Best hamstring rehab(strain, tear, tendinitis, tendinopathy treatment|massage|exercises)

#hamstringstretch, #hamstringstrain, #hamstringstrainrehab, #Hamstringstrainmassage, #Hamstringtendinopathyrehab

If you have a Hamstring strain or partial tear(depending on how big), you can start with gentle massage as shown in the video. and then you can introduce the bridge exercise in a lying position but don't do eccentrics straightaway. You need to do isometric exercises first, which means you stay up while lifting your hip up for up to 45 seconds x 5 times a day. (slowly build up from 5 or 10 seconds)

and then you can progress to eccentrics as long as the pain allows.
It is mostly the same if you have tendinitis or tendinopathy but for tendon issues, see the below
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Guidelines (massage and exercises) – this is just a guideline so please do it at your own pace – you know your body best. Listen to your body!
1. Muscle massage 30-60seconds as frequent as you can(once you get used to it you can push quite hard to get rid of possible knots)
2. Eccentric exercises (Start with 2sets x 5reps and slowly build up to 3sets x 15reps twice a day)

Once you get to the aim, you can do exercises a bit faster and stronger so that your tendons can work harder. Start with low weights and then slowly increase. Next level would be weight/plyometrics training.

Precautions
1. below 4/10 pain is ok with exercises but you should not have any new or increased pain during/after exercises and following morning (Always monitor your pain after exercises as tendons talk to you 24 hours later). For example, you have increased the eccentrics from 2sets x 10reps to 3sets x 15rep with an increased pain in the following day. Then you should go back to 2 sets x 10reps or less for a couple of days with frequent ice(5-10minutes every 2-3 hours) on the irritated tendon, frequent massages on relevant muscles. After that maybe try 3 sets x 8 reps instead and then 10-15 reps

2. Progress slowly. Many people want to recover faster so exercise a lot, which can irritate their tendons even more and it may take several weeks to settle. Be aware tendon injuries can sometimes take longer than bone healing so please be patient..

Tendon Rehab normally takes at least about 12 weeks. According to research, it takes 4-6 weeks until the pain settles down if you have done exercises correctly. If you play sports, you need to do extra training including weight, speed, power and sports-specific plyometrics before getting back to sports. Even if you are back to sports, resume 20-30% of your normal training level and slowly increase by 5-10% every week or so. Even if you don’t play any sports or any injuries, it’s good to do these simple exercises 2-3 times a week anyway!

References
van Dyk, N., Behan, F. P., & Whiteley, R. (2019). Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. Br J Sports Med, bjsports-2018.

van der Horst, N., Smits, D. W., Petersen, J., Goedhart, E. A., & Backx, F. J. (2015). The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. The American journal of sports medicine, 43(6), 1316-1323.

O'Sullivan, K., McAuliffe, S., & DeBurca, N. (2012). The effects of eccentric training on lower limb flexibility: a systematic review. Br J Sports Med, 46(12), 838-845.

Behm, D. G., Blazevich, A. J., Kay, A. D., & McHugh, M. (2015). Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied physiology, nutrition, and metabolism, 41(1), 1-11.


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The key principle of rehabilitation is to continuously navigate the middle of doing too much and too little. You are the only one who can do it and I really hope this video can help with your symptoms. However, you should not take the information in my channel as medical advice. It is best to see medical professionals if you have any pain or injuries and it is also advisable for you to do these exercises with a proper assessment and supervision.

If you want to know the latest evidence and concepts of tendon rehabilitation, please check the below videos. Rehab safely!

1. Never stretch your tendon


2. Tendon rehab Q and A


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