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Thread: Hamstring Tendinopathy - experience here?

  1. #81
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    Default Re: Hamstring Tendinopathy - experience here?

    What helped my low back pain more than anything is using the movement of the prone instability test as an exercise

    Repeated leg lifts as there (30+).
    Hamstrings , gluts, and spine extensors. Be carefull though...
    Ps delete the space before youtube in the link.
    Last edited by rabo; 05-04-2021 at 05:34 PM.

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    Default Re: Hamstring Tendinopathy - experience here?

    So yesterday my back got progressively worse to the point where I had to lay on the lounge room floor for w while. Turns out this...

    Quote Originally Posted by j44ke View Post
    Favoring your leg and canting your hips?
    ...was absolutely bang on.

    I was better today after a decent rest, but I still went to the chiro this afternoon - a couple of painful adjustments, but Iíve already improved loads. Thankfully itís muscular rather than a disc compression or anything else more severe.

    Bizarrely, I think it was my glute exercises that might have contributed too, though.

    Also bizarrely, I canít feel any pain or tension in the location of my tendinopathy anymore. Iím now wondering if the pain I was feeling there was actually referral from my back being on the verge of giving out. Who knows...

    MRI on my tendinopathy on Monday - thatíll tell us whatís really going on.

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    Default Re: Hamstring Tendinopathy - experience here?

    Sometimes a nerve irritation in the lower back can actually cause you to lift or loose pressure on the corresponding heel. Same with sitting in hard surface chair with your feet flat on the floor and knees at 90 degrees, you'll actually be lifting your corresponding hip slightly. My pilates instructor would have me do a few excercises, like stand on a block with my heels off the edge and raise and lower my heels together and independently with arms out forward and/or sitting on the floor arms & legs out straight in front legs flat on the floor and "walking" forward on my butt by shifting my hips. Seemed to reacquaint my body with exerting down pressure in both areas and thereby realign the lower spine. Before felt a bit like a weak leg and after all was much better.
    Jorn Ake
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    Default Re: Hamstring Tendinopathy - experience here?

    This reminds me of something said on here once about someone having a well fitting bicycle but not knowing how to sit on it properly. There are so many things that should be automatic, like sitting, standing, walking etc. that we all do slightly differently and some of us do them differently enough to cause issues.

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by RichTheRoadie View Post
    MRI on my tendinopathy on Monday - that’ll tell us what’s really going on.
    Well, I was going to have my MRI today...

    My back gave out again on Saturday - ironically, almost immediately after the chiro called me to check how I was doing (which, at the time, was a very positive conversation!). I'm booked to go back to the chiro today instead of my MRI now because I can't get in the car to drive to my MRI, and I know they can try to contort you into odd positions in the tube to get the images they need; and that's *definitely* not happening right now!

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    Default Re: Hamstring Tendinopathy - experience here?

    I meant to add: When my back is good enough to begin contemplating such things again, I think I need to dedicate some time to putting a few things right - namely, my flexibility, my core strength and my posture.

    I keep saying I'm going to do something about these things but never actually do. When I did dedicate some time to flexibility and core strength a year or so ago the benefits were palpable, and even with not a lot of effort. I've already had 2-months off the bike and I'm expecting that to extend for at least a third month, so my mileage goals for this year are shot to shit anyway - might as well spend the rest of the year focusing on making some improvements that will hopefully put both of these injuries to bed as well as helping eliminate my migraines (which are usually tension headaches from poor posture that turn bad) and make me sit better on the bike when I do eventually get back to it.

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    Default Re: Hamstring Tendinopathy - experience here?

    So sorry mate, we all need reminding to take care of our overall bodies. Especially as we age.

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    Default Re: Hamstring Tendinopathy - experience here?

    Thanks.

    It turns out that this...

    Quote Originally Posted by RichTheRoadie View Post
    I wonder how much my leg length discrepancy (circa 15mm at the hips) and associated scoliosis will (or has) come into play with this...
    ...could even be the root of the problem in the first place.

    The chiro thinks that my back may have been weakening - mainly on my long leg side - and that the tendinopathy (which is on my long leg) could have come about because of the hamstring taking up some of the slack. Add in super-tight hip flexors and poor posture (both of which are worsened through being both a desk jockey and a cyclist), plus the leg length discrepancy resulting in me standing and sitting in certain ways; and eventually my back gave out.

    Another theory, but it fits.

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by RichTheRoadie View Post
    Thanks.

    It turns out that this...


    ...could even be the root of the problem in the first place.

    The chiro thinks that my back may have been weakening - mainly on my long leg side - and that the tendinopathy (which is on my long leg) could have come about because of the hamstring taking up some of the slack. Add in super-tight hip flexors and poor posture (both of which are worsened through being both a desk jockey and a cyclist), plus the leg length discrepancy resulting in me standing and sitting in certain ways; and eventually my back gave out.

    Another theory, but it fits.
    It's the rack for you then!

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by j44ke View Post
    It's the rack for you then!
    Is it wrong that I can see how that would relieve some of my discomfort?! Especially if the arm ropes could somehow safely pull on my neck... And, to be fair, some days the chiro feels like that anyway!

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    Default Re: Hamstring Tendinopathy - experience here?

    Funny that...I remember reading that hanging from a bar is actually good for your shoulder joints? But does also load up the forearms too.
    Riding has to be fun, and part of the fun has to be that youíre not worried about having too much technology on your bike. - Tom Ritchey

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    Default Re: Hamstring Tendinopathy - experience here?

    Resistance bands are great for stretching but maybe not the neck.

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    Default Re: Hamstring Tendinopathy - experience here?

    Late to the party here but I have (touch wood) just about overcome high hamstring tendinopathy which began last August.

    Via 2 bike fitters and 3 physios, I have eventually established that the cause was a saddle 7-10mm too high, and a saddle design which pinched on the tendon insertion. When I dropped the saddle and changed the type (I massively recommend SMPs, btw), then it got 50% better very quickly. In the short term, I rode with a saddle that was 'on paper' 10mm too low, but it took some of the stress off.

    What appears to have done the rest is eccentric glute bridges. I raise with 2 legs, then do 10 second negatives with 1 leg. I could barely do 3 like that when I started; I can now do 4 sets of 6 with a 25kg db perched on my lap (and yes, you do need to be very careful!). As my hamstring has got stronger, so the pain has disappeared.

    Genuine tendinopathy needs loading to heal, so you will get some flares. Don't go mad but do persevere.

    Usual caveats; I'm not a doctor, n=1, etc, but eccentric loading is increasingly recognised as the number 1 treatment method for tendinopathies, and over-extension and compression are the 2 main injury mechanisms.

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by JamesHD View Post
    Late to the party here but I have (touch wood) just about overcome high hamstring tendinopathy which began last August.

    {snip}

    Genuine tendinopathy needs loading to heal, so you will get some flares. Don't go mad but do persevere.

    Usual caveats; I'm not a doctor, n=1, etc, but eccentric loading is increasingly recognised as the number 1 treatment method for tendinopathies, and over-extension and compression are the 2 main injury mechanisms.
    Some good insight and feedback there, James - thank you.

    I'm fairly confident that my saddle isn't too high as I currently run it around 15mm lower than I used to 6-8yrs ago (and bike fits back then seemed to indicate that I was in the right ballpark at the higher height). However, it may be that my body has changed and it does need to move, or that lowering it for a stint would help.

    I plan to have a bike fit, but I've put it off because I haven't been riding. The person I intend to use is a physio and fitter - when I told her the issue I have she mentioned that sitting on the area can be a problem, and that makes total sense. I spent *years* trying to find a saddle I like so I hope I don't need to change my saddle too, although I'm open to it if it'll help resolve the problem. Having been on the SQlabs for around 5/6yrs now I'm confident they're not the cause, but I did notice a different feel in the pressure on the area when I put my Master together and took it for a spin around the drive recently - the curve of the Flite saddle on that definitely resulted in less pressure.

    Eccentrics have been mentioned repeatedly, and are part of the routine I've been given. Unfortunately bridges and divers also contributed to me putting my back out recently (likely weakened through not riding), so I'm focusing on hamstring curls with a band at the moment.

    Now that my back has improved I'm going to revisit the MRI option as that will at least tell us how bad the injury is (or isn't) and will help guide next steps.

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by RichTheRoadie View Post
    Probably, yes. Itís my long leg too - I wonder how much my leg length discrepancy (circa 15mm at the hips) and associated scoliosis will (or has) come into play with this...
    That,s a lot. How did they measure this?
    We don,t function symmetric. If you measure / map, your hip- and core strength in every direction, and strengthen the weak side if more than 10% difference, you have a very good starting point imo.

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by rabo View Post
    That,s a lot. How did they measure this?
    We don,t function symmetric. If you measure / map, your hip- and core strength in every direction, and strengthen the weak side if more than 10% difference, you have a very good starting point imo.
    It was measured as a difference at my hip on x-rays.

    I compensate by 5mm as a shim between the sole and cleat on my right shoe. When I had power meter pedals recently my output was within 2-4% on each side.

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    Wink Re: Hamstring Tendinopathy - experience here?

    Today was exciting: my first ride in 10-weeks.

    Not even 30km, and horrendously unfit; but the key was that there was no discomfort from my tendinopathy.

    This from James earlier in the thread:

    Quote Originally Posted by JamesHD View Post
    Genuine tendinopathy needs loading to heal, so you will get some flares. Don't go mad but do persevere.
    ...plus a comment from my chiropractor the other day (“if it doesn’t hurt to do it, you’re ok to do it”) made me get back out there to test it.

    I took a route that gave me plenty of bail-out or easy turn back options if things weren’t going well, and a route that didn’t involve any long or challenging climbs; and I took things *very* steady. Frankly, I had to - my fitness is In. The. Toilet.

    The ride felt almost entirely fine. I say “almost” because one thing I could feel was pressure from my saddle. That’s where James’ second comment that struck a chord with me came in; and is the other thing I wanted to test:

    Quote Originally Posted by JamesHD View Post
    ...and compression are the 2 main injury mechanisms.
    I’ve touched on this a couple of times already in this thread. As I noted in direct response to James’ post, I don’t want to change my saddle, but it does look like I may need to if I’m going to start riding comfortably - and, perhaps more importantly, prevent injuring myself further through pressure on the point of the problem. Luckily I have 2 Flite saddles on the way (impulse purchases for my Vitus build), so one of those will serve as a ‘starter for ten’. I’m going to start looking into other options too - although at this stage everything will be pot luck. Unfortunately I already know I don’t get on with SMPs at it seems like they may have been a good place to start.

    I’ve also now set myself up with some bands and anchors to do an upright alternative to bridges for eccentrics - mainly to help protect my back after the episode I had with that.

    I need to see how my leg recovers over the next 48hrs and to be careful with doing too much too soon, but being back on the bike is a promising start - and an almighty relief!

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    Default Re: Hamstring Tendinopathy - experience here?

    This is superb news! A heads up - it's not a linear process and there will be setbacks; God knows I had enough days where I moaned to the other half 'Why is it suddenly worse again?', or nasty flares after rides that were longer/hillier/harder than I was 'supposed' to do. BUT over time, if you're diligent, those flares get progressively less intense and shorter, and it helped that I found 2 good physios (the first prescribed the correct exercises, the second is a cyclist himself and understood the injury mechanism in cyclists).

    What I was told was that if the pain isn't worse than 3/10 at the time, and returns to baseline within 24 hours after the activity, that's ok; more pain or a longer flare means you've overdone it. In essence, you are trying to restore the tendon's capacity for loading, both in terms of power and endurance, and to do that you've got to GENTLY push the envelope. Good luck!

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    Default Re: Hamstring Tendinopathy - experience here?

    Noted - and I don’t doubt it. I’ve already had times like that just from walking, or doing the rehab exercises.

    I’m a bit curious about my physio. Early on he told me to keep riding and gave me some fairly strenuous eccentrics to do, only to then seemingly backtrack after talking to one of the more senior physios (although his own background and experience seems to be perfectly notable). I wonder if he now fears ramping things up again and is hedging his bets until im basically ‘fixed’.

    I was beginning to think a second opinion was worth seeking. I think it may be time to pull the trigger on that.

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    Default Re: Hamstring Tendinopathy - experience here?

    Quote Originally Posted by RichTheRoadie View Post
    It was measured as a difference at my hip on x-rays.
    Standing-weightbearing x-rays?

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