Apex Clinic: Don’t let recurrent hamstring trouble stop you in your tracks:


Don’t let recurrent hamstring pain stop you in your tracks:

We know, from years of experience of treating runners of all levels at Apex Clinic, that recurrent hamstring pain (or pain in the back of the thigh) is something that affects most runners at some stage in their lives.  Whether you are an international, club or recreational runner, the pain is often enough to slow you right down or literally stop you in your tracks.

Runners have repeatedly told us how they have tried endless amounts of sports massage, soft tissue work, pummelling with elbows to the local area, ultrasound/laser, hocus pocus machines combined with never ending hamstring stretching till the cows come home to no avail.  The million dollar question remains: what is the solution to clearing hamstring pain and getting back out on the road again?

The symptoms of ‘hamstring’ pain:

It is common, although not always the case, that sufferers of hamstring pain will feel a ‘tightness’ at the back of the thigh which, despite all attempts to stretch the muscle out, cannot be relieved.  Other symptoms may include a sharp, nipping, pinpoint pain, or a tight band or pulling feeling in the muscle.  Unlike acute hamstring pain caused by a rip, strain or tear in the muscle, the symptoms of persistent back of the thigh pain can linger for months, or even years, if misdiagnosed or left untreated.

Getting to the source of your pain:

Persistant pain in the back of the thigh is one of the most commonly misdiagnosed complaints, which is why many runners suffer from it in the long term. Rebecca Nelson, who heads the team at Apex Clinic and is a specialist in nerve pain and nerve related problems, recognises two MAIN causes for recurrent pain in the hamstring area: these are nerve tissue dysfunction and referred pain from the lumbar spine (lower back).

Nerve tissue dysfunction:

Scar tissue, caused by torn muscle fibres of the hamstrings from a previous tear or micro trauma, possibly unnoticed at the time, forms and attaches itself to neighbouring nerve tissue in the thigh.  This means that the nerve tissue in the back of the thigh, which should move freely and slide between all the muscles that surround it, is now restricted in its movement (known as altered neural dynamics).

Feature:  This injury is often worse when running downhill (with a longer stride length) or when running faster.  It is often worse after running compared to at the time.

Cure:  We recommend a specific regime of mobilisation or movement of the nerve tissue as it passes through the back of the thigh.  This will be followed by tailored home exercises to maintain nerve mobility.

Referred pain from the lumbar spine (lower back):

Stiffness or previous injury of the lower back can commonly cause referred pain to the back of the thigh.  Often this is misdiagnosed as a local ‘hamstring’ injury when in fact the source of the pain may be a joint or disc in the lower back.

Feature:  This posterior thigh pain is usually worse when running uphill compared to on the flat.

Cure:  We recommend manual mobilisation or loosening of the affected joints of the lower back in a position dependent on the individual runner’s presentation. This will be followed by home exercises to maintain mobility of the involved area of the spine.

The key to beating recurrent hamstring area pain lies in finding the correct diagnosis of the origin of the pain and then treating the pain at its source.  If you have symptoms in this area that don’t seem to be clearing, act now, seek a second opinion and make unhappy hammies a thing of the past.