Have you got sore butt when you sit on it? Do you stretch your hamstrings A LOT and continue to get high hamstring pain? Do you get a pull at the base of your butt when you run upstairs or the next day after hill training?
You may have a proximal Hamstring Tendonipathy.
WHAT IS IT?
The hamstring complex is made up of the 3 muscles (biceps femoris, semitendonosis & semimembranosis) which all attach to the inside aspect of your sit bones or the ischial tuberosity as pictured here. This area can be injured through acute mechanisms e.g. a dancer stretching passed normal range and straining the high hamstring. More commonly, we would see this as a progressive overload which injures the tendon e.g. increasing running distance/intensity or adding lots of deadlifts to a program.
The biggest cause is “compression” of the tendon around the sit bones and “tensile” load as the muscle contracts around the insertion and quick increases in “load”. For the tendon heal it is paramount you address the compression and tensile factors.
HOW CAN I ASSESS HAMSTRING PAIN?
- Sitting tolerance: How long can you sit for?
- Does it hurt to touch your toes?
- Does it hurt to do a single leg bridge?
- When you pull your knee to your chest and straighten the knee
- If you feel the ‘sit bones’ and the top of the hamstrings does it feel more tender than the other side?
- Seek professional help to exclude lumbar spine, hip joint or referred pain
QUICK TIPS ON MANAGING HAMSTRING TENDON PAIN?
- Do NOT rest completely
- You will need a cushion for hard chairs and the car
- AVOID stretching the hamstrings
- Start isometric loading for pain relief e.g. bridges
- Shorten stride length
- De-load by reducing plyometric or hill training
- Then lastly LOAD the tendon to its former glory in positions that do not add to the compression e.g. standing leg hamstring curls or bridges