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Proximal hamstring tendinopathy

Ke-Vin Chang, Wei-Ting Wu, Henry L Lew, Levent Özçakar
Ultrasound has emerged as one of the most utilized tools to diagnose musculoskeletal disorders and to assist in interventions. Traditionally, sonographic examination of the hip joint has been challenging because most of the major structures are deeply situated, thus requiring the use of curvilinear transducer for better penetrance. The posterior lateral hip is a frequent area for musculoskeletal pain and nerve entrapments. Common disorders include greater trochanteric pain syndrome, gluteus medius tendinopathy, piriformis syndrome, pudendal neuralgia, and proximal hamstring tendinopathy...
April 2018: American Journal of Physical Medicine & Rehabilitation
Vasileios Korakakis, Rodney Whiteley, Alexander Tzavara, Nikolaos Malliaropoulos
OBJECTIVE: To evaluate extracorporeal shockwave therapy (ESWT) in treating Achilles tendinopathy (AT), greater trochanteric pain syndrome (GTPS), medial tibial stress syndrome (MTSS), patellar tendinopathy (PT) and proximal hamstring tendinopathy (PHT). DESIGN: Systematic review. ELIGIBILITY CRITERIA: Randomised and non-randomised studies assessing ESWT in patients with AT, GTPS, MTSS, PT and PHT were included. Risk of bias and quality of studies were evaluated...
March 2018: British Journal of Sports Medicine
Lincoln Paiva Costa, Antônio Augusto Guimarães Barros, Carlos Cesar Vassalo, Bertrand Sonnery-Cottet, Victor Atsushi Kasuya Barbosa, Eduardo Frois Temponi
INTRODUCTION: Proximal hamstring tendinopathy (PHT) is the result of chronic overload caused by repetitive eccentric contraction. Surgical treatment becomes an option for patients with chronic symptoms that do not respond to conservative treatment. CASE REPORT: This report describes a case of a 48-year-old man, an amateur triathlete, with deep gluteal pain in the left hip for 12 months, leading to a decline in sports performance. Magnetic resonance imaging revealed abnormalities that suggested a PHT...
November 2016: Journal of Orthopaedic Case Reports
Nicholas R Beatty, Ioonna Félix, Jessica Hettler, Peter J Moley, James F Wyss
Proximal hamstring tendinopathy (PHT) comprises a small but significant portion of hamstring injuries in athletes, especially runners. PHT is a chronic condition that is clinically diagnosed but can be supported with imaging. The main presenting complaint is pain in the lower gluteal or ischial region that may or may not radiate along the hamstrings in the posterior thigh. There is little scientific evidence on which to base the rehabilitation management of PHT. Treatment is almost always conservative, with a focus on activity modification, addressing contributing biomechanical deficiencies, effective tendon loading including eccentric training, and ultrasound-guided interventional procedures which may facilitate rehabilitation...
May 2017: Current Sports Medicine Reports
Gabriele Mattiussi, Carlos Moreno
BACKGROUND: Proximal Hamstring Tendinopathy-related Sciatic Nerve Entrapment (PHTrSNE) is a neuropathy caused by fibrosis interposed between the semimembranosus tendon and the sciatic nerve, at the level of the ischial tuberosity. METHODS: Ultrasound-guided Intratissue Percutaneous Electrolysis (US-guided EPI) involves galvanic current transfer within the treatment target tissue (fibrosis) via a needle 0.30 to 0.33 mm in diameter. The galvanic current in a saline solution instantly develops the chemical process of electrolysis, which in turn induces electrochemical ablation of fibrosis...
April 2016: Muscles, Ligaments and Tendons Journal
Patrick J Battaglia, Kevin D'Angelo, Norman W Kettner
OBJECTIVE: The purpose of this study was to present a narrative review of the literature of musculoskeletal causes of adult hip pain, with special attention to history, physical examination, and diagnostic imaging. METHODS: A narrative review of the English medical literature was performed by using the search terms "hip pain" AND "anterior," "lateral," and "posterior." Additionally, specific entities of hip pain or pain referral sources to the hip were searched for...
December 2016: Journal of Chiropractic Medicine
S M Thompson, S Fung, D G Wood
PURPOSE: Injury to the proximal hamstring complex (PHC) is becoming more frequently diagnosed. Patients attending our tertiary referral centre demonstrated 'pathological changes' in the unaffected normal contralateral PHC on MRI. The prevalence of PHC pathology, however, has not been previously documented in the literature in asymptomatic subjects. It is the hypothesis of this study that the natural history of asymptomatic pathological change on MRI in the PHC is not clear. The aim is to quantify the natural history of PHC degeneration...
January 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Samuel K Chu, Monica E Rho
Hamstring injuries are very common in athletes. Acute hamstring strains can occur with high-speed running or with excessive hamstring lengthening. Athletes with proximal hamstring tendinopathy often do not report a specific inciting event; instead, they develop the pathology from chronic overuse. A thorough history and physical examination is important to determine the appropriate diagnosis and rule out other causes of posterior thigh pain. Conservative management of hamstring strains involves a rehabilitation protocol that gradually increases intensity and range of motion, and progresses to sport-specific and neuromuscular control exercises...
May 2016: Current Sports Medicine Reports
Thomas S H Goom, Peter Malliaras, Michael P Reiman, Craig R Purdam
Synopsis Proximal hamstring tendinopathy (PHT) typically manifests as deep buttock pain at the hamstring common origin. Both athletic and nonathletic populations are affected by PHT. Pain and dysfunction are often long-standing and limit sporting and daily functions. There is limited evidence regarding diagnosis, assessment, and management; for example, there are no randomized controlled trials investigating rehabilitation of PHT. Some of the principles of management established in, for example, Achilles and patellar tendinopathy would appear to apply to PHT but are not as well documented...
June 2016: Journal of Orthopaedic and Sports Physical Therapy
C J Barton, D R Bonanno, J Carr, B S Neal, P Malliaras, A Franklyn-Miller, H B Menz
IMPORTANCE: Running-related injuries are highly prevalent. OBJECTIVE: Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries. DESIGN: Mixed methods. METHODS: A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining...
May 2016: British Journal of Sports Medicine
Luke T Nicholson, Steven DiSegna, Joel S Newman, Suzanne L Miller
BACKGROUND: Proximal hamstring tendinopathy is an uncommon but debilitating cause of posterior thigh pain in athletes subjected to repetitive eccentric hamstring contraction, such as runners. Minimal data exist evaluating treatment options for proximal hamstring tendinopathy. PURPOSE: This retrospective study evaluates the effectiveness of fluoroscopically guided corticosteroid injections in treating proximal hamstring tendinopathy. STUDY DESIGN: Case series; Level of evidence, 4...
March 2014: Orthopaedic Journal of Sports Medicine
Jon A Jacobson, Joshua Rubin, Corrie M Yablon, Sung Moon Kim, Monica Kalume-Brigido, Aishwarya Parameswaran
OBJECTIVES: Percutaneous ultrasound-guided needle fenestration has been used to treat tendinopathy of the elbow, knee, and ankle with promising results. The purpose of this study was to evaluate the clinical outcome of ultrasound-guided fenestration of tendons about the hip and pelvis. METHODS: After Institutional Review Board approval, a retrospective search of imaging reports from January 1, 2005, to June 30, 2011, was completed to identify patients treated with ultrasound-guided tendon fenestration about the hip or pelvis...
November 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Kathleen L Davenport, Jose Santiago Campos, Joseph Nguyen, Gregory Saboeiro, Ronald S Adler, Peter J Moley
OBJECTIVES: To compare the effects of ultrasound-guided platelet-rich plasma (PRP) and whole blood (WB) injections in patients with chronic hamstring tendinopathy. METHODS: In a prospective double-blind randomized controlled trial, PRP or WB was injected under ultrasound guidance into the proximal hamstring tendon in a cohort of patients with clinically suspected hamstring tendinosis. Questionnaires were administered before injection and 2, 6, and 12 weeks and 6 months after injection...
August 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Daniel Cushman, Monica E Rho
STUDY DESIGN: Case report. BACKGROUND: Proximal hamstring tendinopathy in runners is characterized by pain with passive hip flexion with the knee extended, active hip extension, and pain with sitting. Relatively little literature exists on the condition, and publications on nonsurgical treatment protocols are even more scarce. Surgical intervention, which comprises the majority of literature for treatment of this condition, is an option for cases that fail to respond to nonsurgical treatment...
July 2015: Journal of Orthopaedic and Sports Physical Therapy
Lasse Lempainen, Kristian Johansson, Ingo J Banke, Juha Ranne, Keijo Mäkelä, Janne Sarimo, Pekka Niemi, Sakari Orava
BACKGROUND: proximal hamstring tendinopathy (PHT) is a disabilitating disease often causing underperformance in the athletically demanding patients. The main symptom of PHT is lower gluteal pain especially during running or while prolonged sitting. Mainly affecting athletically active individuals, PHT is a considerable challenge for treating health care professionals. PURPOSE: this paper aims to concisely present the literature on PHT to guide health care professionals treating these patients and doing research on the subject...
January 2015: Muscles, Ligaments and Tendons Journal
Ryan R Fader, Justin J Mitchell, Shaun Traub, Roger Nichols, Michelle Roper, Omer Mei Dan, Eric C McCarty
BACKGROUND: chronic proximal hamstring tendinopathies is a disabling activity related condition. Currently, there is no well-accepted or extensively documented non-operative treatment option that provides consistently successful results. PURPOSE: to evaluate the efficacy of ultrasound guided platelet-rich plasma injections in treating chronic proximal hamstring tendinopathies. METHODS: a total of 18 consecutive patients were retrospectively analyzed...
October 2014: Muscles, Ligaments and Tendons Journal
Matthias J Feucht, Johannes E Plath, Gernot Seppel, Stefan Hinterwimmer, Andreas B Imhoff, Peter U Brucker
PURPOSE: The current study was undertaken to better define the gross anatomical and dimensional characteristics of the proximal hamstring origin. METHODS: Twelve paired whole-lower extremities from six embalmed cadavers were dissected. The gross anatomy of the proximal hamstrings was studied. With the tendons attached to the ischial tuberosity, the width and thickness of each tendon was measured 1 cm distally to their origin, and the distance from the most proximal border of the common origin of the semitendinosus (ST) and long head of the biceps (LB) to their distal junction was assessed...
September 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthew D Bucknor, Lynne S Steinbach, David Saloner, Cynthia T Chin
OBJECT: Extraspinal sciatica can present unique challenges in clinical diagnosis and management. In this study, the authors evaluated qualitative and quantitative patterns of sciatica-related pathology at the ischial tuberosity on MR neurography (MRN) studies performed for chronic extraspinal sciatica. METHODS: Lumbosacral MRN studies obtained in 14 patients at the University of California, San Francisco between 2007 and 2011 were retrospectively reviewed. The patients had been referred by neurosurgeons or neurologists for chronic unilateral sciatica (≥ 3 months), and the MRN reports described asymmetrical increased T2 signal within the sciatic nerve at the level of the ischial tuberosity...
August 2014: Journal of Neurosurgery
Dhinu J Jayaseelan, Nick Moats, Christopher R Ricardo
STUDY DESIGN: Case report. BACKGROUND: Proximal hamstring tendinopathy is a relatively uncommon overuse injury seen in runners. In contrast to the significant amount of literature guiding the evaluation and treatment of hamstring strains, there is little literature about the physical therapy management of proximal hamstring tendinopathy, other than the general recommendations to increase strength and flexibility. CASE DESCRIPTION: Two runners were treated in physical therapy for proximal hamstring tendinopathy...
March 2014: Journal of Orthopaedic and Sports Physical Therapy
Angelo Cacchio, Fosco De Paulis, Nicola Maffulli
BACKGROUND: There is a need for a patient-reported outcome (PRO) questionnaire to evaluate patients with proximal hamstring tendinopathy (PHT). OBJECTIVE: To develop a PRO questionnaire based on VISA questionnaire forms for patients with PHT. METHODS: Item generation, item reduction, item scaling and evaluation of the psychometric properties were used to develop a questionnaire to assess the severity of symptoms, function and ability to play sports in patients with PHT and healthy subjects...
March 2014: British Journal of Sports Medicine
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