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
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Injury Prevention
How to treat the IT band - What is IT Band Syndrome? The Iliotibial Band, or IT Band, is a dense band of connective tissue that originates in the hip (iliacus), runs down the outside of the leg and inserts just below the knee. Every time you bend your knee the IT Band crosses over a bony protrusion at the outside of your knee. If the band becomes tight it starts to snap more aggressively over this bone and it can then get irritated and inflamed. When this happens you have IT Band Syndrome.
Common signals or symptoms:
- The most common symptom is pain at the outside of the knee.
- Tightness at the outside of the hip. - Soreness in the lateral (outside) quad muscle. - Swelling around the knee Prevention Tips:
There are a number of things a runner can do to prevent IT Band Syndrome.
The easiest thing to do is use a foam roller, "the stick" or some other form of self massage. This is probably the most effective thing you can do to keep the IT Band loose. There are also various IT Band stretches but many people have a hard time getting into a position where they actually feel an effective IT Band stretch. Other causes:
The most effective treatment is rest.
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Injury Prevention
Let's talk about Plantar FasciitisWhat is Plantar Fasciitis? Most often felt in the heel, over 50% of Americans will experience this pain during their lifetime.
PF occurs due to a variety of reasons: overuse of improper, non-supportive shoes, over-training in sports, lack of flexibility, weight gain, too much standing.
As with any pain ice and rest is the first step. Fill a bucket of water and add ice to it. Stick your foot in. Another option is to freeze a plastic bottle of water and roll your foot with it. If pain is present for more than three weeks, see a medical professional about the problem. Treatment options such as orthotics, foot taping, cortisone injections, night splints, and anti-inflammatories can help.
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Injury Prevention
This is the pain felt along the front of your lower leg, at the shin bone. Shin splints are common among runners who increase frequency, volume, or intensity of training, along with improperly fitting footwear or worn out shoes can cause problems. Also frequent running on hard surfaces can cause shin pain.
The first thing is to understand what they are. Then you know what stresses you are putting on your body. Consider the age and appropriateness of your shoes and review your training to make sure you aren’t making any huge sudden jumps. Many runners with shin splints also report tight calves and relatively modest strength in the lower leg muscles. Proper stretching and strengthening of the calf muscles can help. One productive exercise is heel walking. [Check out our Heel Walking Demo Video here.]
There is an inflammatory component here, so ice can help a lot. A reduction in training intensity and a change in running surfaces may be required to allow the symptoms to subside. Anti-inflammatories may be appropriate, but consult your physician to ensure they are a safe choice for you. If symptoms persist or become steadily worse, make an appointment with your doctor.
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