Hamstring pain can really be divided into two types: In the first, the pain is experienced in the main bulk of the hamstring-mainly in the middle part. This usually comes on more acutely/suddenly during a run in which you may be doing some speed work. Management of this type of hamstring injury is a bit easier than the next type and I described general guidelines is a blog I previously wrote here: www.promotiongb.com/blog/early-vs-delayed-rehab-for-acute-muscle-injury
The first thing that needs to be done if you have been struggling with pain in the Hamstring is to get a thorough assessment of your problem to make sure that it is truly a hamstring problem. Pain that is felt in the hamstring can be also be caused by multiple source outside the hamstring and you would hate to waste your time resting and treating an area that is not the source of your pain. Secondly, although it seems intuitive that if a muscle is sore and tight, you should stretch it out. However, this is not something you want to be dong with PHT. The pain in the tendon can be aggravated by compression where it wraps around your sit bone (see picture above). Stretching usually adds more compression. The same can be said for foam rolling. If you have been doing this-stop! You are likely just adding more compression to a sensitive tissue. If you have pain high up in the hamstring that has just come on recently, backing off on some of your training and resting the area may be useful. However, if you have had these symptoms for a longer time, further rest may not be what the tendon needs. Resting may make it feel better, but when running or other exercise is re-initiated, the pain just comes back, leading you to become more frustrated. What is more important in these situations is that you progressively start loading the hamstring and tendon. The remainder of this article will outline some basic principles. However, everyone is different and it is imperative that the exercises are matched to the stage of your condition and you are educated in how to know what symptoms are ok and how to progress or regress your program based on what you are feeling.
The 3rd Phase of the rehab progresses to mare challenging loading and involves the addition of more hip movement during the exercises. These are exercises that many people try to do right away, only to find that it make their symptoms a lot worse because they are implemented too early. However, with a gradual progression and the right education on how to progress, these exercises can eventually be done in order to prepare the hamstring for the demands of your sport. I hope that this information is useful to you. This is not meant to be a prescriptive solution for your specific problem, but instead it is meant to educate you in evidence-based options for getting past hamstring or tendon pain and back to running the way you want. As I have said throughout this article, appropriate education and guidance is needed as each individual's problem is different.
If you or someone you know has been struggling with pain in the hamstring region, feel free to reach out to me and I would be happy to talk with you about your problem and possible solutions. Thanks for reading, Bob
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