Hamstring tendonitis: Devastating but treatable

Hamstring tendonitis is a tricky injury and demands caution when treating it. Athletes from all sports have at some stage probably felt a twinge or slight pull in the back of the leg, which might well be a close scare (in best case scenarios) related to hamstring tendonitis.

Goals of treatment and rehabilitation

1. Protect the injured tissues to allow healing and to control the early inflammatory phase.
2. Rehabilitate flexibility, strength, proprioception, and muscle imbalance, and control physical activities with the aid of taping and splinting.
3. Sport-specific activities must be tested to ensure the athlete can return to sport safely.

If proper rehabilitation is not undertaken, the athlete may be competing too soon, with residual instability, proprioceptive disturbance and muscle weakness and imbalances. Individual programmes must be planned and implemented for each athlete. This is where the help of a skilled coach can come in handy.

Here are 10 practical guidelines that will help an athlete avoid getting injured

1. Never train hard when stiff from the previous effort.
2. Introduce new activities very gradually.
3. Allow lots of time for warming up and cooling off.
4. Check over training and competition courses beforehand.
5. Train on different surfaces, using the right footwear.
6. Shower and change immediately after the cool down.
7. Aim for the maximum comfort when traveling.
8. Stay away from infectious areas when training or competing very hard.
9. Be extremely fussy about hygiene in hot weather.
10. Monitor the athlete daily for signs of fatigue. If in doubt, ease off.

Warming up and cooling down

In the British climate this is particularly necessary. Warm muscles stretch much better than cold muscles. Ligaments and tendons are much more likely to tear when the muscles are cold and inflexible.

The warm-up procedure helps in several other ways, too, both physically in diverting the blood flow from non-essential areas to working muscles, and mentally, in focusing the athlete on the approaching event.

I would recommend at least 15 minutes and up to 30 minutes warm-up before hard training starts. In ball games this can often be done with a ball, carrying out various skill routines, but in all cases it should start with 5-10 minutes of gentle movement, gradually increasing in pace, followed by 5-10 minutes of stretching, still in warm clothing. After that, one moves to fast strides and eventually to short sprints, then stays warm and loose until the start. A sprinter might well take 45 minutes to warm up for a 10-second burst of energy. During the cool-down period, which should last for 10-15 minutes after a competition or a hard training session, the body temperature returns to normal and the fatigue products are flushed out of the muscles, which reduces the chances of stiffness the next day.

The final word

If severe hamstring tendonitis hits an athlete, swift and knowledgeable treatment is essential if they’re going to get back on track quickly. Following these key tips is a great start to understanding an injury that plagues athletes from all sports.