Upper Hamstring Tendinopathy | Uphill Athlete

Upper Hamstring Tendinopathy

  • Creator
  • #35016

    I started the 5-week Alpine training plan this week as a transition back after injury. I did an intro mountaineering class in September and had trained for a couple months on my own by doing steep hiking, squats and 1-leg dead lifts (30 lb), along with my usual exercise routine (vigorous vinyassa yoga 4x/week, gym or short outdoor climbs 1-2x/week). I didn’t realize that the soreness I felt doing the 1-leg DL wasn’t “just” a muscle ache, but a tendon getting very angry. I wasn’t taking many rest days. After experiencing intense pain from 8 hrs sitting in a car each way to the Sierras I looked up “pain in the a–” and went right to my PT. Pain is gone now after a few weeks of PT and about 10 weeks of totally resting hamstrings (no running, no climbing, no squats or 1LDL).

    My question: Is there anything I should be particularly cautious about with the training plan? I am easing back in to running/hill climbs, going slowly and with a short gait to minimize torque on the tendon.

    I also have a couple questions about the training plan itself but I’ll post that to the General forum.

Posted In: Injury & Rehab

  • Participant
    Pete Dickinson MS,PT on #35070

    Glad to hear you are getting better with the PT and modifications! I recommend normalizing your gait during running, and finessing the return to running activities with a gradual ramp of run time as you allow your structure to adapt to the loads of dynamic activity. An initial walk/jog program can gradually give way to longer run blocks. Terrain can be progressed from flat/rolling/uphill etc. We just had one of our world cup skiers perform this progression with a nice return to the final sprint heat after being unable to complete a race. Strength should still be pursued, but with care with aggravating movements. The single leg deadlift is the end point of loading activities, you would probable tolerate double leg loaded strength first with bridges, squats, DL’s, with progression into single leg loaded bridges, and eccentric lowering from tall kneeling.
    Hope this gives you some ideas.

    Raz on #35113

    Thanks, Pete. I’m glad to hear this plan has had some good results. The strength progression is similar to what PT recommended. It’s certainly hard to stay patient, but any time I even hear that tendon murmur I back off a bit. I’ll ease back into normal gait — I have to be careful because I tend to like stretching it out a lot.

    What is “eccentric lowering from tall kneeling”?

    Pete Dickinson MS,PT on #35222

    Eccentric lowering from tall kneeling is a hamstring loading exercise. It’s quite robust and I would do it when you are out of an acute stage as you are able to be more active with the injury. Perform the movement by going to your knees and assuming a vertical upright position with the rest of your body, have someone behind you anchor your calves to the floor by grasping above the ankles and not allowing your feet to lift off the floor. Cross your hands on your chest, and lower your body to the floor without breaking at the waist. Repeat x5 and perform 3-5 sets. As with all exercise addressing an injury, start off slow and observe response.

    Raz on #35250

    Ah, OK. I’ve never seen that one. Thanks.

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