Hamstring Tendinitis
The Hamstring tendon is the soft tissue which connects the hamstring muscle to the outer aspect of the knee. Hamstring tendinitis occurs when this tendon becomes damaged or inflamed due to excessive strain,overuse or force being placed on the tendon.
The most common cause of hamstring tendinitis is through overuse, particularly in patients who participate in running and jumping sports. This is also common in sports such as football due to the rapid changing of speed which is undergone while running.
Whatever it is, this injury is typically seen as a result of overuse, hamstring tendinitis can also occur suddenly if the tendon becomes over stretched for example when warm-up exercises have been missed out or are inadequate for the level of activity, causing the patient to over strain the hamstring while performing running, kicking, jumping or skipping movements.
Individuals who have just started exercising or have increased their level of fitness are also at risk of sustaining this injury as they may lack strength and flexibility need for their new level of activity.
Causes
- Overuse injury common in running and jumping activities
- Excessive speed changing while running
- Insufficient warm up exercise
- Poor core strength
Hamstring Tendinitis Symptoms
Patients who suffer hamstring tendinitis are likely to feel pain in the back of the knee which gradually becomes more apparent through continued activity. This is due to the tendon becoming inflamed and swollen and in more severe cases; this pain and swelling can be felt in the thigh and calf muscles. When the injury is caused by sudden pressure or force to the tendon, pain will usually come on suddenly at the point of injury.
Patients are likely to feel aching and stiffness which becomes more apparent first thing in the morning and often the knee joint will feel a weak, making the patient unable to resume activity.
Hamstring Tendinitis Treatment
In order to treat hamstring tendinitis, rest is crucial in order to allow the injury time to heal and to prevent any further activity which could cause damage or discomfort to the injury. Applying ice to the injury is an important aspect of healing as it will reduce any swelling and inflammation as well as providing cooling pain relief to the injury. Using the PRICE method (protection, rest, ice, compression and elevation) is beneficial for the first 72 hours of the injury occurring as it will reduce swelling to the area and by keeping the injury elevated blood flow is restricted which can prevent further inflammation.
Anti-inflammatory medications can also be taken in order to reduce swelling as well as relieving pain or acheness from the injury.
Taping and strapping techniques are often used for hamstring injuries as they can help stabilize and support the area whilst relieving pressure. Some athletes find it beneficial to continue with these methods after recovery to prevent a re occurrence of the condition.
When the injury has begun healing and you are advised by a physiotherapist or doctor, it is important for the patient to undergo a rehabilitation program such as strengthening and stretching exercises which will keep the area strong and make it easier to return to sports once the injury has fully recovered. These exercises should not be carried out if the patient feels pain in the area and the advice of a physiotherapist should always be sought in order to obtain an exercise regime suitable for the individual.
Physical therapy Treatment|:
Patient should starts treatment as early as possible. The earlier the rehabilitation, the faster he/she will return to previous normal function.
Therapy takes from weeks to months depending on the condition and the history of previous injuries.
Controlling the pain is one of the important therapy goals, this is possible through ice, electrical stimulation of the tendon and pulsed ultrasound.
Correction of pelvis misalignment has to be taken into consideration, as it might increase the tension on the hamstring muscles,and affects muscle strength. Anterior pelvic tilt is the most common misalignment and it could be easily corrected by manual or chiropractic manipulation.
Soft-tissue mobilization has to be included in the rehabilitation program. It’s very beneficial to break up the adhesions and scar tissues. A friction treatment with transverse frictions is commonly used. The therapist has to pay attention to not compress directly on the ischial tuberosity as it can irritate underlying edema. Techniques like ART (Active Release Technique) or Gastron can be included as well.
At the same time the patient may start a gradual stretching program for the hamstrings. starting with double-leg non weight bearing isometric exercises followed by single-leg closed-chain isometric and isotonic open-chain exercises.
Eccentric muscle strengthening program is a good treatment program for teninopathies , as it can normalize the thickness and structure of the tendon. It can also prepare the hamstrings for the high-force load while running.
Core strength is a considerable element for the rehabilitation of hamstring origin tendinopathy as it reduces the risk of recurrent hamstring strains..
If the ROM of the muscle is normal and pain-free, pool running and stationary biking could be put into the rehabilitation program.
Stretching of both legs is crucial for balance. Even the antagonist hip flexor muscles should be stretched for an optimal function.
ROM can be increased by the use of ultrasound or shock wave therapy before stretching. Frequent stretching may avoid a recurrence of the injury. Some of useful Exercises are,
Standing Forward Bend With Raised Leg
Patient should starts treatment as early as possible. The earlier the rehabilitation, the faster he/she will return to previous normal function.
Therapy takes from weeks to months depending on the condition and the history of previous injuries.
Controlling the pain is one of the important therapy goals, this is possible through ice, electrical stimulation of the tendon and pulsed ultrasound.
Correction of pelvis misalignment has to be taken into consideration, as it might increase the tension on the hamstring muscles,and affects muscle strength. Anterior pelvic tilt is the most common misalignment and it could be easily corrected by manual or chiropractic manipulation.
Soft-tissue mobilization has to be included in the rehabilitation program. It’s very beneficial to break up the adhesions and scar tissues. A friction treatment with transverse frictions is commonly used. The therapist has to pay attention to not compress directly on the ischial tuberosity as it can irritate underlying edema. Techniques like ART (Active Release Technique) or Gastron can be included as well.
At the same time the patient may start a gradual stretching program for the hamstrings. starting with double-leg non weight bearing isometric exercises followed by single-leg closed-chain isometric and isotonic open-chain exercises.
Eccentric muscle strengthening program is a good treatment program for teninopathies , as it can normalize the thickness and structure of the tendon. It can also prepare the hamstrings for the high-force load while running.
Core strength is a considerable element for the rehabilitation of hamstring origin tendinopathy as it reduces the risk of recurrent hamstring strains..
If the ROM of the muscle is normal and pain-free, pool running and stationary biking could be put into the rehabilitation program.
Stretching of both legs is crucial for balance. Even the antagonist hip flexor muscles should be stretched for an optimal function.
ROM can be increased by the use of ultrasound or shock wave therapy before stretching. Frequent stretching may avoid a recurrence of the injury. Some of useful Exercises are,
Standing Forward Bend With Raised Leg
- Stand up straight and place the heel of one leg on a chair, Make sure your leg is not above hip height or below knee height and that your support leg is straight, but the knee is not locked. Bend forward from your hips, keeping your back and the raised leg as straight as possible, and stop when you feel the stretch along the back of your raised thigh and knee. Don't try to touch your toes, as this will move the stretch to your back. The aim is to restrict the stretch to your hamstring muscles in the raised leg as much as you can. Hold the stretch for up to 30 seconds, then slowly return to an upright position and repeat the stretch on your other leg.
Standing Forward Bend With Crossed Legs
Stand up straight and cross one foot over the other, at your ankles, keeping both feet on the floor, says The Walking Site. Depending on how tight the backs of your legs are, this position may give you enough of a stretch down the back leg. To increase the stretch, slowly bend forward from your hips, walking your hands down a wall for stability if you need to. Only go as far as is comfortable--you should feel a tug, but no pain--and stop when your back is parallel to the floor, says The Walking Site. Keep your hands on your hips if you need to support your lower back in this position; otherwise, let your arms fall straight down so your fingers are pointing toward the floor. Hold for up to 10 seconds, then slowly return to the starting position and repeat with your legs crossed the other way.Stretch for the Back of the Knee
According to The Walking Site, this exercise not only stretches the backs of your knees and hamstrings, it also lengthens your calf and back muscles. Stand facing a step and position one foot so the heel is on the ground, the ball of the foot is raised, resting on the edge of the step, and your toes are pointing in the air. Your other foot should be flat on the ground. Slowly bend forward from the hips, reaching your fingers toward your raised toes. Try to keep both legs as straight as possible throughout the exercise, but only go as far as is comfortable--don't force the stretch, says The Walking Site. Hold for up to 20 seconds, then slowly and carefully return to the start position before returning the upraised foot to the ground and repeating on the other side.Seated Stretch with Rotation
Sportsinjuryclinic.net says to sit on the floor with one leg stretched straight out in front of you and the other one bent so your foot is resting against your other inner thigh. Slightly turn the outstretched leg inward, then bend forward from your hips. You should feel the stretch up the back of the straight leg. Hold for 30 seconds, then repeat on the other leg. To move the stretch along the inner thigh, start in the same position, but slightly rotate the straight leg outward. Lean forward from the hips and hold for 30 seconds. It is more important to keep your back and outstretched leg straight than to get your chest close to your leg. Don't force the movement, but as your flexibility increases, try to bend a little deeper.Standing Hamstring Stretch
Stand up straight, with your legs hip-width apart and one foot slightly behind the other, says Sportsinjuryclinic.net. Keep your front leg straight, but bend your back knee and lean forward from the hips, taking care not to hunch over as you lower your torso toward your knees. You can rest your hands gently on your bent knee for support or, for an extra balance challenge, try stretching them out to your sides. Hold the stretch on each leg for about 30 seconds. If you need more of a stretch, try pointing the toes of your outstretched foot up toward the ceiling. - THIS VIDEO SHOWS THAT SOME OF STRENGTHENING EXERCISES FOR HAMSTRING TENDINITIS
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