Five Main Things to Avoid Proximal Hamstring Tendinopathy

Five Main Things to Avoid Proximal Hamstring Tendinopathy

1. Excessive Rest

   • Why to Avoid: While rest is important to reduce initial inflammation, excessive rest can lead to muscle stiffness and weakness. This can slow down the healing process and make tendons more prone to re-injury.

   • Alternative: Engage in gentle, low-impact activities that keep muscles active without overloading the tendons.

2. Aggressive Stretching

   • Why to Avoid: Over-stretching can irritate and exacerbate the tendons, leading to increased inflammation and pain.

   • Alternative: Focus on gentle range-of-motion exercises and specific strengthening activities that support tendon healing without causing further irritation.

3. High Compression Loads

   • Why to Avoid: Activities that create high compression loads, such as prolonged sitting with crossed legs or using spikey balls directly on the tendon, can lead to increased inflammation and pain.

   • Alternative: Avoid positions and activities that compress the tendons. Use gentle massage on the surrounding muscles and ensure proper posture to reduce compression.

4. Ignoring Pain Signals

   • Why to Avoid: Ignoring pain and pushing through it can lead to overloading the tendons and further injury. Pain is a signal that something is wrong and needs to be addressed.

   • Alternative: Listen to your body and use pain as a guide to adjust activities. Follow the Traffic Light Model to monitor and manage pain levels effectively.

5. Overloading with High-Intensity Activities

   • Why to Avoid: High-intensity activities without proper conditioning can overload the tendons, leading to increased pain and inflammation.

   • Alternative: Gradually reintroduce activities with a focus on low-intensity, consistent training. Follow the 80/20 training rule, keeping 80% of your workouts at low intensity and only 20% at high intensity.

By avoiding these common pitfalls and focusing on gentle, supportive practices, you can enhance your body's natural healing processes and achieve a more effective recovery from hamstring tendinopathy.

New Program to Help with Proximal Hamstring Tendinopathy in Runners

Hi, I’m Dan O'Grady, Physiotherapist, Running Coach, and Former PHT Sufferer

Are you an endurance runner who is tired of battling persistent buttock/hamstring pain that just won't quit?

As someone who has experienced the frustration of proximal hamstring tendinopathy (PHT) firsthand, I understand the challenges you're facing.

CLICK TO READ MORE

"Run, Recover, Thrive: Empower Your Knees, Enhance Your Life"

The Resilient Knee Project: A Simple Approach

The Resilient Knee Project is a holistic approach to improving knee health, designed to be straightforward and effective.

At its core, the project uses a blend of targeted physical exercises, pain education, and lifestyle adjustments to promote knee resilience and overall well-being.

1. Start with Assessment: Use the Resilient Knee Matrix to evaluate your current knee health across two dimensions: biomechanical integrity and functional capacity.

2. Educate Yourself: Learn about the science of pain through Pain Neuroscience Education (PNE), which helps reframe your understanding of pain as part of the healing and growth process, not just a signal of injury.

3. Implement a Balanced Routine:

   • Exercise: Incorporate low-impact running and functional exercises to strengthen the muscles around the knee, improving stability and shock absorption.

   • Recovery: Adopt recovery techniques like proper hydration, nutrition, and sufficient sleep to enhance muscle recovery and reduce inflammation.

4. Monitor and Adapt: Regularly assess your progress. Adjust the intensity and frequency of exercises based on feedback from your body, using pain and discomfort as guides to manage your load.

5. Support System: Engage with a community or professionals who support your journey, providing motivation and advice when needed.

The key is consistency and a balanced approach.

By gradually challenging the knees and providing them with the care they need to recover, you can enhance your knee health and function without overwhelming the body.

This simple method ensures that you build capacity and resilience in your knees, promoting long-term health benefits for the body and mind.

Are you ready to join us?

Why You Can Have Pain Without Tissue Damage: A Physio’s Guide

Pain is a complex and fascinating experience, and sometimes it can be really intense even when there’s no actual injury.

How does that happen?

Let’s dive into it with a simple explanation.

The Role of Acid-Sensing Nociceptors

Our bodies have special nerve endings called nociceptors.

Think of them as danger warning sensors.

This type of danger sensor is just like your fuel gauge in your car. It lights up when you are getting low on fuel (but your car is structurally OK).

One type of nociceptor is particularly interesting: acid-sensing nociceptors.

How Do Acid-Sensing Nociceptors Work?

When we exercise or stress our muscles, they produce metabolic byproducts, including lactic acid.

This lactic acid can increase the acidity in our muscle tissues.

Acid-sensing nociceptors detect this change in acidity and can trigger signals that we experience and can label ‘pain’, even if there’s no real damage to the tissues.

Here’s another simple analogy -

Imagine you’re cooking and you accidentally burn a bit of food.

The smoke detector goes off, even though there’s no fire – just a little smoke.

Similarly, acid-sensing nociceptors can sound the pain alarm in your muscles without any actual injury, just due to increased acidity.

Why This Matters

Understanding that pain can occur without tissue damage is crucial for managing our pain.

It helps us realize that pain isn’t always a sign of something broken or injured.

Instead, it can be a warning system that’s trying to protect us.

Practical Takeaways

1. Recognize the Signals: Know that pain doesn’t always mean harm. Sometimes it’s your body’s alarm system reacting to changes, like increased acidity in your muscles.

2. Manage Stress and Exercise: Both physical and emotional stress can increase acidity in your muscles, triggering these nociceptors. Regular, moderate exercise and stress management techniques can help keep these sensors from becoming overly sensitive.

3. Pain Management Strategies: Techniques like deep breathing, gentle stretching, and mindfulness can help calm your nervous system and reduce the sensitivity of these pain signals.

By understanding how pain works, especially the role of acid-sensing nociceptors, we can better manage it and lead healthier, more comfortable lives.

Remember, pain is complex, but with the right knowledge and tools, we can handle it more effectively.

Feel free to share this with anyone who’s struggling with chronic pain – sometimes, understanding the science behind it can make all the difference!

Running does not cause knee arthritis

Written by Daniel O’Grady, Knee Specialist Physio and Running Coach

Many runners worry that their favorite activity might lead to knee osteoarthritis (OA), but research suggests otherwise.

In fact, runners do not have a higher prevalence of knee OA compared to non-runners.

Let's explore why running might actually help your knees stay healthy.

The Misunderstood Relationship Between Running and Knee OA

1. Cumulative Load vs. Peak Load:

   • Cumulative Load: The total stress your knees experience over time is more important for OA risk than the peak load during a single stride. Surprisingly, running has a low cumulative load compared to walking the same distance because of the shorter ground contact time and longer stride length.

   • Peak Load: While running involves higher peak loads, the overall stress on knee cartilage is managed better in runners due to their conditioned cartilage.

2. Cartilage Conditioning:

   • Adaptation: Regular running conditions knee cartilage to handle the mechanical stresses of running. This means the cartilage becomes stronger and more resilient over time.

   • Mechanisms: Running increases the thickness and glycosaminoglycan content of knee cartilage, which helps in shock absorption and lubrication, making it more resistant to wear and tear.

3. Misconceptions About Joint Loading:

   • High Peak Loads: Although peak knee joint loads in running are high, they do not necessarily lead to OA because the body adapts to these loads.

   • Dynamic Loading: The dynamic nature of running loads, with high rates of loading and unloading, is less harmful to cartilage compared to static loads, which are common in occupations requiring long periods of standing.

Key Takeaways

• Low Risk for Runners: Recreational runners have a low risk of developing knee OA. Running might even protect against OA by conditioning the cartilage and keeping it healthy.

• Stay Active: Regular, moderate running can be beneficial for your knee health. It's important to listen to your body and avoid excessive training volumes to prevent injuries.

By understanding these insights, runners can feel more confident that their passion for running is not only safe but also potentially beneficial for their knee health.

Keep running smart, and your knees will thank you!

If you’d like help on your journey getting back to running with knee pain or OA - join Physio Dan at The Resilient Knee Project - an innovative and unique program that gets you back to running and doing what you love - let’s get started today!

Journal link

Joint Loading in Runners Does Not Initiate Knee Osteoarthritis

Ross H. Miller

Exerc Sport Sci Rev. 2017;45(2):87-95

A new view of pain

“A new view of pain as a homeostatic emotion Bud Craig”.

Neuroscientist Bud Craig wrote this research paper 20 years ago.

I just discovered in last year and was blown away by the explanation of pain through the lens of homeostasis and interoception.

It links the body and brain in a plausible and scientific explanation that is based on Mr Craig’s decades of pain staking anatomical dissection and innovative tracing methods.

Currently as a society we are going through a epidemic of pain.

Our traditional models are not helping.

It could be argued they are making the problem worse due to iatrogenic harm.

Once you are caught in the biomedical matrix, it is very challenging to escape.

I found this paper to be a game changer as it helps us to use a m0re accurate explanation of pain that links body and brain in a way that is much more empowering.

Subsequently I have been reading more of Mr Craig’s work as well as his amazing book.

Making sense of pain is arguably the greatest therapy there is.

I have included the full PDF in the link below.

Some of the highlights from the research paper I have also outlined below.

As it is written for a scientific lens, if you reading this and would likely to comment or connect to find out more - just leave a message below or send me an email dan@kinfolkwellness.com.au

“Pain is both an aspect of interoception (the sense of the physiological condition of the body) and a specific behavioral motivation. This striking conceptual shift incorporates the multiple facets of pain into one concrete framework, and it provides sound explanations for pain as both a specific sensation and a variable emotional state”.

“Changes in the mechanical, thermal and chemical status of the tissues of the body – stimuli that can cause pain – are important first of all for the homeostatic maintenance of the body.”

“Pain normally originates from a physiological condition in the body that automatic (subconscious) homeostatic systems alone cannot rectify, and it comprises a sensation and a behavioral drive with reflexive autonomic adjustments.”

“The behavioral drive that we call pain usually matches the intensity of the sensory input but it can vary under different conditions, and can become intolerable or, alternatively, disappear, just as hunger or thirst.”

“The new view of pain as a homeostatic emotion arises directly from functional anatomical findings in cat and monkey, rather than from philosophical considerations.”

“These results have identified specialized central substrates that represent pain, temperature, itch, muscle ache, sensual touch and other bodily feelings as discrete sensations within a common pathway.”

“These data indicate that in humans pain is an emotion that reflects specific primary homeostatic afferent activity.”

“Activity that produces pain in humans ascends in this pathway because its primary role has been homeostasis for millions of years.”

“Humans experience increasing discomfort at temperatures below 24C, but cold does not normally produce pain until 15C, where HPC activity accelerates and, significantly, cooling-specific lamina I cell activity plateaus.”

“This physiological evidence confirms the anatomical finding that homeostasis, rather than the heuristic simplification ‘nociception’, is the fundamental role of the small-diameter afferent fiber and lamina I system and is the essential nature of pain.”

“These findings indicate that pain in humans is a homeostatic emotion reflecting an adverse condition in the body that requires a behavioral response.”

“The new findings provide specific substrates for each of these aspects within a common framework of homeostasis.”

“This new view differs fundamentally from the prior conventional view in several ways. It incorporates specific sensory channels for different kinds of pain and for pain of different tissue origins. It provides a fast (sharp) pain channel that can elicit fight-or-flight behavior and a slow (burning) pain channel that can engage long-term responses, sickness behavior and immune function”.

“This perspective suggests new directions for research that could have strong impact on clinical therapy. For example, other homeostatic variables, such as salt and water balance, could have direct impact on the integrated activity that underlies the motivation called ‘pain’, as in the mysterious fibromyalgia syndrome.”

“Understanding the mechanisms underlying the augmentation of activity in the polymodal nociceptive channel could be particularly fruitful for identifying new therapies for chronic pain.”