I believe imbalances and weaknesses definitely contribute to this problem. Core strength is important but not as much for this problem.....I could hold a plank for 4 minutes without even trying at the time I injured my hamstring. For me personally, when I first started rehab, I could not even resist slight downward force on my side lifted leg. The PT thought I was not even trying. As well, I had zero balance standing on my right leg, but decent balance with my left. Through focused exercises, I’ve been able to improve both of these (and more).

LISTEN to Mortysct, he knows what he’s talking about, no need for continued discussion,....

It's more likely you got these issues because you had HHT rather than these issues causing your HHT.

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Endurance coach | Physiotherapist (primary care) | Bikefitter | Swede

It mat not be a true tendinopathy, rather an enthesopathy. The latter should not be stretched because it just keeps re-injuring the enthesis (practically re-ripping the tendon off the bone and re-inflaming the periosteum).

So again, any time someone has an injury, the first step to recovery is a correct diagnosis.

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Two wheels good. Four wheels bad.

There is always the possibility this is true but who knows. MRI showed similar inflammation of glute tendons, and hamstring tendon, on both sides. But, to this day, I remain completely asymptomatic on the left side. Who knows what causes what? It's a lot like asking which came first, the chicken or the egg?

Part of the issue with research on HHT is its mostly limited to case reports and small studies. The evidence is not huge so a lot of folks have many theories as to the why or what.

I agree that correct diagnosis is critical - it took about a year to figure out my problem, as I was experiencing referred pain due to the proximity of the sciatic nerve to the tendon (apparently - I'm an engineer not a doctor). It took two MRI's to figure it out, as I was presenting with what appeared to be a pulled calf muscle.

The second MRI was at the request of a specialist who looked at the first MRI and couldn't see an issue, and refered me to an even more specially specialist which was really good of him (and displays no ego!).

As for the cause, well I did ask, and I didn't really get an answer other than "it happens" (and I'm getting on a bit - 50 next year, eeeeek!). I don't know if it was weakened by something, I had a big "off" on my mountainbike about three or four months prior, or whether it is age/training/sport over an extended period of time (Judo, Kayaking, Rowing, Running, Triathlon, Rugby...) but I suspect that the year of no clear diagnosis did no favours - I would wait until my calf settled down, then start training, and it would go again. RInse and repeat.

But I am pleased to say that after surgery in April 2017, I have completed two 70.3 events this year (March and two days ago, both at Taupo) and although not quick, I got round OK. The HHT was not the limiting factor. My fundamental lack of fitness and excess kg's was...

I’d love a doc and/or rehab therapist in the Sacramento area!

Kkhill wrote:

I’d love a doc and/or rehab therapist in the Sacramento area!

Dr Jesse Saenz at Epic Chiropractic. He is the team chiro for the Sacramento Republic soccer team and has also worked with soccer teams in the Premier League too. He is MUCH more than just a chiropractor. Absolutely the best sports injury doc that I have ever dealt with.

https://epic-chiropractic.com/

I am doing exercises provided by a PT -- they have helped some, but I am interested in the ones you mentioned -- swiss ball (did you do hamstring curls on a swiss ball?)

Also-- what does RDL stand for?

Much thanks!

luv2run, how far along are you with this aggravating problem? I ask because it can make a huge difference how you approach it.

I had it a couple of years ago, but it went away on its' own. I also slalom waterski -- which is what brought it on in the first place. I am 52 and used to run up to the marathon distance competitively (there is high mileage on this hamstring) and I have become aware of muscular imbalances through PT.

I only water skied X2 last summer and it got so bad that my whole left glut (that is the injured side) became inflamed and dysfunctional. I had a cortisone shot which helped reduce out of control inflammation, but the hamstring pain came back as soon as it wore off. I have been doing PT for four months -- IMS and strengthening. I had great results at first and then was away for work and ran on a treadmill instead of swimming one day in mid-Nov. It didn't hurt at all during the run, but afterwards it caused a huge set back.

My PT has Rx eccentric hamstring and glut strengthening exercises, but she was also having me do 'deadlifts' with an exercise band. We have removed that exercise as of yesterday. She asked me to pursue a PRP referral via my family doctor. I am also considering buying a cold laser (Class 3B).

Any advice would be appreciated!!

Have you had an MRI to confirm this HHT?

If so, it's a longer road to recovery for us >45 folks. I trained through my issue for years until it was severely limiting and mentally draining (no fun finishing a long run limping).

Here's what I did last off season to finally lick it:
1) Stop running for month, confirmed HHT with MRI
2) PRP injection followed by almost no lower body exercises for a month.
3) Slowly began working my way back. I got 60% tendon attachment back (my guess)
4) Month 4 got another PRP injection followed by almost no lower body exercises for a month.
5) Slowly began working my way back. I got 90% tendon attachment back (my guess)
6) By 6 month mark start slow running for next 3 months.

I'd say 9 months to get to 100% and get fitness back. I did lots of planks, core & light weights to get my way back.

It was a humbling process but it also gave me a chance to refocus my athletic life. I have a much more balanced approach to my fitness goals now. I'm mentally and physically better for it.

I believe my weak hamstrings contributed to getting the injury in the first place. Also flexibility.

Gave me a chance to finally get good at pull ups too!

Google RDL lifts, hard to explain, involves a barbell with weights. I did swiss hamstring curls on the ball.

Keep at it, takes a long time to get better. Mine has never fully went away, but I can run as much as I want, and do speed work. Just have to build up real slow. I still do hamstring curls etc. I do believe this is the best exercise for it, just give yourself a day to recover between doing them.

Don't give up, it will get better. Don't think it will magically go away one day, like a lot of injuries can, think about it like slowly tolerating more and more load on the tendon and the pain slowly going away as you add more load, just have to give it time to adjust. Once I started thinking this way, my mental state about the injury was much better.

Thanks -- it was after reading your post that I thought I should pursue and MRI to confirm if there is a tear and what %. Thanks for sharing the process... I know I am I for the long haul.

I am in the process of being referred to a high level sports med clinic for a PRP consult and I suspect they'd be the ones who could also request an MRI (LONG waitlist here in Canada). I am starting to wonder if I have a tear and not just tendinopathy.

I also appreciated hearing your perspective on the >45 reset of your athletic mindset. Fortunately I am a strong swimmer and can hammer decent workouts in the pool without bothering my hamstring. Did you swim freestyle during your four weeks off running?

RDL -- Roman Deadlifts. Yes! My PT has had me doing them with a thick band versus a barbell. I loved doing them and more recently began to wonder if they were contributing to aggravating it.

Thanks for the encouragement to persevere.

Sadly, I love to waterski almost as much as I love to run and slalom skiing (the water start) puts maximal stress on the high hamstring -- like a one max rep deadlift would. Ouch! Not sure if I'll be skiing this summer...

Had your 2017 post bookmarked for over two years before I actually started doing the movements (and stuck with them). Had symptoms for over three years and was able to do a few IMs during the first stretch of that timeframe, but no “fast” running.

Finally stuck with it for longer than three days and kept the running easy and three months later, I’m running pain free and have been able to add some faster running back in. Raise my hand as a success story.

I found these guys to be the most helpful for what I had going on.
https://www.pogophysio.com.au/...er-hamstring-injury/
Especially considering that I been obsessively scouring the Internet for information so much that it was making my head spin. It sounds like my situation was about the same as yours, the pain wasn't stopping me, it was just an annoyance that wasn't going away and progressively worse the longer I ran. Also, one thing that helped a lot was that my chiropractor/ sports doc checked out a video of my running, and saw that I was over striding, which puts a lot of extra strain on the hammies. It seemed like once I addressed that, along with the excercises he prescribed, I started to make progress, and I'm fine now. Also, what he was telling me was in line with what the Pogo Physio guys ☝were saying. Btw, they did a podcast on this issue as well. Good luck.