Proximal hamstring tendinopathy (PHT) is a pathology of the tendon with a combination of tissue damage, inflammation, and possibly pain at the proximal tendon where the hamstring attaches to the ischial tuberosity. PHT is very common among yoga practitioners as well as in other populations. Jules Mitchell and I talk about this within the context of a 2016 clinical commentary entitled Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management from the Journal of Orthopaedic & Sports Physical Therapy.
Jules Mitchell is a yoga teacher, educator and massage therapist based in San Francisco.
- Sometimes PHT involves pain without tissue damage. And sometimes there’ss a lot of damage and no pain.
- PHT is common in people who do sagittal plane movements and people who do sudden movements like running, hurdling. Squatting and sitting can also cause PHT
- Yoga teachers don’t treat or diagnose pathologies but they work people who are achy but not so bad that they need to see a doctor, and those who have sought medical intervention and are reentering their active lifestyles.
- A clinical commentary is kind of an opinion piece that combines the research with clinical expertise and puts it together to provide a best solution.
- Strength and flexibility are not opposites. We don’t lose flexibility by getting stronger.
- 4 stage protocol to strengthen the tendon
- isometric hamstring loads
- isotonic loads – moving with a little resistance
- Isotonic loads with more extreme hip flexion
- energy storage loading – for athletes with graded exposure
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