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Hamstrings Tendinopathy

Causes, Symptoms, Treatments, and Other Resources

What are the Hamstrings?

Your hamstrings are the thick muscles in the back of your thigh that are responsible for the movement of your hip, thigh, and knee. The hamstrings are made of three distinct muscles:

  • Semitendinosus
  • Semimembranosus
  • Biceps Femoris

What is Hamstrings Tendinopathy?

Tendons are thick pieces of connective tissue that connect muscle to bone. They function to transfer the force generated by muscle contraction into movement.

Hamstring tendinopathy, also known as a “calf strain,” is an injury to the affected tendon. It usually occurs when you bend your knee or extend your leg, putting too much force on the hamstring tendon.

Causes of Hamstrings Tendinopathy

The most common cause of hamstring tendinopathy is overuse or activities that involve bending the knee and extending the hip such as running. Other factors include age, gender, heavy exercise, and extra body weight.

Hamstring injuries are one of the most common injuries in athletes. The hamstrings are responsible for knee flexion and hip extension, which are essential movements in running. Hamstring injuries can be caused by a variety of factors, such as overuse, sudden overload, increasing mileage or intensity too quickly, prior hamstring injury, poor flexibility, and muscle imbalance.

What are the Symptoms?

The symptoms of hamstring tendinopathy are a pain in the back of the thigh, swelling due to fluid buildup, difficulty straightening the knee joint, and sometimes a clicking feeling during flexing. Read about each below

Back of Knee Swollen

Back of knee swollen? Swelling in the back of the knee is not something that is talked about too often. It can be uncomfortable or sometimes painful with the movement of the knee or, even with rest. It often stems from an orthopedic-related issue or, perhaps some other medical condition. Let’s dive in…What’s Causes Swelling in the Back of Your Knee? The back of the knee contains a variety of anatomical structures that can be affected and result in pain, swelling, numbness, tingling, etc. Muscles and tendons behind the knee that could be the source of pain or pathology could be one or more of the following: Gastrocnemius, Soleus…

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Back of Knee Tight

Stiffness in the back of the knee can be a sign that there is damage or inflammation in the joint, arthritis, or a baker cyst. This might be due to an injury, overuse, or medical condition. If you are experiencing stiffness in your back knee, it is important to see a doctor determine the cause and get treatment. Common causes of stiffness in the back of the knee include: tight muscles, tendons, and ligaments, Injury to the joint or surrounding tissue, overuse such as from running or biking for long periods. Stiffness at night can potentially indicate damage to the joint…

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Bruising in Knee

Bruising in the knee, also known as a knee contusions, is an uncomfortable yet common condition that occurs when you strike your knee with force or a symptom of a knee condition. When the tiny blood vessels are damaged and blood leaks out beneath the skin, causing the typical swelling and red/purple discoloration seen in these injuries, it is termed a bruise or contusion. Although a knee contusion does not usually require medical intervention, you may need to visit your doctor to ensure that you do not have a more significant problem. If you hurt your knee and have swelling/pain that gets worse instead of better…

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Fibular Head Pain

The proximal fibula is the part of the bone that lives just below the knee joint on the outside. It’s attached to the leg bone (tibia) via strong ligaments and there is a small joint here. There are many things that attach here, so it’s a critical point where pain can occur. There is a small joint between the fibula and the tibia known as the proximal tibiofibular joint. This is a plane-type joint which allows some sliding of the fibula on the tibia. It has cartilage just like the knee joint, so it can get arthritis which means worn down cartilage and bone spurs.

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Gluteus Medius Pain

The gluteus medius is one of the major muscles in your buttock and hip. There are three gluteal muscles you have probably heard about: They layer one upon the another much like a layer cake. The gluteus minimus is closest to the body followed by the gluteus medius and then the larger gluteus maximus.Gluteus Minimus – The gluteus minimus is the smallest of the three gluteal muscles. It is a small triangular muscle that lies underneath its bigger brother, the gluteus medius. It functions to stabilize the hip, rotate the thigh, and move the hip in an outward direction.Gluteus Medius -A powerful muscle that starts at the backside of your waist bone…

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Hamstring Pain Behind Knee

Hamstring pain behind the knee is a real problem, but many people are unaware of its severity. The hamstring muscle group spans the back of the thigh and consists of three muscles – Biceps Femoris, Semimembranosus, and Semitendinosus. Pain in the posterior aspect/backside of the knee has to do with one of three hamstring muscles. These can be roughly categorized as follows: Pain in the lower portion of the hamstring (semitendinosus and semimembranosus) is typically due to an injury sustained at their origin, or where they attach; this may be referred to as ‘insertional pain’. Pain located in the middle portion of the hamstring…

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Hamstring Pain when Sitting

The hamstring is composed of the three long muscles that are found on the back of the upper leg. These are semitendinosus, semimembranosus, and biceps femoris. All three muscles run down the length of the thigh before they join together to become one tendon that attaches itself to the backside of the lower leg bone, called the Fibula. When these tendons contract it pulls the lower leg downwards towards our feet. The muscle contracts concentrically as it shortens. And relaxes eccentrically as it lengthens. This contraction action is also known as knee flexion. When these muscles are weak or injured it can be difficult to stand on…

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Knee Pain

Knee pain can be caused by many factors. Overuse injuries, direct trauma to the knee and arthritis are the most common causes of knee pain. Damage to the knee structures may cause swelling, scar tissue formation (fibrosis), and loss of function of the joint. Pain is often accompanied by difficulty walking, weakness, and instability. When the knee is overused, the thigh and shin bones (femur and tibia), cartilage, or tendons may experience stress. This leads to pain and discomfort as well as stiffness in the knee. Overuse injuries are common among athletes who participate in sports that involve running, jumping…

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Knee Swelling

Swelling of the knee, also known as water on the knee, is a condition in which fluid collects around the knee joint. Swelling can occur for a variety of reasons and affect patients of any age. Some swelling can be treated with over-the-counter medicines, but persistent and continuous swelling might result in tissue damage, bone softening, and cartilage deterioration. Over-the-counter medicines will assist relieve pain for individuals with a history of osteoarthritis and swelling following physical activity, such as exercise or running. During and after activity, the patient may apply compression sleeves to reduce the inflammation. Ice is another method…

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Lower Back Pain When Sitting

After a long day on your feet sitting down is supposed to be way to relaxing. Unfortunately for some sitting for any length of time can be painful. Most people experience low back pain at some point in their life. The lifetime prevalence of low back pain is 85% (1). Let’s take a deeper look at the different types of pain and causes of low back pain when sitting. Pain can present in many different ways. It can be intermitent or constant. The quality of the low back pain can also vary depending upon the actual source of injury. Common examples include: Sharp and Stabbing, Dull and Aching, Throbbing/ Pulsating, Pins and Needles, Burning, Electrical

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Lower Back Pain When Standing

When you’re seated, the facet joints in your lower back are in an open and slightly flexed position. When you stand up, these joints compress. If they are painful or have arthritis, you’ll have pain as you stand up because this puts pressure on the painful joints. In addition, if there is any type of movement of one vertebra forward on another (called spondylolisthesis), then this shift will have occurred as you sit. This is called degenerative spondylolisthesis. When you get back up, the vertebrae will come back into position after a few seconds, leading to that awkward “walk it out period” that starts out painful and ends up more normal.

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Pain Behind Knee

First off, this is where the hamstrings and calf muscles attach. They have tendons here that are inserted into the bone. So if there’s a problem in the muscle or the tendon, you’re going to feel it right here. This is also where deep muscles like the popliteus and plantaris live. So, if these have issues, you’re going to feel it in the back of the knee. In addition, the tibial nerve is back here. So if there’s an issue with a nerve in your back or a nerve locally, behind the knee, you’re going to feel it here. And the meniscus or the joint spacer lives back here. And the meniscus or the joint spacer lives back here. So a tear in the meniscus could cause pain…

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Tight Hamstrings & Calves

The hamstrings are a group of muscles in the upper leg. They are located on the backside of the upper leg and are comprised of three muscles:  biceps femoris, semitendinosus, and semimembranosus.  The calf muscles are located on the backside of the lower leg and are comprised of two muscles: the gastrocnemius and soleus.  Tight hamstring and calf muscles can be painful, limiting someone mobility.  They also make lower extremity muscles more vulnerable to injuries.  Tight hamstrings and calves can arise from different sources which include: medication, muscle and tendon injury, overuse, muscle imbalance, dehydration, poor posture, low back injury…

Read More About Tight Hamstrings & Calves

Tightness in Knee

What could tightness in your knee mean? When fluid builds up inside the knee as a result of an injury, overuse, or medical problem, the knees become swollen and tight. Swelling might be mild, so you may not always notice it unless it is serious damage. You may feel this as stiffness in the knee since swelling may not be visible. Swelling restricts movement since there is less room in the knee. Fluid buildup can be caused by irritation, internal bleeding, and injuries to the knee. Arthritis, gout, tumors, and baker cysts are all causes of swelling. Pain and swelling are the responses of your body to damage. Together they can lead to stiffness in your knee…

Read More About Tightness in Knee
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What are the treatment options?

There are various treatment options available for this condition, including rest, medication, injections, or surgery.

NSAIDs

The other day I was evaluating a patient and reviewing the treatment options for their spine condition.  After discussing prior treatments, we got to the topic of medications taken for pain relief. She explained that she mainly utilized anti-inflammatory (NSAID) medications and then she told me to hold much she takes and has been for many years…..she takes close to 2 grams (2000 milligrams) on a daily basis which equated to about 9-10 capsules of medication per day.  I was shocked, considering she was pre-diabetic and with high blood pressure plus the kicker of it is that her PCP (primary care physician) is ok with this…

Read More About NSAIDs

PRP Knee Injections

PRP stands for Platelet-Rich Plasma. Platelets are blood cells that prevent bleeding. They contain important growth factors that aid in healing. Plasma is the light yellow liquid portion of our blood. So PRP is simply a concentration of a patient’s own platelets that are suspended in plasma and are used to accelerate healing. PRP is NOT stem cell therapy. Regrettably, blood contains few circulating stem cells. Rich sources of stem cells are bone marrow and fat. PRP is rich in growth factors. There are many different types of growth factors with different properties. VEGF is a very important one as it can increase the blood flow to an area.

Read More About PRP Knee Injections

Our Doctors That Can Assist With Hamstrings Tendinopathy

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Mairin Jerome, MD

Mairin Jerome, MD

Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.

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Other Resources on Hamstrings

Free Download: The Knee Owner’s Manual

This e-book by Dr. Chris Centeno examines the knee and its role in the human musculoskeletal system and the body as a whole. The Knee Owner’s Manual provides a series of tests and clearly defined exercises that you can perform on your own to assess and monitor your own knee health. It will allow you to look for trouble spots where your own body may be having difficulty with stability, articulation, symmetry, and neuromuscular function. You’ll be able to see how these deficits in other regions of the body relate to the knee.

The Knee Owner’s Manual also discusses how Regenexx is pioneering the development of interventional orthopedics, a new branch of medicine that employs regenerative biologic therapies such as adult bone marrow concentrate and platelet-rich plasma to help repair and strengthen damaged tissues in other areas of the body.

This is contrasted with invasive knee surgeries, which often remove important tissues or replace the entire knee itself when it becomes damaged. With hyperlinks to more detailed information, related studies, and commentary, this book condenses a vast amount of data, images, and resources into an enjoyable and informative read. This is the first edition of The Knee Owner’s Manual, a companion book to Orthopedics 2.0.

  • Surgical Complications: A Tale that is Seldom Told

    Specialized doctor discusses pulomonary embolism after knee surgery requiring long term anti-coagulation.

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