Treatment For High Hamstring Tendinopathy
Treatment for high hamstring tendinopathy is typically managed by a physiotherapist and the approach is to minimize stress to the area to allow healing and address any muscle imbalances, lack of flexibility as well as address form and biomecahnics associated with the chosen sport/s. Other modalities employed by physiotherapists include soft tissue techniques, dry needling, shocwkave therapy… If physiotherapy and all it encompasses fails to resolve the issue after approximately 3-6 months then more minimally invasive and invasive options may be considered as discussed below.
High Hamstring Tendinopathy And Shockwave Therapy
Shockwave therapy is a non invasive treatment approach used to good effect in other areas of the body such as treating the plantar fascia and the Achilles tendon. Generally it is accepted theory that shockwave therapy is effective in promoting healing by improving blood flow and breaking up fibrotic scar tissue. I have experienced good results with use shockwave therapy in the treatment of high hamstring tendinopathy when combined with appropriate rehabilitation guidance and exercises. In my clinic I typically use shockwave therapy when treating high hamstring tendinopathy when the condition has been present for three months or greater and am less inclined to use it as a treatment modality in the more acute stages of the injury.
Cortisone And PRP Injection Use In High Hamstring Tendinopathy
A non-invasive treatment program such as physiotherapy rehabilitation for proximal hamstring tendinopathy can last 3-6 months. Patients that fail to improve and return to play within this time period may consider alternative treatment options.
Corticosteroid injections more commonly referred to as cortisone injections are once such alternative and are relatively frequently used in the management of high hamstring tendinopathy pain. A cortisone injection is generally not delivered directly into the tendon itself as this may impact the healing of the tendon and increase risk of rupture. However the use of ultrasound imaging to help guide the injection to surrounding irritated tissue such as the ischial bursa can provide good symptomatic relief in some chronic high hamstring pain patients. The ischial bursa is a small, fluid-filled structure that acts as a buffer between the overlying gluteal muscles and hamstring tendons at the sit bone (ischial tuberosity).
An injection of platelet-rich plasma (PRP) where a concentrated platelet separation of the individuals blood is injected into the damaged area. Platelets are the body’s “healing cells” and when injected release a multitude of “growth factors” that have regenerative and healing properties and as a result it is believed that PRP, by releasing of growth factors locally into a damaged tendon, will induce tissue healing and regeneration.
Surgery For High Hamstring Tendinopathy
In rare situations surgery is sometimes employed as a management approach for high hamstring tendinopathy but typically this is not the norm, most are managed conservatively with physiotherapy or minimally invasive approaches such as PRP injections or cortisone injections. Surgical treatment can involve anything from debridement (removal of diseased or damaged tissue / tendon) to complete tenotomy (a release of the tendon through cutting of the tendon and reattachment to the bone).
Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on High Hamstring Tendinopathy Conservative Treatment should consult his or her physiotherapist or otherwise appropriately skilled practitioner.