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high hamstring pain help

My pain is just below the glute area on the left leg.  It's in that high hamstring/insertion point region.  It's in the dull ache/low roar on the intensity scale, it alters my running, but I can gut out a Z4 run and Z2/3 runs.  It's been a problem for 3 months now, to varying degrees.  Here's what I'm thinking, please let me know your experience/recommendations.

  • Running:  replace Z4 with Z3 running, try to accumulate same rTSS per week as long as pain doesn't get any worse.  NO strides, ABC's, nothing to increase loading on hamstrings.  Not optimal in my GF plan, but think it's better than no running.  Tried the 2wks totally off from running in March and saw no change.
  • ROM/flexibility:   NO hamstring stretching until pain during running goes away.  Spend time doing death stretch.  Actually started quad/hip flexor work last fall with death stretch/couch stretch work following roller/lax ball massage, so if anything, front of upper leg is more flexible.

    (Question:  could increased ROM of front of leg be revealing weak hamstrings?  If so, what to do about it?)
  • Strength:  once pain free, what strength work do you recommend?  Not a big fan of it, but will do it if effective, is hill running (uphill only, I know) better than anything else?

Thanks for your help,

Chris

Comments

  •  I had the same problem earlier this year. If you are compensated while running you will exacerbate the problem and likely cause other issues before it gets better.

    I am a believer in Active Release Technique

    check out this web site -- http://www.activerelease.com/

    the premise (and it worked in three treatments for me) is a combination of movement, heavy stimulation, and nerve massage. Doing ART requires certification and they certify portions of the body, nerve systems etc. I would suggest you find a provider through the search engine on the above site, and go check it out.

    It can be "somewhat" painful, especially if you having a nerve involved and they get into nerve stimulation, but works wonders. In fact, I have continued to see the person here in CHS once a week for the last 10 weeks, since getting treated for the hamstring issue.

    I am moving better and more fluidly than I have in years.

    good luck!

  • After two years of this flaring up in the OS and slowly resolving as i came off the OS, I think for me at least, I've narrowed it down to two causes.
    1. Intensity of runs, the VO2 intervals probably sent me up for this.
    2. My road bike. I was doing all OS trainer rides on my road bike and I think I had the seat too far back. When I switched to my tri bike at the end of OS, the hamstring would slowly get better. A couple weeks ago, I rode my road bike on the BRP Camp and my glutes/hamstrings took a beating until I raised and moved forward my saddle. Since then, its been better.

    I tried everything from massage/PT, stretching, Epson Salt soaks, etc. but those were just treating the symptoms and it would re-occur. I'm about totally convinced it was a bike fit issue coupled with high intensity running intervals. Will test this theory next OS.
  • (Knocking on Wood) I'm about 90% healed from this same injury - High Hamstring Tendonitis.  Hit me hard around Week 12 in Ironman training for IMCDA.  Here's what helped me and what I would recommend to others.

    1. Back off the Z3 work.  The Z3 work is where I got into trouble with this - I am convinced of that.  Just too much of it, too long in duration, etc.  I eliminated Z3 completely.  I took a couple weeks off of doing any speed work at all.  Dialed it back to Z1/Z2.  When I started back up with Z4 work I broke it down into Half Mile repeats.  I've worked back up to Mile Repeats.  Didn't miss a beat.  No fitness loss at all.  

    2.  Stengthen the Hamstring - I got into a very intense set of PT work.  I did some modified Lunges, Bridging on the Ball, Sliding on the Clipboard, etc.  No lie, just doing a couple weeks of this every other day got this injury back on the right track.  Go see a PT who treats runners.  Be careful to integrate/start strenthening slowly - the exercises totally fixed my hamstring but screwed up my low back (a worse injury).  Be smart.  BTW - I did not wait to be pain free to start strengthening and my PT told me some discomfort is expected and actually good for blood flow and eventual healing.

    3.  Drop your Seat Post on your bike 1-2mm.  That will take some pressure/stress off that hamstring. 

    4.  Do not listen to anyone who tells you to "Stop Running" or rest for a month or whatever.  Someone tells you to quit running, do a 180 and walk out.  You can absolutely, positively run while rehabbing this one. 

    5.  Do not believe all the crap you read on-line about people having this chronically for years.  They are the 1% of the population that can't get better.  The other 99% of us DO and WILL get better.

    6.  A good NSAID to ask for by name is Diclofenac Sodium.  Pretty powerful RX that can get you through the rough patches and calm that thing down.

    7.  Ice did nothing for me.

    8.  Foam roll helped BUT I got carried away sometimes with the Foam Roller and the Ball and really pissed it off.  Nice medium pressure with the foam roller a few times a day.

    9.  NO HAMSTRING STRETCHES AT ALL.  None!  It reinjures your High Hamstring every time you do it.  But do a TON of frequent Quad and Hip Flexor stretching.  That will help.

    Good luck.  You will heal.  I'd get to a PT soon and get doing some excercises. 

     

     

  • Chris,
    Been thru this myself, last year, and still need to be aware of it although it hasn't affected training. Initially experienced during a weekend of mountain riding.
    The only treatment that really helped me was a really deep and painful massage...followed up 3 times or so, and she dug it out. Let me tell you that I was sweating profusely due to pain but it worked. I, like Paul, get regular ART and have for years...while I think that helps, it didn't fix this problem for me.
    Stay off the intervals until healed.
    Good luck.
  • Chris, I had the exact same problem with my hamstring, started november 2011 and took a few months to work out..  High on the leg just under the but.  it took a while but I aggree with:

    1.  NO stretching of the hamstring.  It may feel good initially after the stretch but it does not help the problem go away.

    2.  active recovery worked for me.  I continued to run but laid off zone 4.  I tried not to over lengthen my stride.  I also did faom roller but it is a difficult area to reach.

    3.  I did go to an ART specialist.  helped somewhat

    4.  strength excercises.  single leg lunges.

    Be patient with it and don't "gut" through zone 4s.  it won't help if you continue to push through pain.

    hope this helps

  • Ah!  Can't believe I forgot another key recovery tactic was changing my stride/gait.  I am a heel striker - many are - but I was striking with my leg fully extended (bad).  The PT I went to did a very short (but revealing) gait analysis video of me.  We changed up my gait so I was kicking my foot higher during the flexion stage of the leg and then working a bit on more midfoot striking.  Key point here is, have your gait checked.

  • I had the same issue on and off for years after doing a number on it running a mountainous relay outside of Calgary. It became a chronic nuisance that would flare up at times and get really hot and ache-y; this went on for 4+ years. PT told me that I had a muscle imbalance between my glutes and my hammies and that my hammies were firing and doing more work b/c my glutes had basically, "learned to be lazy". Tx involved strengthening the muscles and re-teaching my glutes to work (see exercises recommended by previous posters).

    This past year I have had zero issues with it at all and the only difference is that I started doing boot camp 1-4x a week. Finally I have been running with no concerns of niggling hammy/glute pain and with the added bonus of occasional AG placings in local races :-)

    Definitely be patient with it -- hope you start to feel some improvements.
  • https://encrypted-tbn3.google.com/images?q=tbn:ANd9GcSk95BzElzA_v47seGKQjK_MU55HC1DTBQ5BcplNB7SnI58Ub2vgQ I did this exercise, expect I would stack one foot on top of the other and raise up with one leg. It hurt like a b@^&ch, and I could only do 5 at first, but I know can do 20.
  •  Wow, thanks for all the nuggets of gold!  Here's what I'm going to implement, starting today.

    @Dave C:  Your n=1 is now a n=2.  This problem arose when I changed my road bike setup.  I lowered the saddle considerably and moved it back even more.  I lowered it because it was *actually* too high:  video analysis showed I favored my right leg by sitting on the saddle cockeyed.  I'm 95% sure lowering the saddle was the way to go, because a nagging PFPS-like pain went away quickly.  But, moving the saddle back was based more on feeling and "balance" on the bike based on rules of thumb.  When you say you raised your saddle, you just mean you raised it by ~1/2 the distance of the forward move to keep the same saddle-BB distance?  Or you mean raise it in addition to this number?

    @Jim M:  Were you able to run hills to add intensity?  I was kicking around starting with hill repeats once the thing calms down?  Obviously, you have to get back down the hill by walking or jogging slowly so as to not overextend.  As long as I keep my cadence around 93, I think I'm landing forefoot or midfoot.  The wear on my Newton lugs confirms this as well.

    Also, I can massage my glutes (sore from riding in rear position) with tp ball or quad roller and lower hamstrings using ball or quad roller, but will stick to foam roller for the specific area.

    @Brenda R:  Thanks.  Will put feet in TRX loops and go to town.  Will bring furniture sliders to work and work on it 1-2 through the day.

     

    Agian, thanks for all the help!  

     

  •  I didn't see it mentioned but the high hamstring problem can be caused by your quads and/or hip flexors being over tight creating anterior pelvic tilt and constantly straining your hamstrings. 

    I had the same the same issue last year and went to see my freind who practices ART and after 1 visit and a couple days of foam rolling and stretching it has never come, however I do try to keep up with it a couple times a week.

  •  Hills are a no no for this one.  I would avoid hills for the time being.

  • @ Christopher Yes I moved my saddle forward to change my hip angle, then up slightly to keep my distance from Saddle to BB the same. I moved the saddle forward about 3/4" and up about 1/4" It was rough, on the fly, to see if it helped. It did and I rode another tough mountain course last week with no more problems.
  • Thanks for the response Dave!

    Did hs curls on the TRX last night, did 3x8, got me to thinking. It would be better to increase the resistance (pain free) and keep it at 3x8 than to increase the reps, right? We're trying to increase strength, right?

    Thinking a little more generically than just hamstring issue, obviously, it's hard to increase resistance on rehab type stuff for the most part.

    Sorry to hijack my own thread.
  • Ahhh, haven't had my KStar fix in a while, thanks Brenda! Tack and floss, you supple leopards!

    On the strengthening and rehab front, got some good info on ST (insert B Fife syurpriiize syurprize here). Short version is do GHD raises, but just do the eccentric lowering phase. Basically, have someone or something hold your ankles to the floor and lower yourself by extending the knee. Try not to break nose by lowering too fast ;-)

    On the injection front (@J Moss), consensus was that cortizone worked for a few people who tried it as a band-aid, but save PRP injection for when you are doing hard reset on running (most did it during 3 mo layoff).

    Link is here
    http://forum.slowtwitch.com/cgi-bin/gforum.cgi?post=2980146;search_string=high hamstring pain;#2980146
  • Dealing with this issue probably caused by new bike 7 weeks prior to IMLP with the seat too high. I got a TTbikefit with Todd. Definiteley worth the trip up to RI. Had some PT and two sessions of ART with good but temporary relief. 3rd ART Friday and dry needling on Saturday. I have been doing eccentric strenghthening and glute and hip flexor strecthing. The Hamstring stretches (I have tried three different) seem to make it worse so I'm laying off those. Ran 3miles last Sat with no pain but then had ache doing 1 mile yesterday and stopped. I think I need to be patient but continue to run easy and short even if it aches a little. Anybody with any other input?
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