Signs You May Suffer from Chronic High Hamstring Tendinopathy (and What You Can Do)

Signs You May Suffer from Chronic High Hamstring Tendinopathy (and What You Can Do) Blog  Hamstring Tendinopathy

Suffering from a deep pain in the buttocks is called chronic high hamstring tendinopathy. The ailment is the result of pain that gradually escalates. The aggravation can increase through repetitive motion or prolonged sitting.

The Cause of High Hamstring Tendinopathy

It is believed the condition results when acute hamstring tears are not given time to heal properly. Another factor is tendinitis (extended inflammation of the tendon), triggering degeneration of the tendon.

High Hamstring muscles connect to the pelvis ischial tuberosity via three tendons at the back of the thigh. When those tendons are subjected to certain repetitive motions, elastic collagen proteins in the tendon can break down, become injured and initiate the degenerative process.

Chronic Hamstring Tendinopathy Symptoms

Here are five signs that indicate tendinopathy.

    1. Discomfort or pain while in a seated position that gets worse.
    2. Gradual pain deep at the back of the hips, buttocks or upper thighs.
    3. When fully bending at the waist for anything from touching toes to picking something up results in pain.
    4. Unexpected pain when sprinting or accelerating.
    5. Pain triggered or worsened by repetitive leg motion (running, biking or other physical activity).

Risk Factors

Individuals most likely to suffer from this ailment tend to have a history of hamstring tears. The more risk factors that apply to an individual, the greater the need to manage injury to hamstring tendons, minimizing future and greater long-term injury.

Here are a list of factors that can lead to chronic high hamstring tendinopathy.

        • Running
        • History of hamstring tear
        • Jumping and kicking
        • History of lower extremity injury
        • Muscle weakness
        • Difficult flexibility
        • Advanced age
        • Muscle imbalances

Some of these factors are out of our control, such as aging. But others can be managed through physical therapy, especially lack of flexibility and muscle imbalance. If you are active, an athlete or have any pain described above, you should consult with your doctor, physical therapist or other medical professional about ways to increase flexibility in taunt muscles, enhance weak muscles, and to optimize form and alignment.

High Hamstring Tendinopathy Treatments

You can apply conservative and non-invasive procedures for promoting the health of hamstring muscles and reducing the risk of injury. For safety reasons, it is a good idea to not engage in any form of treatment without professional counsel.

        • Rest reduces pain. Give hamstring tendons the opportunity to recover. This might require taking time off from training and cross-training or finding alternative activities.
        • Applying ice and heat can reduce inflammation and pain. Use ice baths, cold packs and ice massage in 10 and 20 minute intervals after activity, or utilize two to four hours of application throughout the day. Heat and massage can loosen scarred or fibrotic tissue and, with stretching, are often recommended by therapeutic and medical professionals. There could be a combination of hot and cold treatments.
        • As flexibility is a factor for hamstring tears and tendinopathy, a regimen that includes stretching can improve range of motion. Improvement may not be noticeable for a period of time. It is not unusual for months to pass before tendon pain is managed.
        • Weak muscles can be strengthened under the guidance of physical therapists or medical professionals. Professional athletic training incorporates eccentric hamstring strengthening into practices to decrease the possibility of damage to the hamstring tendons. While this is a conservative approach, it can be a painful one and has to be conducted with practiced and proven technique. Again, best achieved with professional counsel.
        • Certain solutions like aspirin, ibuprofen and naproxen can alleviate pain and reduce inflammation. Discontinue use if there are adverse reactions, such as stomach irritation or gastrointestinal bleeding.
        • Extracorporeal shock-wave therapy is performed in a doctor’s office on an outpatient basis. Probes are attached to affected areas and shock waves are delivered via an electrical charge. This can be painful, but the theory is the treatment promotes healing through improved blood flow and breaking up of fibrotic tissue.

Chronic high hamstring tendinopathy is best treated through preventative measures and guidance from a trained professional. With the above information, you are prepared to begin protecting yourself.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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