Hamstring Tendinopathy

[Justinslow]

So I'm seeing my osteopath and NHS physio (GP was useless) for lower back and groin/leg problems.
I struggle with my back through my job which is physically demanding but for a few months now I've had another problem. My left leg is persistently stiff from the groin downwards through the hamstring, no amount of stretching is able to shake it off. I've had another osteopath session tonight and she really worked the groin area pretty hard, it's eased the dull ache and stiffness for now but I'm sure I'm going to smart a bit tomorrow!
Looking back over the last couple of years I think I've always had a groin issue, I tend to ride with my saddle a bit lower than it probably should be, resulting in my knees sticking out a bit. When I ride I generally get a dull ache deep within my left groin never my right groin, raising my saddle makes this worse. It's not horrific and I have been able to complete rides over 120 miles, however, lately the groin is tender and the leg very stiff (my right leg is fine) and getting worse not better which leads me back to my first paragraph.
I initially went to the osteopath as I thought it may be my back causing the issue but now I believe the groin is the cause.
I haven't ridden my bike in over a month and the symptoms haven't subsided.
The osteopath said if I continue with physio and the groin problem doesn't get better I should eventually get referred for a scan on the NHS, I can't go direct to a scan I have to go "round the houses" first.
Has anybody any experience of the symptoms I describe or what might be going on, the osteopath reckons it is in the area of the upper hamstring and lower abductor muscles around the pelvic area (or something like that)??
Cheers.

 

[fossyant]

Are you sure it's not a back issue - disks and the like ??? Sciatica is a nightmare - had it once only, but my mum had it for a while. I'd go to a private sports physio for an assessment - they will pick issues up and at least you can ask for a referral. I went private with my back, and they worked wonders.

My back has been scanned to death this last year, and I've been informed it's in great nick (the disks) other than the two vertebrae that broke and the squashed disk - basically at my age of mid/late 40's I would already be showing degenerative issues from the scans, I haven't, so he said you'll be good as an OAP (damage aside).

Might be worth a scan as I've got quite a few colleagues with back problems, and similar issues like you (although they don't exercise).

 

[Justinslow]

Are you sure it's not a back issue - disks and the like ??? Sciatica is a nightmare - had it once only, but my mum had it for a while. I'd go to a private sports physio for an assessment - they will pick issues up and at least you can ask for a referral. I went private with my back, and they worked wonders.

My back has been scanned to death this last year, and I've been informed it's in great nick (the disks) other than the two vertebrae that broke and the squashed disk - basically at my age of mid/late 40's I would already be showing degenerative issues from the scans, I haven't, so he said you'll be good as an OAP (damage aside).

Might be worth a scan as I've got quite a few colleagues with back problems, and similar issues like you (although they don't exercise).

Basically I've no idea! My osteopath could feel the "tightness" in the groin area and reckoned it was muscular rather than neurological from my back. I've been recommended a good sports injury guy from our local rugby club, maybe that's the way forward. Most of the "groin strain" stuff I've googled suggest "over use" and rest and cold compress etc so doing more stretching like I have been doing may be making the problem worse.

 

[fossyant]

Go see a physio. Mine works with rugby players. She identified all my issues, and the one I've used at work for my shoulder has advised about that.

The physio will work with it - certainly worth going !!! I have a huge dislike of GP's - they know very little.

 

[vickster]

+1 for seeing your rugby Physio guy

In the meantime perhaps your GP can refer you to a specialist sports physician?

 

[Justinslow]

Update, seems I have hamstring Tendinopathy!
Basically tendinitis of the upper hamstring.
private sports physio, NHS physio and self diagnosis by "google".
I've become more aware of the location of the trouble and aches and pains in other areas of the leg and groin are referred.
It's taken months to get this far.
I have to strengthen my core and hamstrings and glutes, with this I'm also having acupuncture massage and even "cupping" to try to speed up the process.
https://runnersconnect.net/running-...ing-tendinopathy-injuries-a-pain-in-the-butt/

Interestingly the article mentions the "sit bones" as this is where the tendons attach. I'm wondering if a poorly fitting saddle together with incorrect bike set up may have contributed to my condition?

I've hardly ridden since October, but am now going to definitely have a proper bike fit ASAP.

 

[vickster]

Do your bike fit via a Physio, your private sports Physio if offer, some bike shops have physios as fitters. Otherwise another sports Physio practice. Might need to travel a bit

 

[kingrollo]

aghhh - high hamstring tendonathapy is a complete bitch of an injury. I was off the bike with it for 3 years - in part due to misdiagnosis. In the end dry needling sorted it for me.......(well until a couple of weeks a go - its returned in a minor sense)
My advice:-
Bin any physio that recommends traditional hamstring stretches
Google and do daily 'one legged Romanian deadlifts' and other eccentric hamstring work
if you are not in pain - do very light cycling to keep things moving

let me know if you want any more info - I am not a physio - but have a lot of experience of this injury !

be careful of the bike fit - IME you will need you're saddle slightly lower than the fit will probably give.
bizarrely i found a brooks saddle really helped - you sit bones will feel exposed a saddle that gives all over like a brooks - stops the digging in which ocurred on plastic saddles..use chamios cream on every ride

 

[Justinslow]

aghhh - high hamstring tendonathapy is a complete bitch of an injury. I was off the bike with it for 3 years - in part due to misdiagnosis. In the end dry needling sorted it for me.......(well until a couple of weeks a go - its returned in a minor sense)
My advice:-
Bin any physio that recommends traditional hamstring stretches
Google and do daily 'one legged Romanian deadlifts' and other eccentric hamstring work
if you are not in pain - do very light cycling to keep things moving

let me know if you want any more info - I am not a physio - but have a lot of experience of this injury !

be careful of the bike fit - IME you will need you're saddle slightly lower than the fit will probably give.
bizarrely i found a brooks saddle really helped - you sit bones will feel exposed a saddle that gives all over like a brooks - stops the digging in which ocurred on plastic saddles..use chamios cream on every ride

Cheers for the info! Just hope mine can be sorted a bit quicker than that!
I've had this if I'm honest probably for about 9 months, ignoring it at first, but deteriorating so that I can barely tie my shoe laces on my left foot.
To be fair none of my physio people have recommended "old school stretches" but I have been doing a few, none of which have helped. All the rehab really has been directed at strengthening work, bridges etc, self massage with a roller or spikey ball, but I've really only got a handle on this in the last week, up to this point I didn't even know what was wrong.
My "private" physio used to work at Tottenham Hotspur's FC and is pretty confident we can turn it around fairly quickly, but we'll see!
I'm a self employed gardener so quite labour intensive depending on the job so it impacts my work too limiting my ability to bend over easily, and also quite possibly hindering my recovery as I often stretch a bit too much!

Edit, changed title of thread now I know the problem!

 

[ayceejay]

Are you dealing with an injury? Both Rugby and football are notorious for groin injuries and this is probably where the two people you mention got their experience. You should follow their advice but if it is an injury you need to fix it before moving on to the remedial stuff like stretching and strength work.

 

[Justinslow]

Are you dealing with an injury? Both Rugby and football are notorious for groin injuries and this is probably where the two people you mention got their experience. You should follow their advice but if it is an injury you need to fix it before moving on to the remedial stuff like stretching and strength work.

Well, I've not had an injury that I can think of, nothing that went "pop".
The NHS physio put me through a series of stretch and strength tests and none of them really induced any "pain" so they deduced that there was no serious injury.
Like I said it's more of a build up over a period of months.

 

[ayceejay]

Then it is more likely connected with your work. Do you use one leg more than the other when you are digging, say? You may want to have a serious look at the way you use your body at work. Also have a look at your posture as an imbalance here could put more pressure on one leg than the other. A qualified pilates instructor will help you with this.

 

[kingrollo]

basically its micro tears of your hamstring. normally these micro tears repair themselves - but tendonathapy arises when the tearing is haapening faster than the repairing - so just scar tissue.
Core strengh and ecentric hamstring exercises will correct pelvic alignment and muscle imbalances - and thus reduce the tension in the hamstring. However it won't boost the repair process so the tendonathapy will remain.
you will need (at the very least) cross frictional massage - if that doesn't work - Dry needling, and then PRP therapy are your next options.

This IS a serious injury - it ends the careers of many runners/joggers - and like I say I was off my bike with this for 3 years. Although half time I was being treated by some pratt who wasn't adamant it was a spinal disc problem (just overtalked me when i mentioned HHT !) - Once I got diagnosis it was about 18 months rehab - but even then it didn't progress until I started intense cross frictional massage.

 

[Justinslow]

Then it is more likely connected with your work. Do you use one leg more than the other when you are digging, say? You may want to have a serious look at the way you use your body at work. Also have a look at your posture as an imbalance here could put more pressure on one leg than the other. A qualified pilates instructor will help you with this.

I've been doing the gardening for exactly 10 years now with no issues apart from lower back ache, and I used to hit it hard in the early days like a bull in a China shop. I've calmed down a lot with age and experience! My cycling (properly) started in August of 2014 and I had completed my first 100 by that October. Then straight into a season of club TT racing with some some pretty big "base miles" rides. Onto the winter of 2015/16 and I hit the turbo like a man possessed. Some TT's a few more 100's including a couple of 125 milers and that brings us to now.
If it's anything I would guess it's my cycling!
I've never had a proper bike fit, guessed the size of my bike, bought a TT bike again no fit (now sold), maybe I'm paying for this now.
I fitted a Charge Spoon saddle a year ago too which I've been "enduring" I really don't think that was a good idea.

 

[Justinslow]

basically its micro tears of your hamstring. normally these micro tears repair themselves - but tendonathapy arises when the tearing is haapening faster than the repairing - so just scar tissue.
Core strengh and ecentric hamstring exercises will correct pelvic alignment and muscle imbalances - and thus reduce the tension in the hamstring. However it won't boost the repair process so the tendonathapy will remain.
you will need (at the very least) cross frictional massage - if that doesn't work - Dry needling, and then PRP therapy are your next options.

This IS a serious injury - it ends the careers of many runners/joggers - and like I say I was off my bike with this for 3 years. Although half time I was being treated by some pratt who wasn't adamant it was a spinal disc problem (just overtalked me when i mentioned HHT !) - Once I got diagnosis it was about 18 months rehab - but even then it didn't progress until I started intense cross frictional massage.

Yes which is why I'm now having fairly regular sports massage and rolling around like a dog scratching its ar## on my carpet with a roller and a spikey ball!
My physio (private) is a firm believer in acupuncture and cupping so I'm hoping this can only help. Btw those one legged deadlifts were recommended to me too along with one legged bridge raises so similar stuff. The NHS physio didn't think much to paying for massage acupuncture or cupping though, they said I could do it all with a roller at home which I don't agree with, that simply doesn't compare with a good massage!