Hamstring Tendinopathy- Physio's own story!
Rachel Kelly one of our Physiotherapist here at PROmotion shows that us Physio's are only human and still get injured!
Getting injured is never fun, but even worse when you are a Physio that should know better. For the past 8 weeks I have been suffering from a proximal hamstring tendinopathy (a deep buttock pain that is localised to the hamstring insertion). As COVID hit I thought great at least I can continue to run, I don't need a gym or any equipment, I can simply get up and go. This was my first mistake as I reduced my usual strength sessions and added more running sessions, including hill sprints.
It started as a mild ache in my right buttock / hamstring insertion after a long running session. I ignored it thinking its just a niggle and that it will pass. Sounding familiar to most people? The problem was that it wasn't just a random niggle that came and went, it was getting progressively worse and I was ignoring these early warning signs. I continued to run hills and loops of around 12km but it wasn't until I add a Fartlek session into my training when I really thought I had done some damage. Fartlek sessions are intervals that change in speed, for example sprinting for 30 sec and then jogging 30 sec. These sessions are really challenging as they have prolonged speed intervals with little to no recovery time leaving you exhausted, in a good way. Feeling great after my first session I thought I would love to push myself again and do another interval sprint session just 2 days later. Well did I regret that! The following few days I couldn't even sit down without having pain. It was throbbing at night in bed and I was walking up with morning pain. I couldn’t bend over without feeling it pull or stretch. Looking back I can see it so clearly but the main activities that are likely to increase load on the hamstring tendon are hills and prolonged speed work, both which I was doing regularly. The hamstring tendon is most vulnerable when the hip is flexed and has to cope with high speed loading on stretch. The tendon is compressed against the ischial tuberosity causing compression and irritation. I knew straight away I had really flared it up. The number 1 rule for tendons is that they don't love major changes in loading and I completely disregarded this the minute I decided to do 2 sessions of high intensity within 3 days.
So what did my rehab look like? I had to start with reducing load on the tendon which meant avoiding anything that caused pain. Tendons hate being compressed and stretched so this meant that I had to reduce my time sitting and even sit on a cushion if the chair was too hard, I also had to give up my beloved yoga and of course running . I avoided any stretching of my hamstring and started with some isometric strength exercises. These were performed around 3 times a day holding for periods of up to 45 secs of 5 repetitions. It took me around 2 weeks to completely settle the pain down to a level where I had no morning pain. The next stage of my rehab was to improved the strength and load capacity of my hamstring. I started with a slow and heavy strength session aimed at the lower legs (hamstrings, glutes, calves and quads). One of my main exercises were nordics an exercise I still find very challenging. I found that I could start running slowly for around 3km with no symptoms at all and did this initially 2 times a week. I then started to add in more power work in the gym including sled pushes and hamstring plyometric work with the gym ball. I worked on my running technique with running drills and cues to focus on. I then started to progress my distance each week making sure I always had a rest day after running and didn’t wake up with pain the next day. The hamstring tendon as mentioned is renowned for flaring up with high speed running and hills so this was the last thing that I added into my program. It's taken me weeks to finally get back to running 10km without pain and just starting to re introduce speed/ interval work. I continue to strengthen my hamstrings with deadlifts, I am always grateful to experience the rehab journey but the moral of the story is that listening to your body is so important, and you are wanting to introduce something new to your exercise regime to introduce it slowly to avoid boom busting like me!
If this story sounds familiar- Rachel is available for Physiotherapy appointments through out the week at PROmotion- to book click here or call 9284 4405.