High hamstring tendinopathy is a common overuse injury seen in running athletes. Especially those runners that do speedwork and hill repeats. Patients typically report deep buttock and/or hamstring pain. A physical examination and, occasionally, MRI studies are necessary to confirm the diagnosis. Rehabilitation involves soft-tissue mobilization, frequent stretching, and progressive eccentric hamstring strengthening exercises. In difficult cases, surgery may be necessary to release the scar tissue around the hamstring muscles and the sciatic nerve. Acute midhamstring muscle-tendon junction injuries are more common in sprinters. Patients who have high hamstring tendinopathy typically report deep buttock or posterior thigh pain brought on during acceleration and at faster speeds. Tissue biopsies have shown a chronic tendinopathy with dense fibrosis and, in some cases, hyaline degeneration at the attachment of the hamstring to the ischial tuberosity.1 This fibrosis can entrap components of the sciatic nerve, causing radiating pain in the involved leg and thigh. Limited information exists in the literature on diagnosis and treatment of high hamstring tendinopathy. My clinical experience during the past 12 years and the paucity of available research has led me to investigate the biomechanics, causes, diagnosis, and treatment of this condition. My treatment protocol is about 80% effective with most runners pain-free within 3 months. I use theraputic ultrasonic waves to reduce scar tissue, specialized fascial release techniques to do the same and teach patients a home based massage, stretching and strengthening program that they must adhere to for the condition to improve.
If you have gluteal and/or hamstring pain Dr. Runco will perorm a thourough examination to differentiate between sciatica, piriformis syndrome and high hamstring tendonopathy. Afterwards he will teach you about your condition and provide you with any possible treamtent options. Call 619-265-2222. All major insurnaces accepted.
"Before coming to you I thought I just had a tight hamstring. I kept going to massage but it kept getting worse. My PT told me I had weak glutes. You sent me for an MRI that showed a torn hamstring. You started treating it but made me get a surgical consultation with a well known NFL surgeon. He sent me back to you. It is so much better now and I can still participate in 1/2 Ironman competitions. I owe you doc.'
