FEBRUARY 2008
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Running Injuries: High Hamstring Tendinopathy
By Dorothy Hamburg, MS, exercise physiologist

It’s the end of the season for most of us and I’m sure many of us are looking ahead to the next season hoping to improve our training; be faster; and go longer. Typically the winter months are used for active recovery and cross-training allowing the body and the mind to heal from the ardors of the past year. Some of us have incurred running injuries that were ignored during the season but are now needing to be addressed so that they don’t occur next year or prevent us from reaching our potential. 

 

Common musculoskeletal injuries such as piriformis syndrome, plantar fascitis, and high hamstring tendinopathy affect a growing number of runners and triathletes. It’s been my experience that female runners tend to experience high hamstring tendinopathy more than men. Perhaps it’s hormonal. Perhaps it’s structural. Unfortunately research is limited.

 

High hamstring tendinopathy is an overuse injury most often seen in middle- and long-distance runners. High hamstring tendinopathy  is quite literally “a pain in the ass”. As an exercise physiologist and coach,  I’ve worked with many runners will typically complain of a deep buttock or upper hamstring pain brought on during acceleration and at faster speeds. Some will complain of sciatic and buttock pain while seated.

 

The Physician and Sportsmedicine, a peer reviewed  journal, published an excellent article in their May 2005 issue. I’d like to share a few exercises that might be of benefit. The following information is from this article and is available on-line.

Hamstring Biomechanics During Running

During running, the hamstrings have three main functions. First, they decelerate the knee extension at the end of the forward swing of the gait cycle. This action helps provide dynamic stabilization to the weight-bearing knee. Second, at foot strike, the hamstrings elongate to facilitate hip extension, again stabilizing the leg for weight bearing. Third, the hamstrings assist the calf muscles in extending the knee during the takeoff phase of the running cycle.

 

Treatment Options and Rehabilitation


After an initial evaluation and diagnosis by a health care professional, several treatment  options are available for relieving high hamstring pain, preventing its recurrence, and getting the athlete back into running.

Treatment typically includes

•  Pain control. Ice works wonders.
•  Pelvic alignment if necessary. I would recommend a sports chiropractor who has experience working with athletes.
• Soft-tissue mobilization. Breaking up adhesions or scar tissue will help realign muscle fibers. I would recommend a health care professional who specializes in deep tissue massage, myofascial release or muscle energy techniques.
• Progressive hamstring flexibility. An appropriate stretching regime for both legs to ensure a balanced structure.
• Core-strengthening program. I’ve included snapshots of two very effective exercises. These are not as easy as they look and should be performed with someone supervising them. It’s quite easy to think that you’re aligned when doing them, but that’s not usually the case. One side will typically be weaker than the other and there will be a tendency to compensate and use other muscles which might lead to injury.


Prone plank with hip extension

Keeping your head level with the floor, support your body weight on your forearms (elbows bent at 90°) and toes. Maintain a neutral spine while maintaining position. Each leg is lifted and held for 5 secs. Repeat 5-10 times per side alternating legs.

 

Bridge on ball with ball curl
These two pictures are part of a series of stability movements. Hips are raised until the knees, hips and shoulders are in a straight line. It’s important to keep your back in a neutral mid-range position. The bridge position is maintained as you push the ball forward and back. The goal is to be able to do this with both legs and then progress to single leg as shown.

Dorothy Hamburg, M.S., Exercise Physiologist is a USA Triathlon Level II Expert Coach, an ACSM Clinical Exercise Specialist and Health Fitness Instructor, ACE Personal Trainer and TrainingBible Coach & Manager. Dorothy has recently launched TriSportsTraining.com, a site dedicated to women specific triathlon training & coaching. Dorothy is a 2-time IronMan finisher, a SOS survivor as well as an ultra-distance trail runner and Xterra Regional Champion. Dorothy can be reached at dhamburg@TrainingBible.com.

Why TrainingBible Coaching

TrainingBible Coaching provides services to athletes based on the concepts formed by Joe Friel through his extensive coaching experience and his vast knowledge of the scientific literature. This philosophy and methodology is described in his TrainingBible books and extensive writing for various publications over the past 28 years. Joe assists with the selection and training of all of the coaches in the organization. TrainingBible Coaching selects coaches based on their knowledge, experience and certifications. You can be guaranteed that a TrainingBible coach is of the highest caliber. We also have strategically selected coaches from all over the United States. This ensures access to quality coaching on a local level if desired. TrainingBible Coaching and Joe Friel have coached athletes of all abilities for over 25 years. World Champions, Ironman winners, Olympic athletes, age groupers, and first timers have all been involved with TrainingBible Coaching. No matter what your current level or goals, TrainingBible Coaching is equally dedicated to each athlete we work with.

 

Your goal is our mission.

 

 

Everyone can utilize endurance coaching. TrainingBible Coaching focuses on event- and goal-oriented individuals. No matter what your goal – whether it is to cross the finish line faster and fitter; or if it is to increase your aerobic endurance so the Saturday group ride doesn’t kill you; our science-based training will help you reach that goal. TrainingBible Coaching’s heritage lies with training triathletes, cyclists, and runners. But as the demands of other sports and daily life become increasingly difficult, the need for better endurance and aerobic conditioning expands to all sports. The science and training is quite similar whether you are paddling a kayak or spinning the pedals of a bike. No one knows endurance conditioning better than the coaches at TrainingBible Coaching. Whatever your sport, we have the science-based training to condition you for it!