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April 28, 2020

High Hamstring Tendinopathy

Written by Dena Evans
hammie_croppedThis 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.

Supine_plank_startSupine_Plank


Coach: What are some tips for addressing these symptoms or preventing their onset?
RS: If you see bruising in the hamstring it is best to get in to see your physical therapist or physician to assess the severity of the damage.

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
Last modified on May 12, 2020
Dena Evans

Dena Evans

Dena Evans joined runcoach in July, 2008 and has a wide range of experience working with athletes of all stripes- from youth to veteran division competitors, novice to international caliber athletes.

From 1999-2005, she served on the Stanford Track & Field/ Cross Country staff. Dena earned NCAA Women’s Cross Country Coach of the Year honors in 2003 as Stanford won the NCAA Division I Championship. She was named Pac-10 Cross Country Coach of the Year in 2003-04, and West Regional Coach of the Year in 2004.

From 2006-08, she worked with the Bay Area Women’s Sports Initiative, helping to expand the after school fitness programs for elementary school aged girls to Mountain View, East Menlo Park, and Redwood City. She has also served both the Stanford Center on Ethics and the Stanford Center on the Legal Profession as a program coordinator.

Dena graduated from Stanford in 1996.

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