Training for Ironman - Hamstring tendinitis...HELP PLEASE!

Triathlon Forum
1

I think I have hamstring tendinitis and would LOVE some advice please.

I’ve begun training for Ironman Switzerland which is in July 2011. I’ve taken the last year off from triathlons and have done no cycling and limited running, and just began by training for the Ironman on June 1st, which includes just running and cycling - no swimming yet

About 3.5 weeks ago I went riding with some guys, and went out way too fast. Ever since then my left hamstring has been tight. It’s nothing that is extremely painful, but I can tell that it’s holding me back and can be tight and painful, and especially after my workouts. All my bike rides and runs over the past 3.5 weeks have been very slow, which I thought might fix my hamstring, but it still remains tight and sore.

I saw my doctor yesterday and he basically prescribed Ibuprofen and said take it easy…that was it. Sometimes Doctors are worthless. Also, after the injury, I read that hamstring injuries are often the result of a saddle that is too high. Since then I lowered my saddle about 2cm, and I also got a basic bike fit this week and he said my saddle is the correct height and everything looks good.

After reading online, it sounds like Hamstring Tendonitis. The common cure is 4-6 weeks of rest and stretching and anti-inflammatory. But this is often prescribed for non competitive athletes, and I’m wondering what other cyclists / runners / triathletes do.

I’d really not like to take a 4-6 week break from training (even though I’m in base training) as my goal for the Ironman is extremely aggressive (9:45) and I need every waking moment to train. That being said, I need to make sure that I am 100% when my training volume increases and I want to make sure this doesn’t become a chronic injury. I need some suggestsion. Here are some options - and all options would follow a really good recovery protocol of stretching, icing, IBProfin, etc.

  1. Continue my normal mileage (100miles biking easy, 10-12miles running), and keep it at low pace & low intensity for the next 4 weeks.
  2. Decrease mileage to something else?
  3. Do zero training for 2 weeks
  4. Do zero cycling/running, but do some cross training (swimming?), for 2 weeks, then ease back into cycling and running
  5. Do zero training for** 4 weeks**
  6. Do zero cycling/running, but do some cross training (swimming?), for 4 weeks, then ease back into cycling and running
  7. Other suggestions?

I would truly appreciate any suggestions people have, particularly other triathletes that had hamstring problems, and I’d like to know what worked for them and their recovery time required.

FYI, I’m 26 years old, and have done two other Ironman races in the past
3 years, and have been doing triathlons & marathons for 6 years
now.

2

ART, strength training (I used ankle weights and did hamstring curls, hamstring curls on a swiss ball, and squats with light weight), and believe it or not, changing my driving position helped. Also might try TP massage ball on periformis. This is a common problem that does not go away easily. Mine still flares up from time to time, especially if I run a lot or run fast without having a good base. Good luck.

3

Jon - Thanks for the advice. Do you think it would be beneficial to take a 2-4 week break from training or do you think I’ll still likely have problems, and so I should just get used to the feeling, and try my best to cope with it and strengthen the area and massage it? I’d hate to take 2-4 weeks off, if it won’t fix the problem.

4

What you described sounds just like what I have been suffering from since got started in triathlons almost 2 years ago. I have been to the Doc and PT.

What has helped the most is strength training. Hamstring curls but first load with both legs and then let down the weight with one.

After my race last Sunday there was an A.R.T guy at the finish line. Wow did he hurt me. But it really seemed to help. Plan on making an appointment after my race this week-end.

I have taken some time off completely from running in the past and it just comes back. Now I run very, very little because of this and my achilies. Maybe I did not take enough time off but for me it would take a lot of time.

5

This may be a dumb question, but what does A.R.T. stand for?

6

Active Relief Technique.

7

Active Release Technique
.

8

I was talking time off from running as recommended by a physical therapist, then I went to the A.R.T. guy, Dr. DeStephano in Lodi, NJ, who was also an Ironman himself. He did something really painful to my hamstring and told me to make sure I went running the next day and I did and it felt much better. Try that and try the strength training and just shift the position you drive in and hopefully you will be able to train through and still do your IM. I might lower my run volume and the duration of my longest run and substitute that with some more biking and strength training, though, if I were you. Good luck

9
Active *Release* Technique .
10

How would I find a specialist in my area to perform the “Active Release Technique”. Is this something that a good massage therapist would do? I’ve gotten deep tissue massages in the past. Would this be sorta the same thing?

11

Boy do I know the headspace you’re in, but to be honest I don’t think you’re doc’s advice was worthless. This is the first ride you’ve done in a long time. You admit you went too hard. I think I would have given the same advice. You threw too much at muscles that aren’t used to the abuse. Back off and let things cool down. Do very little the for three or four days. Ease into some light stretching. Getting the tennis ball into piriformis is also a good idea. Maybe after five-seven days go for a light ride - maybe do it alone to resist the temptation to join others when they go hard. I have lost much in the past to hamstring/piriformis issues. You want to bring things along slowly. The “I need every waking moment to train” attitude should be scrapped. Forget timelines. Get healthy. You have time. Good luck to you.

12

No answers but sending good wishes.

13

How would I go about finding a Active Release Technique specialist? Are good masseuses trained in this?

14

I had hamstring issues last year, and here’s what I can tell you: It took me 2 weeks of NO biking and running to heal, then a nice, gradual build up after I started again. Swimming was OK. I made the big mistake of taking 2-3 days off, thinking it was better, then reinjuring it within 1-2 runs a couple of times. Or biking hard, thinking that they twinge in my hammie was nothing, then trying to run and feeling crippled. Or taking just one week off, and then reinjuring it almost immediately. My advice: You have until July next year. Rest up now, LET IT HEAL. Take it easy when you start to come back, and watch for warning signs it hasn’t healed. Don’t keep running after it twinges…stop immediately. Instead of just taking two weeks, I kept reinjuring myself due to stubborn, stupid behavior, and probably lost 5-6 weeks of run training, rather than the 2 it may have just cost me had I stopped and listened to my body.

Spot

15

I’ve had hamstring tendinitis for years. For the longest time I couldn’t run more than 13 miles before I had to stop due to the pain- I was DNFing races…it really sucked. I finally went to a PT who evaluated me for 3 minutes and said that I had tight hamstrings and that I needed to start a routine of stretching. She recommended the one below 2 minutes twice a day …haven’t DNFed since . I stretch the hamms religiously now.

http://www.healthline.com/blogs/exercise_fitness/2007/04/doorway-hamstring-stretch.html

16

re: finding an ART specialist

Google - there is a site someone pointed me to once that let you find one by typing in your zip code. OR start a thread “Looking for an ART specialist in _____________”

17

Don’t take this lightly, I’ve been trying to get rid of this for 2+ years now and can’t run at the moment. I have tried:

  • PT
  • Chiro (x3)
  • Massage (x7)
  • Prolotherapy
  • ARP Wave
    to no avail.

I think I am the closest I have gotten to getting rid of this damn thing.

  1. Get someone who knows Rolfing or ART. they sre similar, but you need someone with a good feel for the muscle groups. I have 2, one at the Chrio that is working out all the hip tightness, and another one that is very good at getting the knot in my ass to relax.
  2. Bike fit - mine showed that I was killing my hammies on the bike, and underusing the quads.
  3. A little chiro doesn’t hurt to make sure everything is straight
  4. yoga, try a little Bikram 2 or so times a week. It will get you used to the heat, and stretch all that shit out.

Good luck, I hope you get off easier than I did…

18

I just got back from my masseuse and she found TONS of knots in my hamstring and next to the tendon on the side of my hamstring that is bothering me. I think it will help a lot and I’ve scheduled 2 follow-up appointments for next week, and will likely go 1-2 times a week after that until I’m better. My masseuse gets in really deep and often works with cyclists and runners.

I’ve also decided to take this week and next week off from training completely (maybe some swimming next week), and will likely take a full month off from running.

Taking all this into consideration, do you think it is necessary to see an A.R.T. specialist? I have an appointment tomorrow to see an ART specialist but they are very expensive (not covered under my insurance) and I’m just curious how effective it truly will be. Is this something I should do at the same time as seeing my deep tissue masseuse?

Is A.R.T. really completely different than a deep tissue massage and much better at repairing damaged tissue? At the same time I want this problem resolved ASAP so I can begin my training again.

Thanks everyone for their input!

19

I have an appointment tomorrow to see an ART specialist but they are very expensive (not covered under my insurance) and I’m just curious how effective it truly will be. Is this something I should do at the same time as seeing my deep tissue masseuse?

Is A.R.T. really completely different than a deep tissue massage and much better at repairing damaged tissue? At the same time I want this problem resolved ASAP so I can begin my training again.

This is the tough part. My Rolfer is through a chiropractor so it is covered. This is a HUGE help as I would not be able to afford it otherwise. The key is to have someone who is good at what they do. A good masseur/ART/Rolfer a few times will be far better than someone who isn’t good or doesn’t have good experience.

I would say just go with the massage, and if you reach a plateau, work in the ART. Maybe in this timeframe, you can find one covered by insurance…

20

I used an ART specialist for my back and I do feel it helped. It is very different from massage but I don’t know what would be better for your ailment.
Sorry I can’t help you more.
Good luck