Physio Edge podcast with David Pope4 Mai 2016

046. Proximal hamstring tendinopathy with Tom Goom

Proximal hamstring tendinopathy (PHT) occurs in athletes, runners, weightlifters, and other athletes, as well as more sedentary patients, causing pain at the hamstring origin and limiting your patients ability to sit, run and continue to be active.

There are a number of structures that can contribute to pain in this area, and in this podcast, Tom Goom and David Pope discuss how to clearly identify PHT and differentiate it from lumbar spine referred pain, hip pain, sciatic nerve pain and other conditions.

Tom recently released an article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management with Peter Malliaras, Mike Reiman and Craig Purdam. We explore this article, and the research around PHT, and cover in detail:

Subjective clues to guide you towards diagnosis
Aggravating factors and 24 hour pain patterns
Differential diagnosis
Lumbar spine pain
How the lumbar spine could contribute to development of PHT
Hip pain
SIJ pain
Sciatic nerve pain
Development of PHT
Central sensitisation
Diagnostic tests for PHT
Hamstring tests
Other assessment tests
Functional tests
The value of palpation
Tests for involvement of the rest of the kinetic chain
Running assessment/gait analysis
Testing load tolerance
Biopsychosocial aspects of tendon recovery
Other advice for patients
Whether stretching is helpful
When your patient can return to running
Cross training
Does manual therapy have a role in the treatment of PHT?
Starting treatment (Stage 1)
When and how to progress rehabilitation (Stage 2)
Further rehabilitation progressions (Stage 3)
Advanced exercise progressions for high load sports
Exercises you can incorporate during the various stages
How long recovery will take

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Tags: running, hamstring, tendinopathy, tom goom, podcast, proximal, peter malliaras, craig purdam, mike reiman, treatment, assessment

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