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Proximal Hamstring Tendinopathy

The Hamstrings are the group of muscles at the back of the thigh. At each end of the muscles, they attach to the bone via a tendon and the end closest to your bottom is the end most people have problems. Hamstring tendinopathy can cause problems for athletes and the general population with regards to athletic performance as well as daily activities.

Symptoms of hamstring tendinopathy include:

Pain at the sit-bone with:

  • Sitting
  • Getting out of the car
  • Walking up hills and stairs

What is a tendinopathy?

A tendinopathy is essentially a problem with a tendon which is usually caused by an unaccustomed amount or type of activity. Things that can make you more likely to get a tendinopathy include: increases in loading especially compressive loading, age, genetics, hormones, and some medications.


Stages of Tendinopathy:

There are different stages of tendinopathy which will determine how long it takes to improve.

  • The reactive stage is the first stage and can be managed well with anti-inflammatories, rest, and gradual increase in loading above and beyond your requirements
  • The disrepair stage is when the tendon tries to heal itself but does a poor job, resulting in changes within the tendon which reduce the strength and potentially make it more painful
  • The degenerative stage is where some cells within the tendon begin to die, the structure of the tendon becomes less orderly and less tolerant to load.

What do I do if I have a hamstring tendinopathy?

You can get your body to adapt and improve your performance despite having a tendinopathy. This is where physiotherapy can help. The main aim of treatment is to modify the amount and type of activity you do with the tendon. This is done by customising a program based on your current ability, lifestyle and goals. There are 4 stages to a successful rehabilitation program:

  • Rehab initially focuses on reducing pain and improving strength of the tendon. Often, we start with holding exercises to reduce the pain and begin the strengthening process.
  • The next stage is to progress into slow repetitions through range with increasing loads.
  • Your program then progresses into activities that you would like to do, developing strength and speed as required for what you need to do.
  • Finally, adding speed to increase stiffness and elastic properties if it's required

Passive treatments such as injections, medications and dry needling may offer some relief but do not help the tendon adapt in the long term. In contrast, active approaches that involve progressive loading such as the program mentioned above have good long term outcomes, especially if rehab is continued after your pain subsides and you can perform the tasks required.

Check out the pictures of Courtney, our Massage Therapist and Strength and Conditioning guru, performing some typical exercises for hamstring tendinopathy rehabilitation.

If you have any of the symptoms mentioned above, come in to get a customised program to get your hamstring feeling great again.

Authors: Tylana Woodward, Mark Davis and Mitchell Shorten.

Gluteus Medius Tendinopathy

The gluteus medius is a muscle in the upper portion of your bottom muscles. The Gluteus medius attaches to the bony part on the side of your hip. Gluteus medius tendinopathy can cause problems for athletes and the general population. Athletic performance can be affected due to decreased speed changing directions or suffering pain when running. General populations are most effected when using the hip or when it is positioned awkwardly.

Symptoms of gluteus medius tendinopathy include:

Pain at the side of your hip with:

  • Walking and sitting
  • Laying on your side or pressing on your hip bone
  • Pain standing for long periods

What is a tendinopathy?

A tendinopathy is essentially a problem with a tendon which is usually caused by an unaccustomed amount or type of activity. Things that can make you more likely to get a tendinopathy include: increases in compressive loading, age, genetics, hormones, and some medications.

Another problem related with gluteus medius tendinopathy is trochanteric bursitis. The bursa is a fluid filled sack which helps to reduce friction around the bone. Bursas often become inflamed when there is a tendon issue or loading problem or if there is a direct impact.


Stages of Tendinopathy:

There are different stages of tendinopathy which will determine how long it takes to improve.

  • The reactive stage is the first stage and can be managed well with anti-inflammatories, rest, and gradual increase in loading above and beyond your requirements.
  • The disrepair stage is when the tendon tries to heal itself but does a poor job, resulting in changes within the tendon which reduce the strength and potentially make it more painful
  • The degenerative stage is where some cells within the tendon begin to die, the structure of the tendon becomes less orderly and less tolerant to load.

What do I do if I have a gluteus medius tendinopathy?

With treatment, gluteus medius tendinopathy can be managed in a way where you can get stronger, move better and be more comfortable. This is where physiotherapy can help. The main aim of treatment is to modify the amount and type of activity you do with the tendon. This is done by customising a program based on your current ability, lifestyle and goals. There are 3 stages to a successful rehabilitation program for gluteus medius tendinopathy:

  • Rehab initially focuses on reducing pain through education regarding provocative activities and improving strength of the tendon. Often, we start with holding exercises to reduce the pain and begin the strengthening process.
  • The next stage is to progress into slow repetitions through range with increasing loads.
  • Your program then progresses into activities that you would like to do, developing strength and speed as required for what you need to do.

Passive treatments such as injections, medications and dry needling may offer some relief but do not help the tendon adapt in the long term. In contrast, active approaches that involve progressive loading such as the program mentioned above have good long term outcomes, especially if rehab is continued after your pain subsides and you can perform the tasks required.

Check out the pictures of Courtney, our Massage Therapist and Strength and Conditioning guru, performing some typical exercises for gluteus medius tendinopathy rehabilitation

If you have any of the symptoms mentioned above, come in to get a customised program to get your hip and glutes feeling great again.

Authors: Tylana Woodward, Mark Davis and Mitchell Shorten.

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