Clinical Progression and Load Management For Proximal Hamstring Tendinopathy In A Long-Distance Runner: A Case Report

Area of Science:

• Sports Medicine
• Rehabilitation Science
• Orthopedics

Background:

• Proximal Hamstring Tendinopathy (PHT) is characterized by deep pain near the ischial tuberosity, often affecting long-distance runners.
• Key etiologic factors include tendon compression and shear forces at the ischial tuberosity during hip flexion/adduction.
• Chronic PHT lesions are common in endurance athletes, necessitating effective treatment strategies.

Purpose of the Study:

• To analyze the effectiveness of a progressive tendon loading exercise protocol for Proximal Hamstring Tendinopathy (PHT).
• To assess improvements in pain and functional capacity in an amateur runner diagnosed with PHT.
• To evaluate the impact of a structured, phased exercise intervention on PHT symptoms.

Main Methods:

• A case report involving a 30-year-old male amateur runner with PHT following a 10km race.
• Utilized pain (VAS) and functional (VISA-H) assessments, alongside specific clinical tests (PO, BK stretch, plank, Slump test).
• Implemented a 12-week progressive exercise program with four distinct loading phases.

Main Results:

• Significant pain reduction observed: Visual Analog Scale (VAS) decreased from 7 to 1 over 12 weeks.
• Substantial functional improvement: Victorian Institute of Sport Assessment-proximal hamstring tendons (VISA-H) score increased from 23 to 80.
• Sciatic nerve mobility returned to normal levels by the end of the intervention.

Conclusions:

• A progressive exercise protocol, incorporating isometric, concentric/eccentric, and energy storage loading with increasing hip flexion, proved beneficial for PHT.
• The intervention successfully decreased pain and enhanced function in the case subject.
• Further research with larger sample sizes and robust methodologies is recommended to validate these findings for clinical practice.