What is hamstring tendonosis?
The hamstring muscles are comprised of three primary muscles; the biceps femoris (lateral hamstring), and the two inner hamstrings muscles, the semimembranosus and semitendinosus muscles. The hamstring muscles are responsible for the bending of the knee, like stepping into a car, and pushing your body forward as your leg moves back during walking and running.
Hamstring tendinitis is a disorder involving tissue inflammation and damage to one or more of the hamstring tendons. Hamstring tendinosis is a degenerative condition of the tissue involving little if any inflammation. The three hamstring muscles on the back part of the thigh have tendinosis insertions on the ishial tuberosity (sit bones) and the back of the lower knee (tibia and fibula). Generally the tendinosis pain is felt directly behind the knee over the tendons or directly under the sit bones. A hamstring strain is a tear/strain in the muscle belly or tendon. It is characterized by a sudden movement or stretch that damages the tissues contractile capacity. When the hamstrings contract, tension is transmitted through the tendons if the force is excessive or due to too much repetition damage may occur.
Hamstring tendinosis commonly is caused by a repetitive stress on the tendons. This repetitive stress can be exacerbated by movement dysfunctions or improper biomechanics. Common activities that illicit these stresses are running, jumping, and kicking activities.
What symptoms do hamstring tendinosis or strain cause?
Hamstring tendinosis typically manifests into a pain that develops either proximally on the high hamstring tendons by your bottom (sit bones) or behind your knee in the outside or inside sides of your knee. A radiating pain in the back of the thigh, back of the knee, or mid bottom can also be present. In more acute cases the pain might only be a minor ache or only be experienced during or after a provoking activity.
How is hamstring tendonosis or strain diagnosed?
Hamstring tendonosis can generally be diagnosed by a thorough examination by a Physical Therapist. Alternatively, imaging such as an MRI can be used to confirm tissue changes.
Prognosis of hamstring tendonitis
Most patients with hamstring tendonosis who are diligent with a targeted physical therapy program will be able to return to normal function in a matter of six-eight weeks. If the condition has been a long lasting chronic condition the process can take longer. This is another reason to always take care of pain and problems before they manifest into a serious problem.
How is hamstring tendonosis or strain treated?
Hamstring tendonosis, like many other disorders and conditions, can’t be the exact same program for each individual. A skilled therapist needs to create a targeted program set up to target any strength, mobility or biomechanical movement deficits. Treatment of tendinosis can involve eccentric exercises, stretches, biomechanical movement analysis, manual therapy, and modalities such as ultrasound and cold laser.