight hamstring.
Immediately, my thoughts went to a central problem rather than the pain in the hamstring being caused by a hamstring issue.
Further testing revealed good hamstring length, good hamstring strength and a generally negative neurological exam.
Palpation suggested that his hamstring is normal.
So I asked him to go back to his doc and to ask for an MRI of his lumbar spine. The reason is that he has a central problem. How else could he develop bilateral pain even if it was and is worse on one side? Beyond that with no significant evidence of neurological involvement, and since his pain has been present for more than 5 years, the fact that it is worsening now made me ask him to go get an MRI. There is always the possibility that he is growing something, although it might just be a disc bulge that is causing bilateral pain. At Sports Reaction Center, we perform a complete evaluation including a functional screen and a neuro screen as well as what is known as a Cyriax evaluation designed to reveal the tissue in dysfunction.
So the moral of the story is that unless you can identify a specific insult to the hamstring, there is a good chance that that pain in your thigh originates more proximally.When in doubt get more data. A good PT or Physiatrist can help you sort out your issue.