Proximal Hamstrings Tendinopathy

Dr Ozello's Sports Medicine Report: Proximal Hamstrings Tendinopathy ***Disclaimer: Viewing this video does not take the place of seeing a medical professional. Please visit a medical professional for evaluation, diagnosis & treatment. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Proximal hamstring tendinopathy is a persistent injury with an extensive recovery time. Proximal hamstring tendinopathy is also known as high hamstring tendinopathy. In the past it may have been called proximal hamstring tendonitis. The hamstring muscle group is located on the back of the thigh. It crosses two joints, the hips and the knees. When contracting in a positive or concentric manner the hamstrings work as a unit to pull the hip backwards into extension and bend the knee backwards into flexion. Three long muscles make up the hamstrings. From the inner thigh going outward, the hamstring muscles are the semimembranosus, semitendinosus and the biceps femoris. The biceps femoris contains a long head and a short head. All three of the long hamstring muscles originate on the ischial tuberosity, a bone in the gluteal region. The ischial tuberosity is part of the pelvis. It is the part of the bone we sit on: therefore, it is nicknamed the sitz bone or the sitting bone. The site of the hamstring muscles origin on the ischial tuberosity is the location of symptoms of proximal hamstring tendinopathy. The tendons at the origin of the hamstrings are thick and fibrous with poor blood supply, which makes healing difficult. The hamstring muscles are largely composed of "fast-twitch" Type II muscle fibers which generate a large degree of tension on the tendons. The hamstring muscles perform numerous functions while running. The hamstrings contract in a positive, or concentric, manner to extend the hip and flex the knee backwards. These motions pull the heel backwards toward the gluteal region. They contract in a negative, or eccentric, manner to control the striding leg as it moves forward. The hamstrings assist in internal and external rotation of the hip. When the knee is bent, the hamstrings assist in lower leg rotation. The hamstrings also participate in providing stability to the knee joint. This stability helps to prevent non-contact injuries to the medial collateral ligament and the anterior cruciate ligament. The main symptom is an intense deep ache in the lower gluteal region and upper aspect of the hamstring muscles. The symptoms have an insidious onset. Pain increases with repetitive activity, sprinting, uphill running, downhill running and during acceleration. Pain may be aggravated by sitting on a hard surface and by intense hamstring stretching. Proximal Hamstring Tendinopathy is an overuse injury, caused by the cumulative effect of repetitive loading. Overtraining is the first and foremost extrinsic factor. When running, the hamstring muscles begin to concentrically contract as the leg is far in front of the body. At this point the hamstrings are in an extremely stretched position which increases the amount of tension placed on the tendon at the origin site. Several factors predispose an athlete to proximal hamstring tendinopathy. These include weak core muscles, pelvic instability, downward shifting of the anterior aspect of the pelvis, tight hip flexors, tight hamstrings, weak hamstrings and weak gluteal muscles, especially the gluteus medius. All of these factors are part of or a precursor to poor posture and poor body movement patterns. Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV Web Site: http://www.championshipchiropractic.com/ Blog: https://www.championshipchiropractic.com/wordpress/ Twitter: https://twitter.com/drdozellodc Facebook: https://www.facebook.com/Championship-Chiropractic-280141628688300/ LinkedIn: https://www.linkedin.com/in/dr-donald-a-ozello-dc-716b3233 YouTube: https://www.youtube.com/user/drdozellodc/videos "Running: Maximize Performance & Minimize Injuries" https://www.amazon.com/Running-Performance-Chiropractors-Minimizing-Potential/dp/1493618741