Clinical Progression and Load Management For Proximal Hamstring Tendinopathy In A Long-Distance Runner: A Case Report.

IF 1.6 Q3 SPORT SCIENCES International Journal of Sports Physical Therapy Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI:10.26603/001c.116578
Cristina Campos-Villegas, Lucía Ortega-Pérez de Villar, Javier Gámez-Payá, Jorge Alarcón-Jiménez, Nieves de Bernardo
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Abstract

Background and purpose: The characteristics of Proximal Hamstring Tendinopathy (PHT) include deep, localized pain in the region of the ischial tuberosity. Chronic lesions are often found in long-distance runners. Compression of the tendon and shear force at its insertion at the ischial tuberosity during hip flexion/adduction is a key etiologic factor. The aim of this case report is to analyze the effectiveness of an exercise protocol with progression of tendon loading in PHT in an amateur runner, by assessing pain and functional capacity.

Case description: The subject was a 30-year-old male runner. After participating in a 10km race, he experienced an insidious onset of deep buttock pain in the right ischial tuberosity. His pain was aggravated by running on sloped roads and prolonged sitting on hard surfaces, particularly while driving. The visual analog scale (VAS) for pain, the Puranen-Orave test (PO), the Bent-Knee stretch test (BK stretch), the supine plank test, the Victorian Institute of Sport Assessment-proximal hamstring tendons (VISA-H) questionnaire, and the sciatic nerve mobility (via the Slump test) were assessed. The intervention involved a 12-week progressive loading exercise program divided into four phases.

Outcomes: The initial pain was reduced at 6 weeks of intervention and further decreased at 12 weeks (VAS from 7, to 5 and to 1). Function increased at 6 weeks and at 12 weeks (VISA-H from 23, to 53, to 80). Sciatic nerve mobility was normal.

Conclusion: The progression of training in a subject with PHT tendon injury based on isometric exercise, concentric/eccentric, energy storage, progressively increasing hip flexion was beneficial, increasing function and decreasing pain. Studies with a larger sample size and a more precise methodological design would be necessary to support this type of intervention in clinical practice.

Level of evidence: 5.

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一名长跑运动员腘绳肌腱近端病变的临床进展和负荷管理:病例报告。
背景和目的:腘绳肌腱近端病(PHT)的特征包括跗骨结节区域的深层局部疼痛。慢性病变通常发生在长跑运动员身上。髋关节屈曲/外展时肌腱受压以及肌腱插入峡部结节处的剪切力是一个关键的致病因素。本病例报告旨在通过评估疼痛和功能能力,分析业余跑者在 PHT 中肌腱负荷逐渐增加的锻炼方案的有效性:受试者是一名 30 岁的男性跑步者。在参加完一场 10 公里的比赛后,他隐隐感到右侧胯骨结节处臀部深部疼痛。在倾斜的道路上跑步和长时间坐在坚硬的地面上,尤其是开车时,疼痛会加剧。对他进行了疼痛视觉模拟量表(VAS)、普拉宁-奥拉夫试验(PO)、屈膝伸展试验(BK 伸展)、仰卧平板试验、维多利亚体育学院评估-腿筋腱近端(VISA-H)问卷调查以及坐骨神经活动度(通过坍塌试验)评估。干预措施包括为期 12 周的渐进加载锻炼计划,分为四个阶段:结果:最初的疼痛在干预 6 周时减轻,12 周时进一步减轻(VAS 从 7 降到 5,再降到 1)。功能在 6 周和 12 周时有所增加(VISA-H 从 23 到 53 再到 80)。坐骨神经活动度正常:结论:在等长运动、同心/半同心、能量储存、逐步增加髋关节屈曲的基础上,对 PHT 肌腱损伤患者进行循序渐进的训练是有益的,可以增强功能,减轻疼痛。在临床实践中,有必要进行样本量更大、方法设计更精确的研究,以支持此类干预措施:5.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
期刊最新文献
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