High Hamstring Tendinopathy

An athlete’s performance is greatly influenced by the hamstring muscle groups. Since these groups are pushed to extreme limits when a person is running or participating in competitive sports, they are more susceptible to injuries. One rare injury that occurs in this area is high hamstring tendinopathy. This condition causes tendons of the hamstrings to become inflamed, resulting in severe pain and discomfort.

How Does It Occur?

It occurs when a hamstring tendon is damaged and becomes inflamed. Injury in this area typically occurs when the tension of the hamstring tendon is forceful or repetitive. Runners and other athletes are more likely to experience this condition.

The hamstring tendon is connected to the pelvis so the pain radiates to the upper leg and buttocks region. It attaches the hamstring muscles from the pelvis to the top of the bones of the lower leg. The main function of these muscles and tendon is the bending and straightening of the knee as well as influencing movement of the hip.

Symptoms of High Hamstring Tendinopathy

If you are suffering from the injury you may experience pain associated with gluteal, buttocks or upper leg area. Some symptoms associated with condition includes:

  • Pain with sitting. When you sit, the pressure on the ischial tuberosity can cause pain or discomfort.
  • Pain while conducting repetitive activity. Certain athletic activities such as hiking, running, jogging or biking can worsen posterior pain. Actions of repetitive motion make the area agitated, so people suffering from this condition often detect a pattern of pain during a specific time in their routine.
  • Pain when accelerating or sprinting. The pain associated with it can be so bad, runners may be unable to sprint. Because the area becomes more agitated when the heel of the foot strikes the surface, it often becomes worse when a runner accelerates.
  • Pain associated with bending at the hip. Sufferers of this condition may experience chronic tendinopathy and pain when the hip is completely flexed at the ischial tuberosity. An example of this movement would be bending over to stretch with toes touching ground.

What Causes High Hamstring Tendinopathy?

Overuse is the main cause of this condition. Besides excessive exercise, there are several other ways you can injure this area of the body.

  • Running too often and too quickly. New runners’ training for a race often do not give their body time to adjust to the new strains put on the hamstring muscle area. If they push themselves too hard and too fast, damage can occur to the tendon.
  • Imbalanced muscle. Sometimes you are exercising right, but you still suffer this injury. There could be an imbalance in your muscles. For example, if your Glute Max is not functioning properly, it will pass on some of the stress to the hamstring area and thus cause damage.
  • Weak hamstrings.

Treatment for High Hamstring Tendinopathy

1. Pain Control

The best way to control the pain associated with the condition is through application of ice, pulsed ultrasound, electrical stimulation and other similar therapeutic modalities. Anti-inflammatory drugs are often ineffective in relieving pain around the hamstring area and are not particularly recommended.

2. Soft-Tissue Mobilization

Soft-tissue mobilization is applied when scar tissues or adhesions are broken up with a technique known as friction treatment. The ischial tuberosity must be protected from direct compression to prevent aggravation. The treatment begins with gradual stretching of the hamstring to slowly improve flexibility.

3. Progressive Strengthening

When a person is experiencing high hamstring tendinopathy, the hamstrings lose a large portion of their strength. For example, individuals with strains had a lower hamstring-to-quadriceps strength ratio than those without injury. Treatment programs that incorporate gradual hamstring strength training are more successful than those do not. Non-weight bearing exercises are the first to be introduced, then the patient gradually moves on to more strenuous activates. Both eccentric and concentric hamstring exercises can be utilized.

  • Flat Bridge (Glute Muscles): Lie on flat surface with knees bent. Tighten your abs as you lift your hips off the ground. Tighten your glute muscles. Hold this position for 30 seconds. Do 3-4 sets, 15 repetitions each. Use only one leg to increase difficulty.

  • Hamstring Curl with Stability Ball: Lie on the floor, resting your feet on the stability ball. Slowly take turns lifting each into a straight position while the other keeps you stable. Take turns with each leg. Next, with legs outstretched, place your feet on the ball. Pull the ball towards you with your feet, bending at the knee. Complete 2—3 sets of 10 repetitions.
  • Leg Lifts with Toe Down: Position yourself in the push up stance, propping your upper half by your elbows. With your toes and ball of your feet, slowly lift your legs up from the floor and then slowly lower legs back down. Repeat 15 times for 3-4 repetitions. Leg lifts with toes down works muscles in the buttocks, glutes, abs, back and waist.

For different levels of exercise, please click here.

4. Surgery

Sometimes high hamstring tendinopathy requires surgery, especially if pain is persistent. The surgical procedure is very precise with the tendinous tissues divided between the hamstring muscles. This is done near the origin of pain and requires that the muscle is not cut from the ischial tuberosity. This will relieve the tension at the sciatic nerve and alleviate pain.

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