Disclaimer: This program is a general guideline for non-surgical treatment of hamstring tendonitis or tendinosis. Severe or chronic cases may require additional interventions. Always consult with a healthcare provider for a tailored plan. Understanding Hamstring Tendonitis vs. Tendinosis
Hamstring Tendonitis: Acute inflammation of the hamstring tendons caused by overuse or sudden strain.
Hamstring Tendinosis: Chronic degenerative changes in the tendons due to prolonged overuse or poor healing of an earlier injury.
Week 1-2: Acute Phase (Pain Reduction and Protection)
Goals: Reduce pain and inflammation, protect the tendon, and avoid aggravating activities.
Rest and Activity Modification:
Avoid high-impact activities like running, jumping, or bending forward forcefully.
Use a supportive brace or crutches if severe pain limits mobility.
Pain and Inflammation Management:
Ice Therapy: Apply ice to the tender area for 15-20 minutes every 2-3 hours.
Laser or PEMF Therapy: Promote healing and reduce inflammation.
Gentle Mobility Exercises:
Pelvic Tilts: Engage the lower back and hamstrings gently. Perform 10-12 reps, 2-3 sets.
Supine Hamstring Stretch (Passive): Use a towel or strap to assist in stretching. Hold for 15-30 seconds, 2-3 sets.
Isometric Strengthening:
Hamstring Isometric Contraction: Press your heel into the floor or a stable object without moving the leg. Hold for 5-10 seconds, 10-12 reps.
Chiropractic Care:
Address imbalances in the pelvis and lumbar spine to optimize alignment and reduce strain on the hamstrings.
Week 3-4: Subacute Phase (Restore Mobility and Begin Strengthening)
Goals: Improve flexibility, strengthen surrounding muscles, and support the hamstring tendons.
Stretching (Hold each stretch for 15-30 seconds, 2-3 sets):
Hamstring Stretch: Use a resistance band for support while lying supine.
Hip Flexor Stretch: Kneel on one knee and push the opposite hip forward.
Piriformis Stretch: Cross one leg over the other while lying supine.
Strengthening Exercises:
Bridge Holds: Lie on your back with knees bent, lift hips and hold. Perform 10-12 reps, 2-3 sets.
Side-Lying Leg Raises: Strengthen the glutes and hip stabilizers. Perform 10-12 reps per side, 2-3 sets.
Isometric Nordic Curls: Begin in a kneeling position and lower the upper body forward slightly, engaging the hamstrings. Perform 10-12 reps, 2-3 sets.
Proprioception and Stability:
Single-Leg Balance: Hold for 10-20 seconds per side, 2-3 sets.
Lateral Band Walks: Strengthen hip abductors. Perform 10 steps in each direction, 2-3 sets.
Mobility Work:
Dynamic Leg Swings: Forward and backward leg swings to improve mobility. Perform 10-15 reps per leg, 2-3 sets.
Week 5-6: Advanced Phase (Strength and Functional Training)
Goals: Build dynamic hamstring strength, improve tendon resilience, and return to functional movements.
Dynamic Strengthening:
Nordic Hamstring Curls: Lower the torso while keeping the knees grounded. Perform 8-10 reps, 2-3 sets.
Romanian Deadlifts: Use light weights, focusing on the eccentric motion. Perform 8-10 reps, 2-3 sets.
Step-Ups: Strengthen the posterior chain. Perform 8-12 reps per side, 2-3 sets.
Plyometric Training (if pain-free):
Bounding Movements: Controlled forward leaps. Perform 8-10 reps, 2 sets.
Box Jumps: Focus on soft landings. Perform 8-10 reps, 2 sets.
Core and Stability Training:
Plank Variations: Incorporate side planks for dynamic stability. Hold for 20-30 seconds, 2-3 sets.
Single-Leg Deadlifts: Strengthen hamstrings and glutes. Perform 8-10 reps per leg, 2 sets.
Functional Training:
Gradually reintroduce running, cycling, or sport-specific activities. Begin with low-intensity intervals.
Chiropractic Care and Shockwave Therapy
Chiropractic Care: Adjustments can correct pelvic or spinal misalignments that contribute to hamstring strain and biomechanical inefficiencies.
Shockwave Therapy: Research shows shockwave therapy can accelerate tendon healing by stimulating collagen production, improving blood flow, and breaking down adhesions. It is especially beneficial for chronic tendinosis (Notarnicola et al., 2014).
Evidence-Based Sources
Eccentric Strengthening:
Mjolsnes, R., et al. (2004). "A 10-Week Randomized Trial Comparing Eccentric vs. Concentric Hamstring Strengthening in Prevention of Hamstring Strains." Scandinavian Journal of Medicine & Science in Sports. https://pubmed.ncbi.nlm.nih.gov/15265145/
Stretching and Biomechanics:
Davis, D. S., et al. (2005). "The Effectiveness of 3 Stretching Techniques on Hamstring Flexibility Using Consistent Stretching Parameters." Journal of Strength and Conditioning Research. https://pubmed.ncbi.nlm.nih.gov/16287359/
Shockwave Therapy:
Notarnicola, A., et al. (2014). "Effects of Extracorporeal Shockwave Therapy in Tendinopathies." Muscles, Ligaments and Tendons Journal. https://pubmed.ncbi.nlm.nih.gov/24648119/
Conclusion
This 6-week rehabilitation program, combined with chiropractic care and shockwave therapy, provides a comprehensive approach to managing hamstring tendonitis or tendinosis. By addressing strength, flexibility, and biomechanical alignment, this plan supports tendon healing, reduces pain, and minimizes the risk of reinjury.