Looking for information on how muscles and tendons work in the leg. I have suffered a pain in my butt for a year now. Only a problem with running. No problem with cycling.
So I went to an orthopedic doctor that specializes in athletic problems. He diagnosed it as a problem with where my hamstring inserts. He recommended I go to a physical therapist. Which I did yesterday. It has been very difficult to hit the bad spot with stretching. Only stretch that will hit it is with me lifting my leg over my head. The Dr. tried a bunch of different things with my leg and nothing hurt. Asked him why and he said that it needed to be under loads.
So one of the things the PT wanted me to do was strengthen my hamstring. So she had me lay on a weight bench on my stomach and lift some weight with both legs and then let the weight down with the leg with the problem. She first tried 80 pounds and I could not do it. This was the best way to really get to the pain. So it really hurts when under load. She finally put it on the lowest weight and wanted me to do 3 sets of 10. I could only get through 2 sets. I then went home to do it on my weight bench at home and could only do it with 5 pounds.
That is the background. What I don’t understand is what is going on. With my good leg I had no problem using 40 pounds with it. But my bad leg is fried. I am suppose to take off some time from running but this exercise seems a lot worst than running. I use my bad leg hamstring for lots of things without any problem and no weakness. But using it in this particular manner it hurts really, really bad and crazy weak. It seems like the muscle is fine but the tendon or whatever where my hamstring attaches is seriously messed up. But what will make it get better?
It would have seem to me that it would have made more sense to first let it heal some. Then start the hamstring curl at really, really low weight and over time build it back up. But if in pain then stop.
I am going to go back to the doctor and ask these questions but know there is a lot of knowledge on the forum how muscles and tendons work and was looking for some education.
FWIW.
I was a baseball catcher in HS/College and developed a muscle imbalance between my quads (strong) and hamstrings (weak). This lead to knee instability and problems. I did ham curls till I puked and it did nothing for me for years. After I was done with baseball. A buddy suggested straight legged dead lift. Within 8 weeks, I had fixed the problem. My hamstrings were strong. I just make sure my back is straight and I look up with a ever so slight bend in my knee. This is the best exercise that I have found for my hamstrings. I don’t waste my time with ham curls anymore.
Same deal back in 2007, couldn’t run more than 3 miles.
PT never helped
ART saved the day. Chiro said to keep running and I thought he was nuts.
1 year later, I rec’d an MRI as my doc wanted to know why I had a lump in my ass (so did I). Turns out, it was a muscle tear (hamstring) which turned to scar tissue.
At the time, they all said it was siatic nerve and piriformis.
I have lots of clients that are runners with this (also hockey players), the hamstring is strained at the ischeal tuberosity sp? several art sessions along with some ultra sound, deep cross fibre frictions, a little stretch after, along with easy strengthening/ streatching on your own should fix it at least 80% better in a few weeks. ice post workout for 2 weeks or so if tender and sore, heat if just a dull ache.
Get in to see a good sports massage therapist or physio, and they should make a huge difference.
It not piriformis syndrome. It is hamstring is strained at the ischeal tuberosity I believe. The PT did do ultra sound to loosen it up. I have been using a ball on it. Guess we will see how it goes. It is weird that I can bike without any problem. But my hamstring is so weak when doing curls.
I wonder if it is the equivalent of patellar tendonosis yet at the hamstring insertion??? Is there a hamstring tendonosis???
Your problem intrigues me as 1) I have patellar tendonosis on the right and now I have 2) butt pain. Its not really pain - its just a weird “tightness” that occurs when I go from a flexed hip to an extended hip (getting out of car) or when I lean over about 30 degrees (so that would be flexing the hip). I thought mine was piriformis - then I wondered about my back - as I also get some achilles tightness with it sometimes…but I am not sure. I may try some hamstring curls to see if its super weak.
Did you ever get imaged? I’d imagine they could see the tendon insertion by ultrasound but may be difficult to do.
Found a great thread on this injury on runners world. What scares the heck out of me is that mine does not seem anywhere as bad as most people posting on the thread. It also seems no one gets better.
Mine is only bad when running. Can do everything else without problem. Does not hurt when sleeping. Very, very minor pain when sitting. The hamstring curls are killing. I am now somewhat worried about actually making it worst.
If you can get your hands on the August 2009 issue of Triathlete magazine, Dr. Mather and I also wrote an article in that issue on how SI joint precedes Hammie injuries…
Just a thought but seeing how it is sport specific has anyone analysed your running gait? During foot contact there is a tibial rotation that occurs normally, this torque needs to be countered at the hip by the external rotators. When glute med and the ER’s are weak the hamstring attempts to perform this task and an over use injury occurs, often ischial bursitis or hamstring insertion issues. Have someone assess these muscles and anlysis your hip stability during running and functional activities such as single leg squating.
Nobody is wrong. This is a very challenging injury for providers. Their job is really to entertain you as your body heals itself. If it only bothers you while running it is very possible that it is from pelvic instability. Good luck. Drink water, take motrin, and change your socks.
Try this when you can 1 - 5 weeks off of any training that bothers it. MASSAGE (as in one with a very good massage therapist) (once - twice a week). Ultrasound or cold laser everytime you go to therapist (this can make your injury heal twice as fast).
Foam Roller and Rolling on ball, followed by Heat 5 - 15 minutes, Ice massage rubiing in the same direction as the tendon (with frozen water in dixie cup) 5-15 minutes. The reason you do it this way is that it allows your arteries to work as a pump, by bringing bloodflow to the area, then contracting the vessels to pump all the crud that is in the tendon out (this is why you should foam roll first, though you could heat as well b4 your roll). Do all this everyday 2-3 times. You might want to wear compression socks, kinesio tape (or Rock tape), and put some Biofreeze on it during the day.
I would stay away from painkillers as they only dull the pain, and make you more likely to go out and train when you shouldn’t.
Briefly looked at many of the responses as I have desired to send something ref . the healing of my hamstring . After being misdiagnosed by my former Pt and her sending me to Acupuncture it was my Chiro that even came close to giving a proper differential diagnosis. I almost gave up on any possibility of solving this pain as I had done massage, ultra sound therapy, ART, Cold Laser , core strengthening and lastly a lot of eccentric strengthening exercises…not to mention after 3 hours of research one evening to find that most with this complaint (high hamstring tendonopothy ) rarely found relief.
I changed Pt’s and upon my first appointment I wrote that my chief complaint was high hamstring tendonopothy , and at that appointment I was asked if I had heard of dry needle therapy. I was referred to the doctor and after a ultrasound of the area, which as many mentioned is a deep soft tissue area high up on your butt where many things connect, the scar tissue was found.
We started with basic dry needle and then after two treatments to areas were minor scar tissue was causing referred pain I had two PRP treatments to the actual culprit area. The difference between basic dry needle and PRP is that basic includes placing 10 cc of your blood into the area where the scar tissue is and PRP is where 30 cc of you blood is spun into platelets and they are injected into the scar tissue. All of this is very basic meaning the dry needle is placed into the scar tissue (following a local) and then the dry needle is used to break up the scar tissue, thus causing inflammation to occur and the blood / platelets are injected right to the area to increase healing as this area is not a very venous .
This procedure was recently in the NY Times and the only issue really unknown is at what rate can you start putting demands back on the area…personally upon my last treatment I did a lot more than prescribed. I continued with a pretty demanding exercise program through my 8 wk follow up. Currently am pain free and have ramped back up to my swim, bike and run pace prior to my previous IM .
I am able to send more information upon request ( pre - op info and NY Times link and lastly Md . contact info ). Good luck and know that high hamstring pain can be corrected.
Were you able to get rid of this? I did IM in 2007 with no issues, now I have a knot on my ham attachment. After 2 years of chiro, PT, etc I’m getting an MRI on Thursday.
"We started with basic dry needle and then after two treatments to areas were minor scar tissue was causing referred pain I had two PRP treatments to the actual culprit area. The difference between basic dry needle and PRP is that basic includes placing 10 cc of your blood into the area where the scar tissue is and PRP is where 30 cc of you blood is spun into platelets and they are injected into the scar tissue. All of this is very basic meaning the dry needle is placed into the scar tissue (following a local) and then the dry needle is used to break up the scar tissue, thus causing inflammation to occur and the blood / platelets are injected right to the area to increase healing as this area is not a very venous .
This procedure was recently in the NY Times and the only issue really unknown is at what rate can you start putting demands back on the area…personally upon my last treatment I did a lot more than prescribed. I continued with a pretty demanding exercise program through my 8 wk follow up. Currently am pain free and have ramped back up to my swim, bike and run pace prior to my previous IM .
I am able to send more information upon request ( pre - op info and NY Times link and lastly Md . contact info ). Good luck and know that high hamstring pain can be corrected.
I had scar tissue on the ischial tuberosity it primarily was felt while running hills and digressed to even when walking up steep inclines. The motion of lying on my back with bent knee or sitting up at a 45 with bent knee and extending was where I felt it while static. I found this to be linked to the Ishial Tuberosity connection of the hamstring and after an ultrasound scar tissue was found. Here are some articles I found on the more aggressive and more advanced PRP (platelet rich plasma injections) http://www.nytimes.com/2009/02/17/sports/17blood.html and the article the MD gave me prior to my final two which were PRP http://www.nytimes.com/2009/07/23/health/nutrition/23best.html. I can send you copies of the preop that tells more when I get to work tomorrow.
I too injured it in peak training phase prior to IMC 07 and then further exacerbated by conducting little to nothing (living in the moment of first IM) until Feb of following year. Completed IMCDA 08 thinking it was just a problem caused by not stretching well enough and then after a hard hill run approximately 3 weeks later huge inflammation to the point of hurting upon sitting down.
We started with basic dry needle and then after two treatments to areas were minor scar tissue was causing referred pain I had two PRP treatments to the actual culprit area. The difference between basic dry needle and PRP is that basic includes placing 10 cc of your blood into the area where the scar tissue is and PRP is where 30 cc of you blood is spun into platelets and they are injected into the scar tissue. All of this is very basic meaning the dry needle is placed into the scar tissue (following a local) and then the dry needle is used to break up the scar tissue, thus causing inflammation to occur and the blood / platelets are injected right to the area to increase healing as this area is not a very venous .
This procedure was recently in the NY Times and the only issue really unknown is at what rate can you start putting demands back on the area…personally upon my last treatment I did a lot more than prescribed. I continued with a pretty demanding exercise program through my 8 wk follow up. Currently am pain free and have ramped back up to my swim, bike and run pace prior to my previous IM .
I also had a positive experience with PRP injections for a ligament injury in my foot. My particular issue required a series of three treatments approximately a month apart. But, it’s been good to go since the last treatment almost 3 years ago. (Knock on wood.)