Proximal Hamstring: Episode 75
In this episode: Having a pain in the butt? There is a good chance you are dealing with an injury to your proximal hamstring.
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Brief overview of the episode:
The proximal hamstring is the portion closest part to your buttocks. All three muscles of the hamstrings attach to the ischial tuberosity. Which is sometimes referred to as the sits bone. This is the bone you sit on when you are riding a bicycle. An injury to this area will feel like a pain in the buttocks.
Injuries in this area can include tendonitis, tendonosis, avulsions and bursitis. These types of injuries tend to be more irritate and as such can become chronic.
Mechanics of injury is the same for proximal hamstring injuries as it is for muscle belly or distal hamstring injuries. An eccentric contraction with the hip flexed and the knee extended. Putting the hamstring in it longest length. This is most common with slips and falls as well as from sports.
Avulsion fractures of the ischial tuberosity are starting be to seen more often. With an avulsion a small portion of the bone is fractured off, but remains connected to the tendon. In most cases this can not be feel or seen without the use of an MRI. Best evidence at this time has found that most avulsions will heal without the need for surgical intervention.
A good way to differentiate between an avulsion and tendonitis is when performing eccentric contractions of the hamstring. With repeated exercise a tendonitis will improve an avulsion however, will not.
As with most injuries if you suspect some has occurred it is always a good idea to have it check out earlier rather than later to prevent it becoming a chronic issues that will take much longer to heal.
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