Treating the Hamstring: A Pain in the Butt

Does your forward fold in yoga cause pain under the cheek instead of a nice stretch in the back of the thigh? Does your buttock pain cut your run short before you are even tired? You may be suffering from a hamstring tendon injury. A tendon connects muscle to bone and can be injured abruptly or from chronic overuse and microtrauma. Tendinitis is simply inflammation of the tendon and is usually the first sign of a problem. Left untreated, this can lead to tendinosis where the structure of the tendon changes. Over-stretching and overuse of the hamstring are two common causes of injury.
 

Treatment

Rehabilitation exercises are the primary treatment method for hamstring tendinosis. Research has shown that progressive loading exercises are effective at reducing pain and encouraging healing. This means starting with isometric (prolonged static hold, 1st photo), progressing to slow isotonic (moving through a range, 2nd and 3rd photo), and eventually performing plyometric exercises (e.g. running and jumping). Our physical therapists can guide you through these phases with an individualized exercise program. Additional rehabilitation exercises will address core and hip stability and proper gluteal muscle activation. Shockwave therapy is an adjunct treatment modality that can speed the healing process and decrease pain.

This tool emits high-intensity sound waves and is a quick procedure performed here in the office. We also often utilize dry needling to stimulate healing and increase blood flow to treat hamstring tendinosis. If you have been dealing with a “pain in the butt,” contact our office so that you can be thoroughly evaluated by one of our skilled providers. We can start you on a treatment plan that will set you on a path to getting back to the things you love to do.
 

References

Ode G. What Is the Difference Between Tendonitis, Tendinosis, and Tendinopathy? Sports-health (2019). https://www.sports-health.com/sports-injuries/general-injuries/what-difference-between-tendonitis-tendinosis-and-tendinopathy  Reurink G, van der Made AD. Managing the athlete with stubborn proximal hamstring tendinopathy. Aspetar sports medicine journal. September 2019; 8: 262-7. https://www.aspetar.com/journal/viewarticle.aspx?id=467#.XsQcZWhKhPb