Hamstring Injuries: Rehabbing Tendinopathy
Slow and steady wins the race
You know what sucks? Getting injured.
Injuries can happen for many reasons - accidents, not concentrating, not preparing your body properly or over-working yourself.
My current hamstring tendinopathy stems from a couple of those reasons. I have nerve damage and tendinopathy of the left proximal hamstring tendon. It's a real pain.
How did it happen?
Tendinopathy is generally due to overuse. In my case, I've had pain in the area for several months but have been training hard and practising hard for the upcoming TAG Rugby World Cup and so I did what I always tell my clients NOT to do and that was to ignore what my body was telling me. And it was saying STOP.
The problem with this particular ailment is that it comes and goes but if you keep overloading it (which I did), it gets worse. I got to the point where I couldn't run or even warm up.
Ironically, it would be fine if I didn’t play sport but hey ho, that’s not an option for me.
Who gets it tendinopathy?
It could happen to anyone but it's most common in athletes and people who do a lot of gym work.
As I have a general left side imbalance, I am susceptible to issues like this.
How do you fix it?
Total rest isn’t good enough for this one. You have to do specific types of exercise within a certain range. You can't do too much eccentric loading (for example, when you do a controlled squat on the downward movement).
It’s a slow healing process. Everyone and every injury is different. Your physio and coaches will help you find the right combination for you. Patience is key and that is a thing that doesn't come naturally to me.
I've been working hard on getting better for the last four weeks.
What I’m doing
I've been working closely with my physio, getting weekly sports massage with Laura where she works on releasing the muscles around the hamstrings since you can’t actually work the tendon itself; and working closely with my coach, Andy, to create a program that keeps me going within the parametres of what I am allowed to do.
My physio has given me 3 different rehab sessions to do - high, medium and low load days with strict 24 hours and weekend off all load exercises. It's been quite tough for me!
The types of exercises I have been prescribed which are specific to my particular injury and the stage that I’m at, include:
- A very concentrated warm up!!!! Can’t do anything without this
- Lots of Isometrics - strength training in which the joint angle and muscle length do not change during the exercise which means you are holding the position for the duration rather than repeating a movement. This can help with the pain even though it can be painful to do it
- Examples of this type of movement, in my case, are Heal Digs - dig your heel into the wall standing up, holding a bridge and so on
- I'm also concentrating on activating the little muscles, especially around your core, because the big muscles are already strong, they are used all the time and tend to take over from the small muscles. Working the little muscles sometimes looks like you’re not doing anything but you’re working those little ones super hard. And it burns! Modified Dead Bug is an example of this
- Single leg movements feature strongly in my program. I'm doing step ups and split squat variations, among others
- There's also plenty of band work - band walks - lateral, forward and back; Clams with the band, sliders and hamstring curls with very restricted movement
If you suspect you may have this condition, please DO NOT try the exercises written above. Go and see your physio to get a prescription that is specific for you.
I’m working through the injury with a view to being 100% for the world cup. It’s a hard slog so wish me luck!