What can we learn from Dr. Alfredson?

Title: Understanding Proximal Hamstring Tendinopathy: Lessons from Dr. Alfredson

Introduction: Proximal Hamstring Tendinopathy (PHT) can be a debilitating condition for those who suffer from it. In this podcast episode, we delve into the story of Dr. Alfredson, a pioneer in the field of tendinopathy rehab. We’ll uncover the valuable insights his experience offers and explore three key takeaways that can benefit anyone dealing with PHT. Let’s dive in.

Who Is Dr. Alfredson? Dr. Hakan Alfredson, an orthopedic surgeon and sports medicine professor in Sweden, developed a painful Achilles tendon in the mid-1990s. Initially, he considered surgery as a solution, but his boss refused, citing that the issue wasn’t serious enough and the clinic couldn’t afford his absence. Frustrated, Dr. Alfredson took matters into his own hands. He deliberately aggravated his injury with a series of painful exercises. Surprisingly, his condition improved rather than worsened. This sparked his curiosity about why this happened, leading to the development of the Alfredson protocol for tendinopathy rehab.

Key Takeaway 1: Pain is Okay When dealing with PHT, it’s essential to understand that some level of pain during exercises is acceptable. Generally, staying below a pain level of four out of 10 on the pain scale is considered safe, as long as there are no significant flare-ups afterward or the following morning. However, if you experience three out of 10 pain during exercises and find it challenging to progress due to pain, consider adding weight cautiously. Slowly increasing the load may help strengthen the tendon without exacerbating your symptoms.

Key Takeaway 2: Tendons Love Slow, Heavy Loads Dr. Alfredson’s experience emphasizes the importance of slow, heavy loading for tendinopathy rehab. Tendons respond well to exercises that apply a controlled, heavy load. Examples of such exercises include deadlifts, Nordic hip hinges, and eccentric prone hamstring curls. Transitioning from bodyweight exercises to heavier loads can be beneficial in your rehabilitation journey. Ensure a gradual progression to prevent overexertion and injury.

Key Takeaway 3: Slow, Heavy Loading Doesn’t Worsen Tendons Contrary to common fears, applying slow, heavy loads to tendons doesn’t typically make them worse. Dr. Alfredson’s case illustrates that tendons can actually improve under such conditions. While tendon ruptures can occur in extreme cases, they usually involve severely deconditioned tendons and are often painless. Applying a gradual, controlled approach to heavy loading is unlikely to harm your tendons and can lead to positive outcomes.

Conclusion: Dr. Alfredson’s journey from contemplating surgery to developing a successful tendinopathy rehab protocol highlights the importance of embracing pain within acceptable limits, incorporating slow, heavy loading exercises, and dispelling fears of worsening tendons. These takeaways provide valuable insights for those dealing with Proximal Hamstring Tendinopathy. By following these principles, you can take control of your rehab journey and work toward a pain-free future.