This month in Ask the Practitioner, we inquired about high hamstring tendinopathy with Renee Songer, Clinical Director of Agile Physical Therapy. Read on to find out more about one of the most common injury problems among runners.
Coach: What is high hamstring tendinopathy?
RS: Tendons connect muscle to bone. Tendinopathy is a degenerative condition of the tendon structure. High hamstring tendinopathy is a degeneration of the hamstring tendon at it's insertion near the buttock region.
Coach: What are the primary symptoms of this injury?
RS: Primary symptoms include local pain at the top of the hamstring. Often these injuries can be painful to the touch, painful with stretching and painful with forceful muscle contraction.
While running you may feel the pain as you are pushing off the back foot or as the leg is swinging forward.
A quick test is a Reverse Plank (see picture). Pain or weakness compared to your non-injured leg indicates possible problems with hamstring tendon.
Coach: What are some tips for addressing these symptoms or preventing their onset?
If you feel pain in this area acutely, it is often best to rest and ice for the first 24 hours. If pain allows, gently stretch the area and working on a foam roll or massage can help. Slowly return to activity over the next week avoiding activities that cause pain. If pain persists beyond a week see your physical therapist or physician to assess the problem.
This type of injury can also start with a gradual onset as a localized buttock ache, first noticed after a workout and with sitting on harder surfaces.
To prevent high hamstring tendonopathy make sure your glute muscles are strong through a full range of motion. Often we tend to avoid the last 20 degrees of hip extension (straightening) with exercise but we need it to be strong for running. Bowing, single leg bridge, and single leg curtsy squats are excellent exercises to maintain adequate glute strength for running.
Curtsy Video Version I
Curtsy Video Version II
