I found this video extremely helpful for my high hamstring tendinopathy. Once I started to load with weight the improvement was dramatic. Not quite healed fully yet but getting much better.
Also check out thekneesovertoesguy program. He’s known for knees, but his goal is overall bulletproofing your body from the bottom up. Definitely a novel approach to strengthening tendons and muscles we ignore like feet, ankle mobility, tibialis, vmo, hip flexors, glutes. Who knew you have a muscle on the front of your shin?
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Hi. What kinds of exercises were you doing through each phase to help your hamstring tendinopathy? Struggling with this myself at the moment, and whilst rest clears it up, as soon as I start deadlifting again it comes back within a week or two. Thanks.
Ok (long post alert, with the caveat I’m not a physio)…
First, some general principles, which I am parroting directly from my physio, who is excellent:
- Rest alone won’t heal an established tendinopathy - it will just stop it hurting. You need to restore capacity to the tendon: this is absolutely key. Or as soon as you load it again the symptoms will return.
- You need to judge how much to load tendons carefully; too much will aggravate the problem, not enough won’t solve it.
- Tendinopathic tendons hate being stretched or compressed (or worse, both at the same time).
- Some pain during rehab is to be expected; the general rule is that up to 3-4/10 pain that lasts for less than 24 hours after rehab is ok.
- There is some evidence that NSAIDs inhibit tendon healing. After 2-3 days, lay off the ibuprofen. If you really need something, try aspirin. The same with ice; after 2-3 days, switch to a heat pad.
- Massage may have a placebo effect but won’t do much long term. The progressive re-loading is the key.
So, with that in mind…
- Start with isometrics - see Isometric Exercises for High Hamstring Injury - Access Health Chiropractic Center
- Progress to eccentrics - see 1 Leg Eccentric Glute Bridge - YouTube. This was key for me, and I did 10 second negatives, eventually with a 15kg db in my lap.
- Progress to heavy, slow lifts. As 2, but lift slowly with 1 leg as well.
Deadlifts are a real last test for a p1ssed off hamstring: they simultaneously stretch the tendon and compress it against the ischial tuberosity, so they should be almost literally the last thing that you reintroduce. It could easily be 3-4 months before you can do them.
I’d really recommend seeing a good physio with experience in dealing with tendinopathy. If anyone tells you to rest for more than 2-3 days, run away!
It is a pain in the ass, literally, any mine still flares up from time to time, but you can recover and it is manageable with the protocol above. Good luck!
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@RecoveryRide Thanks so much for that! That is all really helpful man. The pain of the tendon being compressed/stretched over the ischial tuberosity is exactly what I feel after deadlifting. Glute bridges and hip raises don’t bother it, so I will start doing them instead, once I’ve progressed with the isometric exercises as per your post. Cheers man!
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I have the same basic problem. Any update on your PT routine and has it helped. I’m just a week past my cortisone injection for the bursitis and starting a PT routine for the tendinitis. Doctor let me ride 30 min easy flat road today. Wooo Hooo.
So a long overdue update. Lots going on. The hips unfortunately years now later is still hurting. Back to a different physio.
I started with some gluten med strength work including lunges, clamshells, squats, banded side stepping, etc. Things flared up twice as bad. Now I am dialing back to a lighter session and took out the lunges and squats based on the physio.
I am really committed to consistency at the point and plan to give it 3-6 months of slow, steady progressive overload.
Crossing my fingers. Unfortunately it’s not my only health issue. If I wanted to I could spend full time in medical offices!
There might also be a nerve issue at play and apparently somehow I also broke multiple transverse process and have pars defects in lower spine and a T9 fracture in upper spine…and never knew it. Likely old martial arts injuries!
Now a days I have had to dial back cycling and do it more as leisure. Miss it though!
Sorry to hear you are still having these issues, plus new issues.
You mention that you are committed to consistency at this point. Is this implying that you have the same issue I have, which is “falling off the wagon” (stopping the exercises) when you start feeling better, and only starting them again when it starts bothering you? I tend to do just enough to keep me on the bike, but that’ll bite me one day and I’ll find myself in front of a physio telling me to stay off the bike again.
I’ve been dealing with muscle imbalance, hip flexor issues and weak glutes on and off for a few years, and the issues showed up again last week. So I was sitting here thinking I need to start doing my exercises again, and keep doing them, and saw this thread at the top.
Update;
Back in the saddle again. Don’t know what was worse. The pain or only riding 30 miles a week for months. I guess the pain was. Glute bridges, any time any where, when I’m lying down . 10 here and there adds up. Was able to put in a 130 mile week with hills last week. Even was able to get out of the saddle on some climbs.
Yep, the pain is unbearable. So I limited to 30 km / 20 mile flat rides. Reality for me is “get off the bike” doesn’t help either. What I am told is rest, etc. doesn’t help after the acute phase and you need to strength train it.
I’m also finding there is a link between the hip and lower back pain.
So right now its consisent strength training.
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Since nerves do go thru the back to the hips and lower legs it is very possible. When I had nerve issues in my L5 it caused phantom pain in my thigh and lower legs. I got the same phantom pain in my lower leg when I got glute tendinitis