Login required to started new threads

Login required to post replies

Prev Next
Re: High Hamstring Tendinopathy Rehab Protocol [Cattiy] [ In reply to ]
Quote | Reply
My bad and misleading English...

The initial MRI was lower back - the thought at that stage was sciatic nerve pinched where it appears from the spine (so MRI not in the correct area). Second MRI picked up the deterioration of the tendon hence the decision to go see Mr Brick and try PRP, which then lead to surgery.

TBH I think it's all to do with the skills and experience of the person reviewing the scans - it isn't a particularly clear image!

In any case, good luck with it, and I hope you find some resolution. My only advice would be to go see the best person you can, and someone who appreciates the sport you do.

I'm still on one crutch some 5 weeks after surgery. Sitting is still a problem, and I haven't done any exercise (so am going slowly insane...). Perhaps I shall try a gentle swim at the weekend?
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [quintana who] [ In reply to ]
Quote | Reply
This is very timely for me. I got a nasty bout of deep glute soreness 2 weeks out from IMNZ this year (I wrote another post about it, and the different diagnosis I received from treating practitioners). Anyway, ended up getting a cortisone shot dee in the glute where the pain was coming from, did IMNZ but got through the bike/run fine.

It's now a good 10 weeks or so post race and the pain has been severe. MRI with a top quality private practice sports doc shows hamstring tendon tear, tendinopathy and bone bruising. I'm waiting to see a referral from the doc to start a rehab program. Doc recommended PRP but I want to try and resolve it without the shots first, of straight rehab and shots don't work he has said surgery is next option.

I did a fair amount of research once I got the diagnosis and have placed myself on a program that involves every second day doing eccentric hamstring loading on a hamstring curl machine with the tendon decompressed (hip not in flexion). Over the space of a week or two it started to improve, slowly, but I can tell the difference.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [rock] [ In reply to ]
Quote | Reply
Hey mate - best of luck with it - mine went undiagnosed for a loooong time, through no fault of any of the folk I saw, it was just that the symptoms I was getting were suggesting other things (calf pain, back pain - possible disc or sciatic issues). Did IMNZ in 2016 (run was v slow) which wasn't the best idea in hindsight...

I did end up doing a lot of work as you described and saw some improvements, but it then plateaued hence PRP and then surgery. I'm 5 weeks on from surgery now and still sore - sitting and driving is the worst....

Not sure if you're based in NZ but I would recommend Matt Brick up on the North Shore. He was pretty fast in his day so knows about triathletes, and has given me confidence that this will get fixed eventually. Good luck with it!
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [darkwave] [ In reply to ]
Quote | Reply
Hi! I know this is an old string. But was curious the outcome of this @Darkwave. I have the same thing...have had fenestration and PRP two weeks ago - but have been off running since dropping a marathon on May 7th. Have NY in November that I'm just going to jog...but the big one is Boston and I want to kill that one. So, trying to figure out the realistic road to being back....PT starts this week.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [teauxja] [ In reply to ]
Quote | Reply


Endurance coach
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [mortysct] [ In reply to ]
Quote | Reply
Thanks....I'm familiar with what to do and not to do. And, frankly, am not worried if I cannot do NY. I was curious on Darkwave's return back for this specific injury. I have coaching, rehab and a plethora of Orthopardic surgeons (whom work with professional sports teams) at my disposal, but opinions differ, as well as clinical studies and infographics, so was just interested in one persons's experience.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [teauxja] [ In reply to ]
Quote | Reply
Hi - I ended up doing three rounds of PRP, with the first on November 1, 2013. I tried to do Boston 2014, but ended up canning it, since I was still battling injury. Eventually, I was able to run Philly 2014 - a year after my first PRP injection. (Philly 2014 sucked, but it had nothing to do with the PRP or the hamstring injury).

I don't think doing Boston next year is unrealistic. In my case, I missed Boston not because the PRP didn't heal me, but because I hadn't yet solved the issues in my gait that kept getting me re-injured. If you don't decypher the underlying cause of your injury, you're just doomed to repeat it.

So key for you is figuring out WHY you injured your hammy.

If it's helpful, my training log/blog is here: http://wellimtryingtorun.blogspot.com/

You can read starting in November of 2013 to see how I structured my come back. I also have the tag "PRP" for specific blog entries describing the injections.

I hope this helps - good luck! FWIW, I set a whole slew of running PRs this spring, so it is possible to come back from this injury and eventually run better than you did pre-injury.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [darkwave] [ In reply to ]
Quote | Reply
Thank you @Darkwave. I'll definitely check out your log. I can pinpoint EXACTLY when and why I injured it - I shorted a warm up trying to merge up with my morning run crew because I got out late. It was last speedwork session leading into the 2 week taper before the Eugene Marathon and was 5X1K repeats. Happened about 1:30 min in on the 5th one. I also had not been diligent on keeping the strength in the glutes and core. :) I'm working on those parts to prevent it in the future.

Bad timing as I had just inked out a 15 min PR 5 months earlier at CIM and BQ'ed by more than 10 minutes...I had been hitting PR's in all distances the last 5 months of 2016 and for Eugene, was looking at shaving off another 5 min from the CIM time. (This after 3 years of getting the same times over 5 different marathons).

Thanks again - I appreciate the response! Particularly since the thread was an older one!

And Way to Go on the PRs!! :)
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [teauxja] [ In reply to ]
Quote | Reply
Thought I would share my experience with PHT. Picked it up in the Spring of 2015, got too aggressive on the TT bike, along with a really long hard run in the hills, both legs got injured within 2 steps on that long run.

I've taken months off of running/biking over the years, which did nothing, I've been to ART, needling, myofascia release etc, with no help.

I'm currently about 80% better, I'm running 2:15min/wk with minimal pain, biking 4-5hrs, and swimming 2x week. I'm working on getting back on the TT bike, I can could the position for about 3-4 minutes.

I started a rehab program about 5 months ago, leg bridges, hamstring curls, Swiss ball, and Nordic curls. I think I have 5 months to go before I'm back to 100%.

IMO here's why this is such a hard injury to heal:
-it takes months of rehab to repair the tendon, which makes it hard to stay focused and positive
-my pain is better, but every week that I add more load, the tendon gets grumpy and acts up. You have to push your tendon a little to make it heal.

I have the same amount of pain each week, but my hamstring can handle more training. I'm putting in about 8-10 hrs per week. Hopefully when I get to 15 hrs and back off, my tendon will be used to the new load and the pain will settle.

i hope this helps someone out there, it's a dark hole, with very little light, I know plenty of people that finally gave up and changed thier lifestyle.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [M&M Tri] [ In reply to ]
Quote | Reply
Just a thought that may help some. I initially had this diagnosis, only to later find out it was a labrum tear and FAI causing the pain.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [winchester] [ In reply to ]
Quote | Reply
winchester wrote:
Just a thought that may help some. I initially had this diagnosis, only to later find out it was a labrum tear and FAI causing the pain.

Thats what I'm dealing with as well. High ham tendonopathy pain, glute pain. Xray shows CAM FIA. Waiting for MRI w/contrast to see what damage is in the joint.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [mortysct] [ In reply to ]
Quote | Reply
Hello

Do you have any reference to specialists in Southern California? I have a complicated case and am seeking the advice of a professional.

Thank you.

Alex
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [ap13evans] [ In reply to ]
Quote | Reply
ap13evans wrote:
Hello

Do you have any reference to specialists in Southern California? I have a complicated case and am seeking the advice of a professional.

Thank you.

Alex

No, sorry, I dont know squat about which caregiver are the best anywhere. I'm just nerdy and into my own studies. I'll be a chartered physio in Sweden in a few months so welcome over ;)

Anyway: you can call around to those who look promising and explain your symptoms. Dont use much medical terms, use "tendon pain" or something open and ask how they manage it. You want to listen to those who are into exercise therapy, know about what kind of loading tendons like and someone who want to cooperate with you, be your guide in the rehab process. Shy away from anyone who explains about their PASSIVE adjuncts, whatever they might be. PRP has no evidence (might even be worse than saline injection), cortisone is worse than anything, massage does bat shit, manual therapy probably even less, it's not your gait, it's not your shoes. Tendon pain is "easy" in that terms, the tough part is figuring out what load you tolerate and how to progress it into meaningful activity.

Endurance coach
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [mortysct] [ In reply to ]
Quote | Reply
Ok. Thank you, I appreciate all the info and your nerdy studies :)

By the way what do you think of surgery for managing chronic hamstring tendinopathy?

Have you heard of Doctor Sakari Orava in FInland who does Hamstring Syndrome surgery?
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [mortysct] [ In reply to ]
Quote | Reply
If anyone out there is looking for guidance, do yourself a favor and listen to mortysct, everything made sense after reading the posts, and I started making progress. Extremely tough injury to overcome.
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [M&M Tri] [ In reply to ]
Quote | Reply
ap13evans wrote:
Ok. Thank you, I appreciate all the info and your nerdy studies :)

By the way what do you think of surgery for managing chronic hamstring tendinopathy?

Have you heard of Doctor Sakari Orava in FInland who does Hamstring Syndrome surgery?

If surgery should be indicated, one should have failed a well planned and properly executed conservative protocol. At least 16 but preferably 24 weeks and surgery can be indicated imo. The problem with surgery is that you remove some tissue that might be causing pain but the degenerated tendon often lies deep and is not possible to remove. And post-surgery you will follow a very slow rehab protocol, which will cause the tendon to de-adapt further. Sometimes it's what someone needs. Also important to remember that the surgery is a very potent behavioural modification. I want to believe that patients that have had surgery will follow their rehab protocol more closely.


M&M Tri wrote:
If anyone out there is looking for guidance, do yourself a favor and listen to mortysct, everything made sense after reading the posts, and I started making progress. Extremely tough injury to overcome.

Thanks and wonderful to hear that you are making progress.

Endurance coach
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [M&M Tri] [ In reply to ]
Quote | Reply
M&M Tri wrote:
If anyone out there is looking for guidance, do yourself a favor and listen to mortysct, everything made sense after reading the posts, and I started making progress. Extremely tough injury to overcome.

What exercises have you used to start loading the hamstring?
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [SBRcanuck] [ In reply to ]
Quote | Reply
I started with the bridges, double then single leg, then progressed to light hamstring curls on the bench progressing slowly with weight, Nordic curls, and Swiss ball curls. I'm not 100%, but getting there slowly. I was told this could take 18 months, I'm 6 months in and believe I still have ways to go. The key is not loading the tendon too much, you know it's too much when you hurt longer than a day after exercising. I found out that 3 days of rehab a week is enough, anymore and the recovery process doesn't happen, just like training.

Let me know if you have more questions, persistence is key!!
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [M&M Tri] [ In reply to ]
Quote | Reply
Thanks, thats pretty much what I've been doing for the past month now. Have had this for over a year now, but only stopped running, not biking, over the fall/winter/summer. So now am off the bike and run, and in the gym hoping to rehab this.. Just never really seems to go away, top of bicep femoris is always hurting...
Quote Reply
Re: High Hamstring Tendinopathy Rehab Protocol [mortysct] [ In reply to ]
Quote | Reply
Many thanks, mortysct, for your posts, they are easily the best and most helpful information I've found. I'm a trail runner and have averaged 3-4 ultras a year, and it's uphill running that caused my high hamstring tendinopathy 8 months ago. I've tried lots of things but suffice it to say that I've not made much progress. I tried your recommended exercise progression and quickly got to W5 with no issues. In fact, the tendon pain disappeared after the very first supine bridges, just as you suggested might happen. I have not yet tried one-leg straight leg deadlifts.

A few questions:
  • How many times per week would you recommend for the exercises?
  • What do you think about leg curls and two- and one-legged planks? If recommended, where would you place them in the progression?
  • Any other exercises you might recommend that's beyond W8?

Thanks again!
Quote Reply

Prev Next