Understanding Weakness vs. Sensitivity in Proximal Hamstring Tendinopathy

Introduction: Welcome to the podcast episode about overcoming proximal hamstring tendinopathy. In this episode, we will delve into a critical aspect of managing this condition – understanding the difference between weakness and sensitivity. Whether you’re an athlete or not, this podcast aims to educate and empower you on the journey to recovery. So let’s dive into the topic of weakness versus sensitivity in the context of proximal hamstring tendinopathy.

The Host: Brodie Sharp

• Host of the Run Smarter podcast.
• Online physiotherapist and recreational athlete.
• A chronic proximal hamstring tendinopathy battler.

Recovery Expectations and Setbacks: Before we explore weakness versus sensitivity, it’s crucial to understand the relationship between recovery expectations and setbacks. Setbacks, often in the form of flare-ups, are common during the recovery process. This episode will help you comprehend these setbacks and how to navigate them effectively.

Weakness vs. Sensitivity: An Example

To illustrate the difference between weakness and sensitivity, let’s consider an example. Imagine someone recovering from an injury, such as plantar fasciitis, and they have successfully built up their strength and tolerance over several months, reaching a point where they can run 10 kilometers comfortably.

One day, they push themselves too hard, perhaps running too fast or overloading their injured area outside of their usual routine. As a result, they experience a sudden flare-up, feeling discomfort and soreness in the injured area. They start to question their progress, wondering if they have lost strength and why they can’t run the same distance without pain.

In response to the flare-up, they decide to take a step back and try a shorter run, but even that exacerbates the discomfort. The fear of losing strength and progress sets in, leading to frustration and doubt.

It’s Not Weakness, It’s Sensitivity

In reality, the issue is not weakness but heightened sensitivity in the injured area. The structure itself, whether it’s a tendon, fascia, or joint, remains the same in terms of strength. However, the pain receptors are more sensitive, causing increased pain and discomfort.

Understanding this distinction is crucial. It doesn’t mean you should ignore the pain signals and push through. Instead, you must pay attention to these signals and find a new temporary adaptation zone to train within. The more sensitive your injury becomes, the lower this adaptation zone becomes.

This concept applies not only to proximal hamstring tendinopathy but also to various injuries, such as shoulder issues for swimmers or knee pain for runners or cyclists.

Managing Sensitivity: Finding Your New Adaptation Zone

When your injury is in a sensitive state, you may need to temporarily transition away from your regular activities and engage in different forms of training. Strength training, such as squats, lunges, or slow and heavy exercises, can help you maintain your adaptation zone without overloading the sensitive structure.

The key is to start cautiously, depending on the severity of your flare-up. If your symptoms are mild, you can test out 50-75% of your current capacity. For more sensitive situations, consider starting at around 15% or explore different forms of training that don’t exacerbate your pain.

Remember that finding the right adaptation zone is a trial-and-error process, and it varies from person to person. Seeking guidance from a health professional or coach can be invaluable in this journey.

Factors That Affect Sensitivity

Several factors in your daily life can affect the sensitivity of your injury, leading to flare-ups. These include:

• Poor diet: Consuming unhealthy foods and excessive sugar can heighten sensitivity.
• Inactivity: A sedentary lifestyle and lack of social interaction can contribute to sensitivity.
• Poor sleep: Inadequate sleep can increase pain and discomfort.
• Stress and anxiety: Negative thoughts, hypervigilance, and anxiety about your injury can make it more sensitive.

Recognizing these factors is essential to managing sensitivity effectively.

Weakness and Its Causes

In contrast to sensitivity, weakness in an injured structure is primarily caused by prolonged underloading. Weakness gradually develops when you don’t subject the structure to its load capacity for an extended period. This process can take around three weeks, but it happens more quickly with complete offloading, such as bed rest or immobilization in a cast.

For example, if you have plantar fasciitis and engage in light, low-level walking during your recovery, you are less likely to experience significant weakness. However, if you remain bedridden or wear a cast, weakness can set in rapidly.

Conclusion

Distinguishing between weakness and sensitivity is crucial in managing proximal hamstring tendinopathy and other injuries. When you experience a flare-up, it’s not an indication of lost strength but rather heightened sensitivity in the affected area. By understanding this concept, you can develop a tailored flare-up plan that aligns with your specific load tolerances.

In our next episode, we will delve into the mental aspects of injury recovery with a special guest, Kerry Cheadle, the author of the book “Rebound.” Stay tuned for “How to Train Your Mind to Bounce Back from Injury.”

As you navigate your recovery journey, remember that knowledge is power, and by understanding the nuances of weakness and sensitivity, you can take control of your rehabilitation.