If you missed part one covering the initial diagnosis, catch up before learning more about determining hamstring tendinopathy treatment approaches!

Last week we stated the importance of thorough assessment in hamstring tendinopathy cases to rule out other injuries and dysfunctions. If you are confident in your diagnosis, it’s time to take a look at the different impairments and activity limitations that will be used to determination the treatment approach.

In their study based on hamstring tendinopathy diagnosis and management, Goom et al. outline some distinct impairments that clinicians should look for during their patient assessment. “Broadly, this may include assessment of joint range of motion, strength, coordination, and functional tasks and should be related to individ­uals’ sport and activities of daily living. While impairment findings in the hip have demonstrated limited diagnostic value, they can be valuable in guid­ing treatment” (2016).

Impairments that can Determine Hamstring Tendinopathy Treatment Approaches

All information in this chart is courtesy of Goom et al. (2016).

All information in this chart is courtesy of Goom et al. (2016).

Addition Hamstring Tendinopathy Intervention Element: Load Modification

As always, one size does not fit all when it comes to rehabilitation. One of the main factors in determining injury intervention is the presence and severity of pain, which Goom (2016) warns should be carefully measured. “Training-load modification is critical in managing pain in patients with irritable symptoms. In practice, abusive compressive and energy storage loads are limited until pain irritability settles to a stable level… In truly reactive or irritable patients, all painful compression and energy storage activity will need to be ceased until symptoms settle and become stable.”

How can you adjust your treatment for patients in pain? The authors have multiple suggestions:

  • Replace provocative sporting activities with cross-train­ing or adapted to reduce compressive load­ing.
  • Swimming and water running are viable alternatives to painful activi­ties.
  • Modifications to the posture of the patient to reduce hamstring origin compression
  • Shaped cushions to reduce compression in sitting as well as adjusting patients into more weight bearing on the posterior thighs rather than on the ischium (Goom, et al. 2016)

Ready for the rehabilitation of hamstring tendinopathy? Tune in next week for the final article in the series!

Goom T et al 2016. Proximal Hamstring Tendonopathy : Clinical Aspects of Assessment and Management. Journal of Orthopaedic & Sports Physical Therapy. 2016;46(6):483-493.

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