Proximal Hamstring Tendinopathy: Lessons Learned and Effective Rehab

Welcome to today’s article where we delve into the world of proximal hamstring tendinopathy (PHT) and the invaluable lessons that can be learned from it. PHT can be a daunting condition, but with the right knowledge and evidence-based treatments, it can be overcome. Join me, Brodie Sharp, an online physiotherapist and recreational athlete, as we uncover the ins and outs of PHT.

Introduction

Proximal hamstring tendinopathy (PHT) can be a real challenge for athletes and non-athletes alike. In this article, I’ll share my personal experience with PHT, how I first developed it, and what helped me overcome it. While I can’t guarantee that I’m entirely free from future flare-ups, I can confidently say that my tendons are now much stronger, and I can manage any potential issues effectively. My goal is to empower you with the knowledge and practical takeaways you need to conquer this condition.

The Impact of Speed on PHT

Lesson 1: The Importance of Speed

One key lesson I’ve learned is the significant impact that speed has on PHT. Even if you’re a well-trained athlete or think you’ve built up sufficient endurance, introducing speed work can still lead to PHT issues. High-speed running places considerably more demand on the hamstrings, and this can lead to tendinopathy. In a 2012 study by Tim Dawn and colleagues, they found that the faster you run, the more force your hamstrings have to withstand. It’s crucial to introduce speed training gradually to allow your body to adapt and prevent PHT from flaring up.

Compression and Managing Pain

Lesson 2: Compression and Managing Pain

Another important lesson in managing PHT is understanding the role of compression and how to handle pain during your rehabilitation. Many individuals with PHT are often fearful of pushing their tendons to the point of discomfort. However, this fear can hinder progress. It’s essential to recognize that controlled and low levels of pain during exercises are acceptable and even necessary for effective rehabilitation.

I had a breakthrough in my own recovery when I discovered that embracing controlled discomfort during strength exercises was beneficial. It allowed me to identify the sweet spot where pain during exercise was around 4 or 5 on a scale of 10, but then decreased to 2 or 1 as I progressed through sets. Over time, I was able to increase the weight, range of motion, or speed to maintain that discomfort level, which ultimately accelerated my recovery. The key is ensuring that pain remains at low levels during and after the exercise, indicating your tendon’s tolerance and adaptability.

Effective Strength Exercises

Lesson 3: Effective Strength Exercises

To overcome PHT, it’s crucial to incorporate strength exercises that challenge your hamstrings, specifically focusing on knee flexion, hip extension, and eccentric movements. Tom Goom, in his research on PHT, recommends a balanced approach involving these three types of exercises to target the hamstrings comprehensively.

Some effective exercises that have aided in my recovery include:

1. Hip Dips: These are similar to Nordic hamstring curls but involve eccentric loading with compression. They effectively mimic the demands of running.
2. Deadlifts and Single-leg Deadlifts: These exercises help build strength while incorporating eccentric movement and compression.
3. Wall Balls: Squatting with a heavy medicine ball and throwing it against a wall combines compression and power in a way that’s beneficial for PHT.
4. Rocket Jumps: These explosive jumps from an elevated surface challenge your hamstrings and can help you regain power.

By gradually progressing through these exercises and ensuring they remain within a tolerable discomfort range, you can strengthen your tendons and facilitate your recovery.

Conclusion

Proximal hamstring tendinopathy can be a formidable opponent, but with the right knowledge and a structured approach to rehabilitation, it can be overcome. Recognize the impact of speed, embrace controlled pain during exercises, and incorporate effective strength exercises into your recovery plan. With persistence and careful management, you can take control of your PHT and work toward a future free from pain.

Remember, knowledge is power, and with the insights shared in this article, you’re better equipped to tackle proximal hamstring tendinopathy head-on. Don’t let PHT hold you back—empower yourself with the right information and take the necessary steps to overcome this challenging condition.