Proximal Hamstring Tendinopathy Research Articles

Fluoroscopically Guided Peritendinous Corticosteroid Injection for Proximal Hamstring Tendinopathy: A Retrospective Review.

Background:Proximal hamstring tendinopathy is an uncommon but debilitating cause of posterior thigh pain in athletes subjected to repetitive eccentric hamstring contraction, such as runners. Minimal data exist evaluating treatment options for proximal hamstring tendinopathy.Purpose:This retrospective study evaluates the effectiveness of fluoroscopically guided corticosteroid injections in treating proximal hamstring tendinopathy.Study Design:Case series; Level of evidence, 4.Methods:Eighteen athletes with 22 cases of magnetic resonance imaging–confirmed proximal hamstring tendinopathy were treated with corticosteroid injection and later contacted to evaluate the efficacy of the injection with the use of a questionnaire.Results:The visual analog score decreased from 7.22 preinjection to 3.94 postinjection (P < .001), level of athletic participation increased from 28.76% to 68.82% (P < .001) at a mean follow-up of 21 months, and 38.8% of patients experienced complete resolution at a mean follow-up of 24.8 months. The mean lower extremity function score at the time of follow-up was 60.Conclusion:A trial of fluoroscopically guided corticosteroid injection is warranted in patients presenting with symptoms of proximal hamstring tendinopathy refractory to conservative therapy.

Rehabilitation of Proximal Hamstring Tendinopathy Utilizing Eccentric Training, Lumbopelvic Stabilization, and Trigger Point Dry Needling: 2 Case Reports

Case report. Proximal hamstring tendinopathy is a relatively uncommon overuse injury seen in runners. In contrast to the significant amount of literature guiding the evaluation and treatment of hamstring strains, there is little literature about the physical therapy management of proximal hamstring tendinopathy, other than the general recommendations to increase strength and flexibility. Two runners were treated in physical therapy for proximal hamstring tendinopathy. Each presented with buttock pain with running and sitting, as well as tenderness to palpation at the ischial tuberosity. Each patient was prescribed a specific exercise program focusing on eccentric loading of the hamstrings and lumbopelvic stabilization exercises. Trigger point dry needling was also used with both runners to facilitate improved joint motion and to decrease pain. Both patients were treated in 8 to 9 visits over 8 to 10 weeks. Clinically significant improvements were seen in pain, tenderness, and function in each case. Each patient returned to running and sitting without symptoms. Proximal hamstring tendinopathy can be difficult to treat. In these 2 runners, eccentric loading of the hamstrings, lumbopelvic stabilization exercises, and trigger point dry needling provided short- and long-term pain reduction and functional benefits. Further research is needed to determine the effectiveness of this cluster of interventions for this condition. Therapy, level 4.

Successful Treatment of Sciatica and Associated Proximal Hamstring Tendinopathy with Ultrasound-Guided Hydrodissection

PM&RVolume 5, Issue 9S p. S223-S223 Musculoskeletal and Sports Medicine Successful Treatment of Sciatica and Associated Proximal Hamstring Tendinopathy with Ultrasound-Guided Hydrodissection Boqing Chen MD, PhD, Boqing Chen MD, PhD UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorTodd P. Stitik MD, Todd P. Stitik MD UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorPatrick M. Foye MD, Patrick M. Foye MD UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorChristine M. Roque-Dang DO, Christine M. Roque-Dang DO UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorLawrence P. Lai MD, MS, Lawrence P. Lai MD, MS UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this author Boqing Chen MD, PhD, Boqing Chen MD, PhD UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorTodd P. Stitik MD, Todd P. Stitik MD UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorPatrick M. Foye MD, Patrick M. Foye MD UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorChristine M. Roque-Dang DO, Christine M. Roque-Dang DO UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this authorLawrence P. Lai MD, MS, Lawrence P. Lai MD, MS UMDNJ- New Jersey Medical School, Newark, NJ, United StatesSearch for more papers by this author First published: 17 September 2013 https://doi.org/10.1016/j.pmrj.2013.08.341Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume5, Issue9SSeptember 2013Pages S223-S223 RelatedInformation

Development and validation of a new visa questionnaire (VISA-H) for patients with proximal hamstring tendinopathy

BackgroundThere is a need for a patient-reported outcome (PRO) questionnaire to evaluate patients with proximal hamstring tendinopathy (PHT).ObjectiveTo develop a PRO questionnaire based on VISA questionnaire forms for patients with...

Surgical management of chronic proximal hamstring tendinopathy in athletes: a 2 to 11 years of follow-up

BackgroundProximal hamstring tendinopathy typically afflicts athletes. The poor knowledge of this pathology can lead to late diagnosis and late treatment, which in chronic cases could be challenging. Surgical treatment could resolve the symptoms and could permit the return to full sport activity also in chronic cases.Materials and methodsWe retrospectively evaluated 17 high-level athletes surgically treated for proximal hamstring tendinopathy. Symptoms lasted for an average of 23 months and were resistive to conservative treatment.ResultsThe follow-up period averaged 71 months. Return to run without pain occurred at a mean of 2.4 months (range 1–4) after surgery. All patients returned to sports at their pre-symptom level at a mean of 4.4 months after surgery. Results were excellent in 15 patients (88 %) and good in two patients (12 %). No results were fair or poor.ConclusionsSurgical treatment to manage chronic proximal hamstring tendinopathy in high-level athletes showed excellent results in terms of relief from symptoms and return to previous sport level.

Shockwave Therapy for Chronic Proximal Hamstring Tendinopathy

ObjectiveTo compare the effectiveness of shockwave therapy with a traditional conservative treatment program for chronic proximal hamstring tendinopathy in professional athletes.DesignRandomized controlled trial, with 12 months of follow-up. Sample size was calculated with 80% power to show a differ

MRI Appearance of the Proximal Hamstring Tendons in Patients With and Without Symptomatic Proximal Hamstring Tendinopathy

The purpose of our study was to determine if six MRI findings of the proximal hamstrings differ in frequency in hamstrings with and without symptoms of tendinopathy. We reviewed the MRI examinations of 118 consecutive patients who had undergone pelvis MRI and evaluation by a musculoskeletal clinical specialist. The proximal hamstrings were evaluated at four consecutive axial locations for tendon size, internal T1 and T2 signal, peritendinous T2 signal, and ischial tuberosity edema. Statistical analysis was performed to determine the association of the MRI findings with symptomatic hamstring tendinopathy. Twenty-one patients had a clinical diagnosis of unilateral proximal hamstring tendinopathy. The mean width or anteroposterior size was significantly larger in symptomatic hamstrings at all three proximal levels (p = 0.002-0.040). More than 90% of hamstring tendons had increased internal T1 or T2 signal that was not associated with hamstring symptoms. Both hamstrings with and without symptoms of tendinopathy had peritendinous T2 signal, but this was significantly more common in hamstrings with tendinopathy symptoms at the three most distal levels (p = 0.001-0.041). Ischial tuberosity edema and a feathery appearance of the peritendinous T2 signal distally were significantly more common in symptomatic hamstrings (p = 0.004 and 0.001, respectively). Increased T1 and T2 signal is commonly seen within the proximal hamstrings but is not associated with symptoms of hamstring tendinopathy. Increased tendon size, peritendinous T2 signal with a distal feathery appearance, and ischial tuberosity edema are significantly associated with symptomatic hamstring tendinopathy but can be seen in asymptomatic individuals.

Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy

BackgroundThe clinical assessment of chronic proximal hamstring tendinopathy (PHT) in athletes is a challenge to sports medicine. To be able to compare the results of research and treatments, the methods...

Proximal Hamstring tendinopathy treatment with Autologous Blood Injections: A one year follow up study assessing pain relief and functional improvement.

Purpose: Autologous Blood Injection (ABI) is a new and, until recently, poorly studied technique as an alternative to steroid injection therapy. By introducing an individual's own blood into an area of pathology it initiates subsequent ’healing’.

Shockwave Therapy for the Treatment of Chronic Proximal Hamstring Tendinopathy in Professional Athletes

Background: Chronic proximal hamstring tendinopathy is an overuse syndrome that is usually managed by nonoperative methods. Shockwave therapy has proved to be effective in many tendinopathies. Hypothesis: Shockwave therapy may be more effective than other nonoperative treatments for chronic proximal hamstring tendinopathy. Study Design: Randomized controlled clinical study; Level of evidence, 1. Methods: Forty professional athletes with chronic proximal hamstring tendinopathy were enrolled between February 1, 2004, and September 30, 2006. Patients were randomly assigned to receive either shockwave therapy, consisting of 2500 impulses per session at a 0.18 mJ/mm2 energy flux density without anesthesia, for 4 weeks (SWT group, n = 20), or traditional conservative treatment consisting of nonsteroidal anti-inflammatory drugs, physiotherapy, and an exercise program for hamstring muscles (TCT group, n = 20). Patients were evaluated before treatment, and 1 week and 3, 6, and 12 months after the end of treatment. The visual analog scale (VAS) score for pain and Nirschl phase rating scale (NPRS) were used as primary outcome measures. Results: The patients were observed for a mean of 10.7 months (range, 1-12 months). Six patients were lost to follow-up because they underwent a surgical intervention: 3 (all in TCT group) were lost at 3 months; 2 (1 in each group), at 6 months; and 1 (in the TCT group), at 12 months. Primary follow-up was at 3 months after the beginning of treatment. The VAS scores in the SWT and TCT groups were 7 points before treatment (P = .84), and 2 points and 5 points, respectively, 3 months after treatment (P < .001). The NPRS scores in the SWT and TCT groups were 5 points in either group before treatment (P = .48), and 2 points and 6 points, respectively, 3 months after treatment (P < .001). At 3 months after treatment, 17 of the 20 patients (85%) in the SWT group and 2 of the 20 patients (10%) in the TCT group achieved a reduction of at least 50% in pain (P < .001). There were no serious complications in the SWT group. Conclusion: Shockwave therapy is a safe and effective treatment for patients with chronic proximal hamstring tendinopathy.

Proximal Hamstring Tendinopathy—Overview of the Problem With Emphasis on the Surgical Treatment

Proximal hamstring tendinopathy is a remarkable clinical problem that expresses itself by lower gluteal pain, especially during running at a faster pace or sprinting, causing impaired athletic performance. This chronic disorder affects athletes and recreational exercisers of various sports activities, but it has been especially seen in sprinters and middle- and long-distance runners. However, it can also affect inactive people. It is known to be difficult to treat, often requiring long rehabilitation times. If conservative treatment is not successful, then surgery relieves pain in most cases. This article overviews the problem of proximal hamstring tendinopathy focusing on the surgical treatment and surgical technique.

Proximal Hamstring Tendinopathy

Background Tendon disorders are common problems in sports and are known to be difficult to treat. Only limited information is available concerning treatment of proximal hamstring tendinopathy. To the authors’ knowledge, no histopathologic findings of proximal hamstring tendinosis have been published. Hypothesis Surgery (semimembranosus tenotomy and exploration of the sciatic nerve) is an effective treatment for proximal hamstring tendinopathy. Study Design Case series; Level of evidence, 4. Methods A total of 103 cases of proximal hamstring tendinopathy in athletes (58 men, 32 women; 13 bilateral operations) with surgical treatment were included. The cases were retrospectively analyzed, and a 4-category rating system was used to evaluate the overall result. At the follow-up, the patients were asked about possible symptoms and their return to sports. Biopsy samples from 15 of the operated tendons were taken and analyzed by a pathologist. Results The average follow-up was 49 months (range, 12-156 months). The result was evaluated to be excellent in 62 cases, good in 30, fair in 5, and poor in 6. After surgery, 80 of the 90 patients were able to return to the same level of sporting activity as before the onset of the symptoms. This took a mean of 5 months (range, 2-12 months). Typical morphologic findings of tendinosis were found in all biopsy specimens. Conclusion Given the good functional outcome and low complication rate, the authors present surgical treatment as a valuable option in proximal hamstring tendinopathy if conservative treatment fails.