Overcoming Proximal Hamstring Tendinopathy

Join us as we dive deep into the intricacies of proximal hamstring tendon (PHT) avulsions, a condition that affects athletes and non-athletes alike. Our esteemed guests, Dr. Alex Hardy and Dr. Nicolas Lefevre, break down the anatomy, causes, and cutting-edge management strategies for this challenging injury.Special Guests:Dr. Alex Hardy – Renowned surgeon specializing in PHT avulsions, passionate about advancing surgical techniques and patient outcomes.Dr. Nicolas Lefevre – A seasoned sports surgeon with over 20 years of experience, known for his expertise in complex proximal hamstring injuries.Key Discussion Points:What is an Avulsion?Discover how tendon detachment from the sit bone occurs, the sports and everyday scenarios that can lead to this painful injury, and why understanding it is crucial for proper management.Diagnosis and the Importance of MRI:Learn why MRI is the gold standard for diagnosing PHT avulsions and why ultrasound may lead to misdiagnosis. Understand the key indicators on scans that differentiate between minor injuries and those requiring urgent care.Surgical vs. Conservative Treatment:When is surgery necessary? Explore the criteria that guide the decision for surgical intervention, including timing, severity, and the patient’s lifestyle.Delve into conservative management strategies, including physical therapy and PRP injections, and when these might be the right choice.Rehabilitation Post-Surgery:Get insights into the rehabilitation process, from initial rest to progressive exercises, ensuring a full recovery and return to activity.Understand the importance of a gradual return to sport and how to prevent re-injury.Risk Factors for Re-Rupture:Uncover the major risks associated with delayed surgery and how they impact long-term outcomes. Learn what patients can do to minimize these risks and ensure a successful recovery.Additional Insights:PRP Injections for Tendinopathy: Explore the potential benefits and limitations of PRP injections in treating chronic hamstring tendinopathy.The Myth of Scar Tissue: Clarify common misconceptions about scar tissue’s impact on the sciatic nerve and learn what really happens during healing.Real Stories and Case Studies: Hear compelling real-life cases that illustrate the challenges and triumphs of managing PHT avulsions.Website: https://www.chirurgiedusport.com/en/specialty/hip/?_specialite=hamstrings Email: hamstring@chirurgiedusport.comResearch Papers:  Magnetic resonance imaging should be the first-line imaging modality for investigating suspected proximal hamstring avulsion injuriesValidation of the Parisian Hamstring Avulsion Score (PHAS) in the Evaluation and Follow-up of Patients Operated for Proximal Hamstring AvulsionPredictors of Early Return to Sport After Surgical Repair of Proximal Hamstring Complex Injuries in Professional Athletes: A Prospective Study🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info

In this episode, we dive into Lily's incredible journey of overcoming proximal hamstring tendinopathy (PHT). Lily shares her unique and challenging experience, from the onset of her symptoms to the various treatment approaches she explored and her eventual recovery. Her story is one of resilience, learning, and finding the right path to healing.Key Takeaways:Introduction to Lily:Lily, originally from the Netherlands and now residing in London, shares her active lifestyle, including tennis, hiking, and Pilates. Despite her vibrant routine, she faced an unexpected setback with her injury.Onset of Symptoms:Lily's PHT symptoms began unusually, with initial hip pain diagnosed as ischial femoral impingement. A medical injection intended to alleviate pain inadvertently exacerbated her condition, leading to intense pain and significant limitations in daily activities.Initial Treatment and Challenges:Initial treatments involved minimal exercises and gentle massages, which provided temporary relief but did not lead to significant improvement. Lily struggled with the limitations imposed by her condition, impacting both her professional and personal life.Breakthrough in Recovery:A pivotal moment in Lily's recovery was finding the podcast and realizing the importance of structured exercise and gradual load management. She began a more focused rehabilitation program, which included targeted exercises like bridges, deadlifts, and prone curls.Mental and Emotional Journey:The journey was not just physical but also mental. Lily had to overcome fear and anxiety related to pain and re-injury. She learned to focus on positive progress rather than dwelling on setbacks, which significantly contributed to her recovery.Successful Rehabilitation:Through consistent effort and a well-structured rehab plan, Lily saw rapid improvements. She was able to return to her active lifestyle, including sitting for extended periods, a significant challenge for her earlier.Ongoing Management:Lily continues to maintain her progress with routine exercises, ensuring that she keeps her hamstring strength up and her symptoms at bay. She also highlights the importance of balancing exercise and rest.Advice for Others:Lily emphasizes the importance of education and structured rehab, encouraging others not to lose hope during challenging times. She highlights the value of focusing on incremental improvements and maintaining a positive outlook.Final Thoughts: Lily’s story is a testament to the power of perseverance, proper guidance, and the right rehabilitation strategy. Her experience offers valuable insights for anyone dealing with PHT or similar injuries, providing hope and practical advice for recovery.Resources Mentioned:Podcast episodes on PHT recovery and rehabilitation strategies.Online support groups and communities for individuals dealing with PHT.Listen Now: Tune in to hear Lily's full story and gain insights into how you can navigate your own recovery journey. Don't miss this inspiring and informative episode!🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info

🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉Brodie reviews a paper titled: Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysisBook a free 20-min physio chat hereJoin our community of PHT rehabbers with our PHT Monthly MembershipIf you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online 

Brodie answers the following membership questions:Janine:1.) Rest days: I've been religious about rest days for months but I've just been out for a short slow mile to start the day and it reminded me how good a daily run streak can feel with a short slow trot on the days you don't have anything else planned.How important are full rest days?2.) Xmas events are starting to interfere with my training schedule. If I am having to cut sessions my sense is I should prioritise a weights session over a run but just looking for some advice on balancing.Melissa3.) I have been told over the years several times by PTs doctors and read it online that tight hips and hip flexors will create a pelvic tilt that pulls on the hamstring and will aggravate PHT or may have even caused PHT. Is this accurate information?4.) How do you know when to increase your weights in your strength training program? It has been several weeks/months since I have increased any of my weights, but they still feel challenging. After my last flare-up, my baseline never returned to a 0 pain, and hovers between a PL1 or 2 and sometimes sitting for really long periods can be a bit uncomfortable again.🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉Book a free 20-min physio chat hereJoin our community of PHT rehabbers with our PHT Monthly MembershipIf you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online 

In this episode, Idelkys shares her journey through proximal hamstring tendinopathy, a challenge that began during the COVID-19 lockdown. From her initial symptoms in early 2021, she discusses the evolution of her condition, the various treatments she underwent, and her eventual progress with a combination of shockwave therapy, steroid injections, and guided strength training.Key Points Discussed:The Onset of Symptoms: Idelkys first noticed symptoms while intensifying her workout routines during the lockdown, starting with a sharp pain during a single-leg deadlift.Seeking Professional Help: After worsening symptoms, Idelkys visited a physiotherapist and later a doctor who prescribed MRIs and diagnosed her with proximal hamstring tendinopathy.Treatment Journey: Idelkys' treatment included shockwave therapy and steroid injections, with limited success initially. She faced challenges with pain management and mobility, significantly impacting her daily life.Strength Training and Rehabilitation: Transitioning to strength training proved crucial. She began incorporating specific exercises like deadlifts, crab walks, and Bulgarian splits, which helped improve her condition significantly.Mental Health and Persistence: Idelkys speaks on the psychological challenges of dealing with chronic pain and the importance of mental resilience and patience throughout the recovery process.Current Routine and Progress: She now maintains a balanced routine of strength training and running, which has allowed her to manage symptoms and engage in activities like half-marathons with minimal discomfort.Her experience underscores the necessity of appropriate and timely medical interventions and the significant role of strength training in recovering from tendon-related injuries. Her journey is a testament to the power of resilience and the critical role of self-education in managing health challenges.Book a free 20-min physio chat here🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online 

Brodie answers these PHT questions:Sandrine: Two weeks leading to race day I typically stop all lower body strength exercises. That is when I sometimes feel a little ache in the proximal hamstring. Now I do some deadlifts which helped up to a week leading to race day. I know body weight exercises like squats will not help but I want to hear your thoughts about body weight squats leading to race day?Lara: Any issues with strength training quads and glutes while rehabbing pht?Jeff: Does sitting prevent healing from PHT?  If I have a desk job with PHT, should I invest in a standing desk?Michelle: For those of us who are recovering from proximal hamstring tendon tears how do we prevent future tears or inflammation?Jason: Do you think some people have a genetic disposition to tendonopathies, I’m currently going through PHT and have had various other tendonopathies throughout my life.Siân: I would love to hear your thoughts on whether some of us are more at risk of tendon issues than others. I read that women are at higher risk when we get to peri/menopause too. Thoughts? What can I do to prevent any more?Patrick:Anything about ischial bursitis/swelling of the sit bone🙏🙏. The constant inflammation is driving me crazy.Louise:I have partial tears but a surgeon said it was my spine, not hamstring. 3 Sports docs don't agree. I just go around the circuit of physio, sports docs etc. I'm about ready to go out of province or country for help. Any suggestions?Fabienne: How come my MRI showed severe tendinitis in hamstring and glute tendons but I never had pain? (Until full avulsion)Maria: Approximately how long does it take to get full strength in your tendon following tenodesis surgery? Book a free 20-min physio chat here🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online 

In today's episode, we delve deep into the world of tendinopathy research with Miles Murphy, a renowned physiotherapist, neuroscience, and lower limb injury researcher. Together with Ebony Rio, they've published influential work that could change how tendinopathies are managed.Key Highlights:Understanding Tendinopathy: Miles Murphy provides a thorough overview of the history, physiology, and pathology of tendinopathies, emphasizing the complexity and nuances of tendon injuries.Innovative Research: The discussion includes insights into recent groundbreaking papers that challenge and expand our understanding of tendinopathy management.Treatment Modalities Explored: Various treatments such as PRP, corticosteroid injections, and shockwave therapy are critically evaluated, with a focus on their effectiveness and practical application in clinical settings.Load Management: The core of tendinopathy management, according to Murphy, revolves around appropriate load management, highlighting the importance of understanding and adjusting the mechanical load on tendons for optimal recovery.Future Directions: The episode concludes with a forward-looking discussion on the potential future directions in tendinopathy research and management, including the development of new outcome measures and a better understanding of pain mechanisms associated with tendon issues.Book a free 20-min physio chat here🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online

In this enlightening episode of the Smarter Scholars podcast, we delve into the intricate world of understanding and overcoming various types of pain. Drawing inspiration from the Huberman Lab podcast and personal experiences, this episode offers a comprehensive look at the physical and psychological aspects of pain, providing listeners with practical strategies and tools to manage and overcome pain effectively.Key Discussion Points:Understanding Pain:Brodie shares a personal experience of a minor accident while running, leading to a broader discussion on the nature of pain.Pain is fundamentally a brain output, regardless of its acute or chronic nature.It's vital to understand that pain receptors, or nociceptors, can only detect heat, pressure, and pH changes, emphasizing the brain's role in interpreting these signals.Strategies for Overcoming Pain:The episode highlights effective interventions for chronic pain, such as intentional distraction, mindfulness-based stress reduction (MBSR), and cognitive reframing.These strategies emphasize the importance of not just sensory experience but also emotional states in managing pain.Psychological Aspects of Pain:The discussion delves into how catastrophization and personality traits like optimism can significantly affect pain perception and recovery.The role of psychological factors, including stress, anxiety, and past traumas, is explored in relation to pain experiences.Role of Physical Therapy and Other Treatments:The episode touches on various treatment options for chronic pain, including medications, nerve blocks, psychological therapies, physical and occupational therapy approaches, complementary alternative medicines, and self-empowerment strategies.The critical role of physical therapists in pain management and recovery is highlighted.Nutrition and Pain:The conversation extends to the impact of nutrition on pain and recovery, emphasizing the importance of anti-inflammatory diets and identifying food triggers.Journaling Protocol for Pain Management:Based on another Huberman Lab podcast episode, a specific journaling protocol is discussed as an effective tool for managing chronic pain and mental health.Conclusion:The episode concludes with a comprehensive understanding of pain, emphasizing that it's not only a physical sensation but also deeply intertwined with our emotional and psychological states. By exploring various methods, including intentional distraction, mindfulness, cognitive reframing, and practical approaches like physical therapy and nutrition, listeners are equipped with a diverse array of tools to confront and manage their pain effectively.Book a free 20-min physio chat here🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online

Today we learn all about Ischiofemoral impingement syndrome and whether you have it instead of PHT or if you have it alongside your PHT. We dive into the clinical presentation, diagnostic tests and potential treatments along with the recent research on the topic. Paper 1: Ischiofemoral impingement syndrome masked by proximal hamstring tendinopathy as a cause of gluteal pain in a marathon runnerPaper 2: Ischiofemoral Impingement Syndrome: Clinical and Imaging/Guidance Issues with Special Focus on UltrasonographyBook a free 20-min physio chat here🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online

Jennifer's PHT Success Story: A Deep Dive into Overcoming Proximal Hamstring TendinopathyIn this episode, we sit down with Jennifer, a passionate runner from Fort Collins, Colorado, who shares her inspiring journey of overcoming proximal hamstring tendinopathy (PHT). Discover the challenges she faced, the evidence-based treatments she explored, and how she busted widespread misconceptions about PHT.Episode Highlights:Introduction to Jennifer and PHTJennifer's athletic background and how she transitioned from soccer to running.Early signs of PHT and initial reactions.Jennifer's PHT JourneyThe onset of symptoms and initial treatments.The struggle with misdiagnosis and the frustration of recurring pain.Turning PointDiscovering the root cause of her symptoms.Adjusting her approach to treatment and rehab.Effective Treatments and StrategiesEvidence-based treatments that worked for Jennifer.The role of weightlifting and specific exercises in her recovery.Challenges and MisconceptionsCommon misconceptions about PHT and Jennifer's experience dispelling them.The psychological impact of long-term injury and finding identity beyond running.Success and Advice for OthersJennifer's return to trail running and her achievements post-recovery.Advice for runners facing similar challenges.Key Takeaways:Understanding PHT and the importance of accurate diagnosis.The significance of a tailored, evidence-based approach to treatment.The mental and emotional aspects of recovering from a long-term injury.Book a free 20-min physio chat here🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online