Hamstring Tendinosis - Member Case Study

author : AMSSM

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For a true hamstring tendinosis, stretching exercises should be extremely helpful. The important issue is when and how you stretch.

Question from slucas67

I started running about a year ago. In Oct. of last year I started experiencing pain behind my right knee. It progressively got worse over the course of about 3 weeks. I am not sure if I can pinpoint one event that caused the injury except that I first noticed it the week after a nine mile run. (A very long run for me) The knee would feel fine for the first mile but then quickly get to the point where I could barely lift my right leg forward.

I went to the doctor and was diagnosed with hamstring tendinosis. He recommended stretching exercises. I tried them for a couple of weeks and things still didn't improve. I went back and he recommended physical therapy. I checked into the cost and it really wasn't an option at the time. So I chose to not run for about a month and a half. I slowly got back into running and things are better now. My question is: Is this and injury that heals and does not re-occur? Should I be careful with long runs or avoid them all together. I can comfortable run 4 miles now. What are some good preventative measures?

Answer:

There could be a number of reasons for the pain behind your right knee. Depending on your age, it may be due to a) tight hamstrings alone, or b) some other abnormality in the knee which is causing swelling and consequent pain behind the knee.

For a true hamstring tendinosis, stretching exercises should be extremely helpful. The important issue is when and how you stretch. A few considerations: First, muscles are most flexible when they are warm, so you're best off stretching after your run. Second, the stretch should be held for at least 30 seconds; 45-60 seconds is even better. If you can do just 3-5 good stretches on each side after each run for that long, you should do quite well. Third, make sure the entire hamstring is being stretched. A lot of people show me their "hamstring stretch," and they're actually stretching other muscles closer to their butt.

Sports medicine physicians or a physical therapist that works with runners, are good options for you to get advice on type of stretches. Either can also evaluate for hip or knee joint problems in your running gait that may contribute to your symptoms. You may want to visit the physical therapist, just once or twice; a couple visits may not be as cost prohibitive as a month-long program. Both can also evaluate your shoes and wear pattern that may suggest a mechanism contributing to the knee pain.

If the above measures are not helpful, feel free to contact the AMSSM. We have a number of sports medicine physicians in the Dallas-Fort Worth area who are used to assisting runners. Many are endurance athletes themselves. Good luck!

Balu Natarajan, MD
Member AMSSM

www.amssm.org
 

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date: April 9, 2005