HAMSTRING
Pain in the hamstring
Medical terms for this are Achilles tendinopathy, Achilles tendinosis and Achilles tendinitis. Pain in the hamstring is a common overload injury. The pain may be located at the base of the heel bone or a bit up on the tendon. Sometimes you can see and feel a tender thickening of the tendon. There is rarely any active inflammation in the tendon. Instead, it is a number of minor injuries to the tendon that lead to the pain picture. For many, vessels also grow into the tendon (hypervascularization). There are nerves in all vessels and when there is a pull in the hamstring under load, these can also lead to pain in the hamstring. For us, it is initially important to make sure that the tendon is not partially ruptured (off). With us at Alta Vita Physiotherapy, we have access to ultrasound diagnostics with which we can ensure this. With it, we can also see what degree of impact there is on the tendon, so that the physiotherapist can more easily start with adequate treatment and rehabilitation training at the right level .
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Why do you get health problems?
The most common reason for pain in the hamstring is that it has become too heavily loaded. It is often about some type of training that includes running and / or jumping. This may be due to the fact that the training intensity or duration has increased too fast, with too little rest between training sessions. Other reasons can be a shoe change or a change of surface on which the training is conducted.
Symptoms of health tendinosis
Pain / pain in the hamstring under load, such as jumping, running or walking. Increased stiffness / pain in the hamstring in the morning and when getting up after sitting for a while is common. If you press on the tendon, it is sore. Sometimes very local, sometimes more widespread over the tendon. Sometimes you can feel a "creaking" if you hold the tendon and at the same time move the foot. It may be a sign of an inflammation of the tendon sheath (peritendinitis) that surrounds the heel tendon. This is exactly what is best treated by doctors.
Treatment of the tendon
Normally, we recommend resting from the activity that probably caused the pain. In the study, we look at mobility in the ankle, among other things. We also look at the foot position, as pronation (that the foot falls inwards under load) can contribute to this problem. We often start with eccentric toe lifts (load in the negative phase of a toe lift, on the way down) for the hamstring. This is combined with shock wave therapy to speed up healing. Rehabilitation training is clearly most important to get back and increase the strength of the tendon, but the shock wave treatment usually helps to shorten the rehabilitation period. To optimize the foot position, a test for anatomical shoe insoles can also be done. If you run, you can medical running analysis is carried out to optimize the running step so that the load on the heel tendon is kept down.
The prognosis for Achilles tendinopathy?
It is good, but it can take time even with optimal treatment. How long it takes, however, depends on how extensive the tendon damage is. After about 12 weeks, however, you usually experience a marked improvement.
Other possible diagnoses
Retrocalcanary achilles bursitis: There is a bursa on the front of the heel bone when the heel tendon is attached and it can become inflamed, so-called mucositis. Shoes where the heel cap presses against the heel tendon can trigger discomfort in this area. If you have these problems, deep toe lifts often give more problems and then we do not recommend eccentric toe lifts.
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Subcutaneous Achilles bursitis: This bursa is located on the back of the heel bone and can become inflamed with prolonged pressure on the heel.
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Haglund's disease: With this injury, the heel bone loosens and an outgrowth occurs on the heel bone. If this growth becomes marked, surgery may need to be performed.
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We physiotherapists at Alta Vita Physiotherapy can join ultrasound diagnostics verify what these diagnoses are.
