Hamstring Tendinopathy

So this month we delve into this common sporting injury within the Hyrox, Cross Fit, and running community.

Hamstring tendinopathy is a injury that occurs due to an imbalance between the load that we put through the hamstring during training and the muscle and tendons actual load capacity. The factors that contribute to this is a rapid increase in:

Volume of exercise

Intensity of exercise

Frequency of exercise

Type of exercise (hill or speed sprints)

Some of the aggravating factors that affect this condition once tendon becomes irritated are.

Deep squats

Sitting

Deadlifts

Lunges

Static stretching

There is a reactive response in the tendon due to the excessive load that leads to some pathological changes occurring such as cellular changes, collagen disorganisation and neurovascular change.

The most common hamstring tendinopathy is the lateral hamstring (bicep femoris 41%), then the medial hamstring (semitendinosis 29%) where the tendon get compressed against the pelvis during hip flexion and hamstring stretching.

The peak activity of the hamstrings is during the terminal swing phase of gait just before foot contact . So with runners if they overstride, have imbalance on the pelvis motion or forward lean will bias them to potentially getting a tendinopathy.

Some of the signs of a hamstring tendinopathy are:

Pain at the tendon insertion into the pelvis

Early morning stiffness

Pain after activity

There can also be other conditions that can mimic hamstring tendinopathy as these need to be assessed for such as:

Referred low back pain

Sciatica

Deep Gluteal syndrome

We must also appreciate other factors that can predispose someone to getting hamstring tendinopathy:

High BMI (Body Mass Index)

Hormone changes

Diabetes

Medication (statins)

Exercise Strategies

Our goals with rehab should be focused on loading the tissues involved in the whole kinetic chain where the hamstring tendon passes through whilst also progressively loading the hamstring locally. We can look at the aggravating factors highlighted above and reduce these motions or tweaks the positions. Isometrics in non compressive positions can be useful. Its important to know that this is a condition where the tendon is not damaged but has become very sensitised and irritated due to excessive load. Please manage you expectations as its one of the slower tendionpathies to settle down and it will take time but its a matter on when not if the tendon will settle down.

If you have questions about this condition or are currently suffering from a suspected hamstring tendinopathy then please get in touch to we can advise you on what to do to get you back to action.

Motion in lotion

Mario