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What Is Hamstring Tendinopathy?

Hamstring Tendinopathy, often termed Hamstring Tendinitis, is a common overuse or repetitive strain injury. It can occur in sports requiring quick changes in direction such as football and hockey. However, it predominantly affects runners when running uphill, which makes it a popular injury in Sheffield.

More specifically, Hamstring tendon injuries of this nature almost exclusively occur in the proximal tendon (the bit at the top of the Hamstring near your buttock). Typically being felt as a deep, localised pain in the buttock region.


What Is The Proximal Hamstring Tendon?

The proximal Hamstring Tendon is one of the thicker tendons in your body. It attaches the hamstring muscle group to the Ischial Tuberosity (the bony bumps on which you sit). It enables you to bend over and lean, as well as climb stairs, run and jump – essentially acting like a big spring.


Tendinopathy or Tendinitis?

As used in many medical terms, ‘itis‘ is latin for inflammation. So Hamstring Tendinitis basically means inflammation of the tendon. ‘Opathy’ is latin for ‘disorder of’, which better describes the overall injury as over time it will go through different stages. Hence the term Hamstring Tendinopathy. Due to a poor blood supply and repetitive strain nature, tendons take time to heal. Usually months.

What’s going on?
Hamstring Tendinopathy

Tendons (and in general all soft tissue) are in a constant continuum of healing. When a tendon becomes painful in the first 3-6 weeks, be it a first time episode or a flare up of a persistent problem, we class this as the ‘reactive phase’. Typically when symptoms are more acute and irritable. For example when walking with every step, bending over or going up stairs.

Over time the inflammation becomes more degenerative in nature due to a build up of scar tissue. This is termed as a ‘disrepair’ of the natural healing process. Hamstring Tendinopathy symptoms in this phase include pain that is worse when initially running, especially uphill, or sitting for prolonged periods on harder surfaces. This can usually improve as you get more mobile but increase again when trying to run, jump or play sport.

Have patience

Commonly tendon irritations can occur in 2 main points, in the mid-tendon or at it’s insertion into the bone. Typically proximal Hamstring Tendon irritations occur at the insertional point. These can be more irritable and therefore take longer to heal, literally making it a pain in the bum to treat.


Diagnosis

Hamstring Tendinopathy

1 simple way to establish what stage of healing the Hamstring Tendon is in, and provide diagnosis confirmation is using Ultrasound Scans. Take a look here for more information on our specialist service for Ultrasound Diagnosis.


Hamstring Tendinopathy | Common Causes

As Hamstring Tendinopathy is an overuse or repetitive strain injury there are usually 3 potential reasons for why symptoms have come about:

  1. Form or technique – poor form during a sporting skill for example can cause certain structures such as tendons to get used poorly and ultimately cause pain such as running and jumping. Assessing functional movement is a big part of our Physiotherapy assessment. It allows us to spot the bits that need tweaking.
  2. Strength & Control – weaker muscles and poorly controlled joints can lead to tendons becoming overworked. Putting together bespoke training plans and rehab exercises is an essential part of Physiotherapy treatment and what keeps you injury-free for longer.
  3. Load management – regular exercise and movement is key to preventing and treating any muscle-skeletal injury. Your body likes variety and steady change. Sudden increases or decreases in the amount of exercises or movement you do can trigger off injuries such as tendon problems. Having a simple, structured training plan or weekly regime can significantly reduce your chance of injury.

Our next blog looks at What Is The Best Hamstring Tendinopathy Treatment?


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