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Management of 43 y.o. female with suspected bilateral hamstring tendonosis.

Exit forum ID Forum Discussion Management of 43 y.o. female with suspected bilateral hamstring tendonosis.

This topic contains 2 replies, has 2 voices, and was last updated by   Scott Glidden November 2, 2017 at 11:14 am.

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  • #3210

    Scott Glidden
    Participant

      43 year old female
      avid runner 3-4 miles 3x/week
      considers herself fairly flexible.

      Has been a patient over a year and has been dealing with hamstring issues the entire time. We got her to the point where she could run with some regularity but then since July she has had this mild lingering problem that vacillates between a 2 and 4/10 in intensity. I have been preaching load management since she was previously running 5-6miles 3x/week while training for a race and she has reduced the runnings while adding yoga 3-4 times per week (which I told her was still too much load).

      Has a consistent 4-5/10 tension/ache at proximal hamstring bilaterally with yoga and running.

      Better with rest.

      B SLR 90 degrees, 2-3/10 tension from ischial tuberocity down hamstring ~6 inches. Dorsiflexion does not change symptom intensity.

      Palpation reveals firm and very tender adhesion at proximal hamstring attachment bilaterally.

      In the IAR seminar we were told that tendonosis would need very consistent treatment and eccentric exercises to promote healthy tendon growth. IAR on with eccentric heel lifts is prescribed for achilles tendonosis, but what about the proximal hamstring? l told her it would take months of regular care (MAR) to fix, but what exercise should I pair with it? Is there an updated ID move to better treat this than exists online?

      #3261

      William Brady, DC
      Participant

        I just found the eccentric hamstring exercise and added it to the bottom of the strength exercise section. The video is from 2011. Enjoy the vintage content. All still accurate, no updates to this exercise.

        If the patient is very lean and you pull the glute max lateral you can expose the proximal hamstring tendon. You can try IAR to this area. You have to rely on palpation with the instrument (do you feel grit?) to determine if you are getting any reasonable dose vs. just irritating the subcutaneous tissue.

        Thanks

        #3262

        Scott Glidden
        Participant

          Thanks for the help doc!

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