Podcast on clinical management of Proximal Hamstring Tendinopathy

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Our articles are not designed to replace medical advice. If you have an injury we recommend seeing a qualified health professional. To book an appointment with Tom Goom (AKA ā€˜The Running Physioā€™) visit ourĀ clinic page. We offer both in-person assessments and online consultations.


For a long time I’ve been a big fan of Physio Edge and their great podcasts so I was delighted when David Pope invited me to produce one with him about Proximal Hamstring Tendinopathy (PHT) and our recent paper. It’s really fitting as this Physio Edge podcast from Alison Grimaldi was really helpful in my learning when I began researching PHT.

You can listen to the podcast in full here on Clinical Edge.

For a link to the full study please see our recent blog.

I’ve included the exercises from our paper below to help complement the podcast. If you’d like to find out more about managing running injury, the latest evidence and clinic base gait analysis sign up to our Running Repairs Course.Ā  For full details of our courses, including how to book, see our dedicated course page.

Stage 1 – Isometrics (usually in minimal hip flexion)

Isotonics (stages 2 and 3)

Typically heavy, slow resistance training starting with ~15RM and progressing to ~8RM.

Stage 2 – working with minimal hip flexion

Often need to build strength first prior to starting Nordics. A gym ball Nordic can be a good way to introduce a patient to this;

Stage 3 – Progressing into hip flexion, increasing range as comfortable

Stage 4 – Plyometrics – usually for those requiring high load capacity for their sports/ daily activities

Many of the exercises from all 4 stages are based on findings from various EMG studies (alongside resistance training and tendinopathy treatment principles) for example Zebis et al. (2013);

 

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4 COMMENTS

  1. Physiotherapists in Tralee…..I love the ”gym ball nordics”……great idea for eccentric work on hamstrings as this exercise can be too hard for a beginner.

  2. Awesome podcast. Great amount of clinical wisdom in there. The only thing I didn’t really gather from the podcast is whether to push this tendinopathy into pain or not. Some tendon loading protocols indicate a few reps should be progressed into pain but I didn’t notice that being discussed here.

    Thanks!

  3. Hello Tom,
    Thank you so much for this. I’m a 40 year old mountain runner suffering from high hamstring tendinopathy in both legs and have found it very difficult to find a doctor or physical therapist (I’ve been to 2 sports medicine doctors and 3 physical therapists) in my area that are aware of this condition and if they are, how to properly treat it (I was told by the last physical therapist to roll my hamstring insertion point on a frozen water bottle). Your podcast and personal experience on this blog have helped me tremendously with putting together a treatment program and get the pain under control. I have one question, do you have any experience using an EMS device on the hamstring for additional strength building? I own a Compex EMS and found it very useful when healthy to build endurance and even out muscle imbalances and would love to use it on the hamstrings in addition to my current stage 2 exercises to get maximum muscle recruitment however I’m not sure if the load generated by the EMS contractions is healthy for the injured tendons.
    Regards,
    Jamie

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