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Hamstring Tendonitis- How long should you wait before running again?

posted over 4 years ago | Report

About seven weeks ago I injured one of my hamstring tendons, and I've been going to a physical therapist during my downtime, to work on strengthening and stretching exercises.

This is the seventh week of my running hiatus. I still feel some slight tenderness in the tendon occasionally, including the point at which it attaches to the bone below the knee, on the inside.

I'm probably not the only person on Dailymile who has experienced this type of tendon injury, so I thought I'd see if anyone out there has ever dealt with this. If you don't mind sharing your experiences, and what you did for recovery, I'd love to hear about it. This is the longest I've ever been sidelined for a running injury. If you've had a similar tendon problem, how long did you wait to run again? When a PT says, "Wait until you don't feel any more pain," is that a relative term, or is that literal?

What I feel now is discomfort. I've regained 15 degrees of flexibility since beginning PT. When I begin running again, I'll be doing it gradually, on a plan the PT wants me to follow, alternating walking and running.

I'm chomping at the bit to be out there again. If you have anything you can share, I appreciate it in advance!

28 posts

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  • Hi Kent,

    I am a cyclist, i too faced Hamstring pain (ie behind my knees) which happends during my long rides and takes a day to heal. Research says due to saddle height, crank distance or weak legs. Will consult a physiotherapist and keep you updated.

    Others please share your view on this!

    Cheers
    Vivek

    posted over 4 years ago

  • Hey, Thanks Vivek- I appreciate it! At the very least, it's interesting to know it's happened to someone else. Most people usually have trouble with the upper hamstring tendon...

    posted over 4 years ago

  • My issue was high hamstring tendonopathy and I had a PRP injection which really helped to speed the healing. PRP stands for Platelet Rich Plasma and is a relatively new treatment. The doctor takes about 30 cc of your blood and spins it to separate the plasma, which they then inject into the trouble spot. The theory is that the plasma is rich in healing platelets which when injected into a targeted area provide a concentrated source of natural healing. The injection doesn't feel good, and the injection site can be sore for days afterwards, but once that starts to resolve you should start to see improvement pretty rapidly. My orthopedist performed the procedure guided by ultrasound. The whole thing cost about $1600 but was covered by my insurance.

    posted over 4 years ago

  • I have this as well. I still run, I have a really good physical therapist, sport massage man and I ice, heat and use massage cream to ease pain. I recently started dynamic stretching this has helped a ton. I heat just before i run now. Good luck and dont five up.

    posted over 4 years ago

  • @Sharon- thanks for sharing this information- very interesting! I seem to be on a slow uphill climb, so hopefully that will continue. I am not sure I would have learned about this without your post- it never came up on any of my internet searches when I was researching therapies and strategies.
    @Janna- I appreciate the response! I knew I couldn't be the only person on Dailymile who has trouble with this, but it seems to be a rare injury here- most people seem to have hamstring muscle problems, instead of one of the tendons. I've been kind of shocked at how long it's taking to get better- in the past if I had trouble with anything, it usually got better within a couple of weeks. Thanks for the tips- I'll try heat and massage cream- and look into the dynamic stretching. Has it been a problem for a long time? I'm trying to figure out how long to expect this to hang around...

    posted over 4 years ago

  • Kent - This is a very stubborn and slow to heal injury because of the lack of blood flow to those tendons. I am going on my one year anniversary dealing with it myself. The first orthopedist I went to just told me flat out to stop running and take advil. Grrrrr.....I'm still mad at myself for listening to him! After a month I started running again and the pain returned. At this point I found an ortho who was a runner himself and fully understood my desire to keep running if at all possible. He got me through a half marathon with some PT, NSAIDS, and a cortisone injection. After that race, with the pain still there as bad as always, he did the PRP injection. Wow! It has been the first thing that has really worked for me. I would say that I am about 75% better and I am able to run as I normally do once again. I will probably need one more injection to get back to 100% but I am trying to see if I can recover fully without it even if it takes longer. My understanding is that these are micro-tears in the tendon, and due to the lack of circulation there just isn't an adequate supply of platelets to the area to fully heal it. I don't think that heat is the right way to go, ice is generally better at reducing the inflammation while the heat will increase the inflammation slowing the healing process. Try to ice it 3x a day for 15 minutes, find a doctor that does PRP in your area, and take some form of anti-inflammatory pain reliever like advil or motrin. Good Luck!

    posted over 4 years ago

  • I have experienced this a few times but in my left arm, commonly referred to as tennis elbow. It was caused by overuse lifting weights and I think brought on by increasing my weight a tad too fast.
    I did not stop lifting weights with that arm though, what I did was use less weight and continued to work my arm, albeit much slower. I found this actually helped the heeling process along in combination with ice and sports massage. Eventually I worked my way back up to the weight where the injury occurred. Today, so far so good :)
    I very rarely take anything for pain, it has to be very bothersome/painfull before I do.
    I can appreciate your feeling of chopping at the bit to get back out there.
    Hoping you have a speedy recovery, good luck!!

    posted over 4 years ago

  • in reply to what said:Kent - This is a very stubborn and slow to heal injury because of the lack of blood flow to those tendons. I am going on my one year anniversary dealing with it myself. The first orthopedist I went to just told me flat out to stop running and take... read more

    Hey Sharon- I should have been more specific, but you're absolutely right to point out the dangers of inappropriate use of heat. I would never apply it after a run, or on a new injury... in fact, I take a short ice bath on runs longer than 15 miles just to reduce the risk of injury. I really just meant I'd try using heat before stretching. I had a good conversation with my physical therapist about the use of heat before stretching. He would use an ultrasonic device to heat it up before stretching in his office, but he said I'd have difficulty getting heat to it because of the lack of circulation, and depth. One thing that worked for me was standing with my back to our woodstove before stretching... but those days are over now that Spring is here.

    I'm going to look into the PRP treatment- that sounds really promising. I'm glad to hear things are going so well for you. I did have one doctor tell me it could be as long as a year before I could run again. The orthopedic doctor and sports med doctors I went to after that didn't think it would take that long, but they did say I needed to be very careful ramping back up. It's good to know there is light at the end of the tunnel.

    posted over 4 years ago

  • in reply to what Rob O. said:I have experienced this a few times but in my left arm, commonly referred to as tennis elbow. It was caused by overuse lifting weights and I think brought on by increasing my weight a tad too fast. I did not stop lifting weights with that arm th... read more

    Thanks, Rob. Slowing down (similar to using less weight) has helped a lot. I find that if I don't warm up enough, or go too fast right now, the pain starts back up pretty quickly. All the responses really are helpful- it's good to know slow but steady will get me back where I want to be...

    posted over 4 years ago

  • Hi Kent,

    Having run 18 miles last September i woke to find my hamstring tendons to have been shortened drastically through earlier damage. It has taken me 6 months to get my tendons back to normal length and flexibility again. However, i am now trying to make strides to increase my running distances from my usual 1.5 miles of slow careful jogging to a few miles at a reasonable stride. I saw two sports injury specialists. The first just treated me for tendonosis and the second has given me a couple of deep tissue massages on my hamstring and upper calf. This has definitely helped. However, having strengthened it gradually i am still having occasional bother with tendonitis reemerging in different tendons.

    So, my only advice i can give you is to never believe your free of the injury until you run your next 15 miler pain free.

    I'd be grateful to hear if you have had any success in your treatment options. Thanks for posting as there doesn't seem to be much information on the topic.

    posted over 4 years ago

  • in reply to what Angus E. said:Hi Kent, Having run 18 miles last September i woke to find my hamstring tendons to have been shortened drastically through earlier damage. It has taken me 6 months to get my tendons back to normal length and flexibility again. However, i am now t... read more

    Hey, Angus. Thanks for your post. You're right- there really isn't a lot of helpful information about this online. It also seems to be more rare than Achilles tendon problems, which looks like it's the more common tendon problem runners face.

    The stretching exercises my physical therapist gave me to do three times a day have helped me get a lot of flexibility back. I completely understand your frustration- I've resigned myself to the fact that this will at least be a nagging problem for up to a year. It will get better, but everything I've read, and been told, is that tendon problems heal very slowly, and there isn't much that can be done to speed it up. (Although it sounds like Sharon has found something that has worked really well for her, and is definitely worth looking into.)

    I am going to start moving my mileage back up- I actually started this week. Once I get up to ten miles, I may start working on pushing the pace back up... slowly and carefully. I'll update this in a month or so, but feel free to send me a friend invite and follow my progress!

    posted over 4 years ago

  • So helpful to hear others share this injury. I have been trying to rehab what seems to be micro tears in hamstrings for over 6 months. I rehab with crosstraining and PT but struggle after every attempt to return to running, even with walk/run discomfort returns after several days. It seems to me that maybe I haven't given it enought time. The Internal Med and Ortho doc are quick to say stop running . I'm beyond frustrated....the search continues for a PT or trainer with helpful advice.

    posted over 4 years ago | edited over 4 years ago

  • Hi Kent,

    I've been tracking your progress to see what seems to be working for you, and seems you've done really well with your recovery. I took on board your long walking warm ups and warm downs, your run/walk approach, and have kept to running every other day. These three steps have worked great since taking them on board.

    From observing Kent's recovery i think my tendons were in slightly worse shape, however, the principals of a successful recovery seem to be the same. For anyone trying to recover from hamstring tendonitis i believe these three steps, along with ample stretching each day, are essential to you recovery. The first three or four months of recovery were never successful until i started this approach consistently.

    Hindsight would probably tell me that you should not aim to start running when your tendons are ever suffering from inflammation (or swelling), and a long period of rest (at least 1 or 2 months), however hard it may be, should be taken. Whether you should start running until your tendons have retained their full length is open to debate. My tendons took six months to return to their prior length. The shorter the tendons the easier irritation will reoccur, and this will essentially increase recovery time.

    I hope this information will help with your recoveries.

    Gus

    posted over 4 years ago

  • Hey, Gus- I'm glad to hear about your progress. You made a lot of good points and it sounds like you are on the road to healing.

    The hardest thing for me has been maintaining discipline. My tendon is still a little tight on some runs, and I still feel occasional tweaks (especially during weeks like this, after a 5k and hard trail run), but overall I'm much better, as you can tell.

    I'm looking forward to our pool opening so I can swim laps for cross training. I'm going to be sticking to three days of running each week, for as long as I feel it's necessary. As I start to increase my speed, I'll be doing it very gradually. I have two races this year that I care about- the Bear Run in July, and the Army Ten Miler in October. The Bear Run will just be an endurance race for me, but I would like to be semi-competitive in the October race, so I'm going to try my best to play it smart.

    The injury was a real wake-up call for me. I agree, I was probably not as bad off as you. It was the worst pain I've ever felt while running, and it still isn't completely healed. Ironically, if I hadn't had a race planned when I got hurt, I might have continued to push it and do more damage. I went to a doctor hoping for reassurance that I could run the marathon I was training for, but she shocked me when she told me I might not be able to run for a year because of the location of the problem. Two more doctors later, I had hope and a plan. I truly believe the key to my recovery was taking the extended break from running- zero running- and then easing back into it with the walk/run intervals, along with the daily stretching.

    It's still not easy- I'm chafing to be back to my old running pace- but the alternative could be a lot worse. I do get frustrated sometimes that I'm slower than I want to be, or that I feel so tight after a long run, but overall, I am very, very happy with my progress.

    Thank you for sharing your comments. It helps reinforce my own continuing work to recover and train responsibly. Good luck with your plan- send me a note every now and then and let me know how it's going, or post an update here.

    posted over 4 years ago

  • in reply to what N Dunlap said:So helpful to hear others share this injury. I have been trying to rehab what seems to be micro tears in hamstrings for over 6 months. I rehab with crosstraining and PT but struggle after every attempt to return to running, even with walk/run dis... read more

    Hey- sorry I missed this earlier- good luck with you training. I hope things have gotten better since you posted this.

    posted over 4 years ago

  • in reply to what Kent P. said:Hey- sorry I missed this earlier- good luck with you training. I hope things have gotten better since you posted this.

    I am not running...but I am finally working with a PT in sports medicine who is more proactive to get me back to where I was. We've started back at the basics with stretching and strengthening the whole time he is monitoring my biomechanics and focusing on my weak or tight areas that may have caused the injury in the first place. He believes it's not simply an overuse issue.
    Also doing the deep massage right in the tender area (which is now right near where the tendon attches to the knee and up a little ways) with some ultrasound to increase the blood supply to the area and heal the tendon more completely. I hope to continue working with him as we slowly increase my strength. I can use the arc trainer or ellipticle for about 30 minutes, which is better than nothing. I'm really missing the running now that spring in Wisconsin is finally here. However, it is less frustrating now that I feel we've got a good handle on what's wrong and can do something about it!
    For those looking for more information, I was an beginner runner who ran my first half marathon last spring and another in the fall, pain free. I developed a hamstring tendonitis in late fall/early winter.I did have initial acute inflammation with swelling behind the knee, with a pain and tugging feeling on the side of my knee progessing slightly up into the inner quad and slightly down into the calf at times.I have never had pain in my knee or discomfort walking up and down stairs.I have struggled to fully heal the tendon always re-irritating the injury when given the ok to increase my activity. In hindsight I wish that I would have found the PT in sports medicine and/or athetic trainer from the onset I may have been back to running by now. I am also embracing the the importance of incorporating more strenghthening exercises specifically for the hip and upper leg and core. Of course I knew that...but had slacked off.
    It's been very helpful to read the stories from other runners. Hopefully others out there trying to diagnose their injury will find this earlier in the process.
    Kent it's great that your recovery is going well! I would be curious which stretches you and the others have found most beneficial.
    Good luck with your continued success!

    posted over 4 years ago | edited over 4 years ago

  • in reply to what N Dunlap said:I am not running...but I am finally working with a PT in sports medicine who is more proactive to get me back to where I was. We've started back at the basics with stretching and strengthening the whole time he is monitoring my biomechanics a... read more

    Hey, I hope things are getting better for you since this post. I agree about the importance of finding a good PT for this type of injury; I credit mine for getting me on a smart recovery path early on in the process. He used the ultrasound on my tendon, as well, for the same reason- to increase the blood flow to the area.

    The stretch that made the biggest difference for me is the new hamstring stretch (new for me, at least) that the PT taught me. Instead of bending over and touching my toes, which the PT told me was really ineffective for stretching the hamstring and tendons, I do a stretch that reminds me more of the type of stretch you see ballerinas doing. I prop my foot up on a piece of exercise equipment, or a chair. Then I stand up straight or lean just slightly forward, with my back straight, and count thirty seconds. Switch legs, and repeat three times. I was doing this three times a day when the injury was at it's worst... now I'm back to just stretching after each run. I hope that helps.

    Good luck, and I hope things are going well.

    posted about 4 years ago

  • Yes! Thanks for checking back. I am back up to a 5k distance about three times a week. And it feels great!
    I found that same stretch works great. I try and stretch it twice a day, or more if needed. I also found laying on my back with my leg up on the wall, careful for proper back position, works well also. If I turn my foot in slighly I can really get a good medial stretch. And I use a 6 inch foam roller to roll both hamstrings and IT bands daily.
    No big training goals at this point. Enjoying running again!!
    Hope you're enjoying your summer. Good luck with your race in July!

    posted about 4 years ago | edited about 4 years ago

  • That's awesome news! I'm really glad to hear it. Thanks for the update... and enjoy the recovery and running again! I'm having a great summer- it sounds like you are, too. Thanks for mentioning the other stretch. I've heard that also works well. I'll try it sometime.

    posted about 4 years ago

  • in reply to what said:My issue was high hamstring tendonopathy and I had a PRP injection which really helped to speed the healing. PRP stands for Platelet Rich Plasma and is a relatively new treatment. The doctor takes about 30 cc of your blood and spins it to separate... read more

    Hi Sharon,
    I just got an PRP injection last Friday after "dragging" my proximal hamstring tendinosis injury since August. The doctor said not to do anything for a week, not even swim. How long did it take you to start jogging again after the injection? Do you still have pain?
    Thanks so much for responding,

    posted over 3 years ago

  • Thanks for posting on this. I seem to have the same thing; I'm 8 weeks off running now. Late last fall my knee seemed stiff after I had been sitting at my desk for a while. It would work itself out when I walked for a few minutes, so I didn't think much of it. I had finished my races for the season, so wasn't too concerned. In January I began training for a half marathon, and an April ironman 70.3. My leg had just not been feeling "right" on long runs, but I couldn't pin point the problem... wasn't sure if it was tight, weak, etc., but it was definitely the side/back of my right knee area. Then one fateful night, I was running intervals on the treadmill and the knee seemed really stiff. I was hitting all my paces and high on endorphins, so I finished the run. BAD CALL. Limped out of the gym and could barely put weight on the leg the following day. It was swollen, stiff, etc. For about 5 weeks after, my knee was stiff after long car rides, sitting a long time, etc.

    Went to massage and PT the following week. Did 6 weeks of physio, with some improvement, but it still hurts to squat the whole way. I would say the last 10 degrees of flexion are what remain tender.

    Does this sound familiar to you guys??? My PT has thought it was hamstring tendinitis from day 1, but I have had a total ACL repair/menisectomy on my OTHER leg, so I'm paranoid I may have torn the cartilage ever so slightly. I saw a sports doc last Monday; he requisitioned an X-ray, and referred me to Ortho. Of course, my knee has never felt better this week. I have been cycling (small-ring), swimming, and realllly working on glutes, quads, and abductors. I think this helps.

    Nice to hear some comeback stories here! I would really like to get back training.

    posted over 3 years ago

  • in reply to what Bria B. said:Thanks for posting on this. I seem to have the same thing; I'm 8 weeks off running now. Late last fall my knee seemed stiff after I had been sitting at my desk for a while. It would work itself out when I walked for a few minutes, so I didn&... read more

    Hello Bria! That sounds exactly like what I went through, almost to the letter.

    The worst part about the whole experience, for me, was knowing that I had done it to myself by not listening to my body. It was a good lesson to learn- I won't make the same mistake again.

    The good news is that it does heal. The bad news, and it isn't horrible- just something to keep in mind- is that this injury takes time to get over. A lot of time. I followed my doctor's and therapist's plans to the letter, and I believe that's why I got back on track. It required a lot of patience. It's been a year since I was injured, and I still feel the tendons behind the knee to some degree. They don't hurt, exactly, but I do have to be aware of how that area is feeling, and I scale back when I need to. Whenever I get frustrated about my pace, which is still not back to my pre-injury level, I just remember that the first doctor told me I wouldn't run again for a year.

    Good luck, listen to your body while you heal, and keep us updated about how you are doing! Feel free to send me a Dailymile friend request, if you decide to start using this site to log your workouts.

    posted over 3 years ago

  • I have been reading these posts. I have pulled my hamstring back in January either from skiing and/or slipping on some ice. I went to the ortho and he said that I pulled a hamstring. It has now been 4 months. My left hamstring is 99% better; however, I still feel some discomfort/slight pain depending on how I move. I took these past four months off from exercising and running and now since it is summer I want to get back out there. Does anybody have any suggestions on how to get these tendons back to normal w/ no pain/discomfort?

    posted over 3 years ago

  • Hi.... Just read your post, I've got high hamstring tendinopathy, and have had it for three years, went undiagnosed for that length of time.... eventually, after an mri and hi tech ultra sound, finally a doctor knew what was wrong with me. I'm primarily a long distance indoor rower but am also a runner. Had my first PRP injection a month ago, but I'm only allowed to bike and swim and do weights, VERY frustrating, only have about a 5 to 10% improvement, having my next injection in three weeks. I could train for the the first two years with it but it got progressively worse, so bad that my back and hip were affected, so I guess I just have to be patient and wait for it to heal....

    posted about 3 years ago

  • I've been there as well. I have had the knee hamstring tendiopathy for three years also, no one knew what it was and I wa sjust biking biking biking. But everytime I'd put on high heels, sandals, (anything other than tennies) or try and walk fast, it'd come back. and yes, my back and hip were affected and involved. so now I"m trying to strengthen those areas. All these PT (intelligent no) had me strengthening my quads, thinking it was runner's knee and in reality, my hamstrings are really weak. Now unfortunately, thanks to Skecher shoes, I've got the same thing in my left leg. I guess I'm prone to this injury. Really sucks. It gose away and comes back fo any little thing. Glad to finally not feel alone.

    posted about 3 years ago

  • in reply to what Runner J. said:I have this as well. I still run, I have a really good physical therapist, sport massage man and I ice, heat and use massage cream to ease pain. I recently started dynamic stretching this has helped a ton. I heat just before i run now. Good lu... read more

    Janna, the ice thing is real important I'm discovered. Ice after every day of exercise even if you don't feel pain. Can you explain some dynamic stretches, what is that , how do you do it, etc for hamstrings, IT, glutes??

    posted about 3 years ago

  • in reply to what Cade L. said:I have been reading these posts. I have pulled my hamstring back in January either from skiing and/or slipping on some ice. I went to the ortho and he said that I pulled a hamstring. It has now been 4 months. My left hamstring is 99% better; howev... read more

    Yes I hear ya. It is better and then you do a certain angled move, like for me a bridge and pain. The problem is that for me, it usually doesn't hurt right when I do the aggravating movement, but afterwards, and then I'm not sure what it was. Also, if I wear anything else than my tennis shoes with inserts for overpronation , pain. I increase anything in exercise, pain. Do we need to stretch more and ice more I'm looking for the same answers as you!

    posted about 3 years ago

  • in reply to what Cade L. said:I have been reading these posts. I have pulled my hamstring back in January either from skiing and/or slipping on some ice. I went to the ortho and he said that I pulled a hamstring. It has now been 4 months. My left hamstring is 99% better; howev... read more

    Hello Cade. I haven't checked in on this thread for a long time- my apologies for missing this. It's been a while since your post, so I hope things are better for you now. The pain takes time to go away, as you've probably discovered, and unfortunately there wasn't anything I could do to speed it up. Good luck! If you check back in and see this, I hope things are better for you now.

    posted almost 3 years ago

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