hamstring tendinopathy

Hamstring tendinopathy

What is a hamstring tendinopathy?

The word tendinopathy refers to degeneration, partial tears of the tendon and/or irritation to the peritendinious junction (the surrounding of the tendon). A hamstring tendinopathy is then when this occurs to the hamstring muscle. This can occur in two sites. The more common site is a proximal tendinopathy (high attachment) where pain is felt deep and localised to the buttock area. Alternatively a distal (low attachment) tendinopathy can occur causing pain towards the knee. Whilst these are very different conditions, the risk factors, prevention and rehab are largely similar. 

What causes a hamstring tendinopathy?

There are many risk factors that can lead to an increased likelihood of obtaining a hamstring tendinopathy. These are listed below in no particular order. 

  1. Excessive or repetitive training (inadequate training plan)
  2. Insufficient warm up
  3. Fatigue
  4. Decreased flexibility of the hamstrings 
  5. Tightness of weakness of the hamstrings or quad
  6. Previous history of hamstring or related injury (e.g. hip, groin or knee)
  7. Misalignment and imbalances of the legs. 

As with the other injuries cover thus far, there is no one cause of hamstring tendinopathy. It’s an overuse injury that is common bought on by a multitude of factors. Therefore to prevent it we must address any relevant factors.  
Visit the physio-pedia – Proximal hamstring tendinopathy page for more info. 

What is the most effective way to prevent hamstring tendinopathy from occuring?

When looking to prevent hamstring injuries from occuring it’s important to look at the risk factors that places an individual at risk. Therefore you would ensure the following is being done to the best of the individuals ability. 

  1. Structured planning of training with adequate rest and changes in exercise modality (e.g swapping run sessions for bike sessions).
  2. Incorporating an appropriate warm up
  3. Building muscle strength and endurance to negate fatigue
  4. Improve hamstring flexibilty
  5. Decrease tissue tension to the hamstring and surrounding areas
  6. Ensure optimal rehabilitation is done (or was done) after previous injury. 
  7. Address any muscle imbalances or alignment issues. 

Additionally it has to be said that the hamstrings undergo high essentric load when running. This means that while running your hamstrings need to be strong in order to rapidly lengthen. 
It’s therefore imperative that no matter if someone is preventing or rehabilitating a hamstring injury. They must undergo strength training. 
To listen to more on this topic, go to the Physio Edge podcast and have a listen to all things hamstring related. My favourite is linked here

Some hamstring strength training exercises can be found in our runner strength training section of YouTube. Click the link at get strengthening those hamstrings. 

How do I rehab my hamstring tendinopathy?

As with many injuries, rehab and injury prevention are approached in very similar ways. However, preventioncan be more broad whereas rehabilitation needs to be specific. Therefore it’s recommended that if you are suffering from a hamstring injury, get it checked out by your osteo or other allied health practitioner. Don’t have one? Hit the button below and we can get your rehabilitation journey started. 

Common rehabilitation tools used at the osteo joint

With the above being said there are tools and treatments that we commonly use here at The Osteo Joint. We will run through them with you now. 

  • Managing your symptoms and training load. This means we look to decrease if not completely stop all injury aggravating activities and plan your training accordingly. 
  • Once person is (relatively) pain free a progressive plan back to full training is implemented. 
  • A hamstring strengthening protocal. We establish a baseline of your hamstring strength and work from there to increase it back to a pre-injury state. 
  • The use of osteopathic techniques. To help decrease tissue tension, increase flexibility and pain in involved areas. 
  • Ensure adequate warm up is done pre-exercise. 

That's a wrap

We hope the above information gave you a clear understanding on what a hamstring tendinopathy is, why they occur and how to rehab them most effectively. 

Thanks for reading, 
Stay safe and injury free. 
Dr Jamey Pemmelaar (Osteo)