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Episode 5 (The Down Week): Proximal hamstring tendon injuries

Welcome to the Down Week segment of the Ready to Run Podcast! These episodes will be shorter than our standard interviews with guests and will be packed with clinical information on some of the most common and challenging cases we see as clinicians. We will be providing listeners a lens into how we use the most current evidence based medicine to help athletes navigate injury in our practice. There will be some parts of the conversation that get more technical but we will try to break it down so that you can take home some practical tips whether you are a clinician working with runners or an athlete wanting to know what options are available and what questions to ask. 

We hope that these episodes will serve as a resource of information to help you get ready to run!

What we talked about:

3:35- Initial assessment and exam

7:40- When is imaging helpful? Advantages and limitations of different imaging modalities? What are we looking for? How do we interpret abnormal findings?

17:25- Considerations for the differential diagnosis - including ischiofemoral impingement, nerve entrapment, lumbar radiculopathy, intra-articular hip pathology

21:10- Tips for reducing sitting pain

24:45- Setting expectations for return to running

28:35- Hamstring rehabilitation - when and how to progress

34:35- Determining readiness to return to running - including graded exposure to speed work, uphill training, and long runs

37:00- Pain-threshold monitoring and assessing load tolerance

42:50- Treatment options for recalcitrant tendinopathy

References

Goom TS, Malliaras P, Reiman MP, Purdam CR. Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management. J Orthop Sports Phys Ther. 2016 Jun;46(6):483-93.

Sherry MA, Johnston TS, Heiderscheit BC. Rehabilitation of acute hamstring strain injuries. Clin Sports Med. 2015 Apr;34(2):263-84.

Davenport KL, Campos JS, Nguyen J, Saboeiro G, Adler RS, Moley PJ. Ultrasound-Guided Intratendinous Injections With Platelet-Rich Plasma or Autologous Whole Blood for Treatment of Proximal Hamstring Tendinopathy: A Double-Blind Randomized Controlled Trial. J Ultrasound Med. 2015 Aug;34(8):1455-63.

Rosales J, García N, Rafols C, Pérez M, Verdugo MA. Perisciatic Ultrasound-Guided Infiltration for Treatment of Deep Gluteal Syndrome: Description of Technique and Preliminary Results. J Ultrasound Med. 2015 Nov;34(11):2093-7.

Lempainen L, Johansson K, Banke IJ, et al. Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy. Muscles Ligaments Tendons J. 2015;5(1):23-28. Published 2015 Mar 27.

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