Hamstring Tendinopathy in Young Athletes: why rest alone isn’t the answer
We have seen a lot of young athletes with hamstring pain since the athletics season kicked off this year. Hamstring pain is common in athletes, especially sprinters. But when that pain lingers, feels deep and close to the sitting bone, and worsens with sprinting or acceleration it may not be a simple muscle strain- it could be a hamstring tendinopathy.
The biggest misconception? That rest will fix it.
What is a hamstring tendinopathy?
Hamstring tendinopathy differs from tendinitis (inflammation of the tendon). A tendinopathy refers to degeneration of the tendon where the hamstring attaches to the pelvis and is usually caused by too much stress being placed on the tissue over time. Unlike muscle strains, tendons heal differently- they don’t respond well to complete rest. As a matter of fact, too much rest can make them weaker and even more prone to being painful and sensitive when returning to sport or activity.
Why does this happen?
This condition develops in young sprinters due to:
- Rapid increase in frequency/intensity of training (think of intense exercise after December holidays)
- Repeated sprinting without adequate recovery
- Poor strength balance between the hips and hamstrings
- Decreased hip control
Why rest alone won’t work:
Rest can help calm pain temporarily- and is often needed in the very acute phase- but it does not restore the capacity of the tendon. Tendons need load to heal properly.
If tendons aren’t loaded sufficiently:
- Tendon loses strength
- Tissue becomes more sensitive
- Higher risk of injury when sprinting, and possibly more serious injury
- Decline in performance
The Key is Progressive loading:
The gold standard for tendon injuries is progressive loading- this means a rehab program with carefully planned exercises that gradually restore the tendon so it can adapt and become stronger.
Rehab will focus on:
- Strengthening the hamstrings through different ranges of movement
- Building hip and glute strength to support the hamstrings
- Improving the ability of the hamstrings to tolerate load before returning to sprints
- Gradually reintroducing running and speed work
Why Early Rehab matters in young athletes:
Young sprinters are still developing:
- Their muscles/tendons and bones are adapting
- Their amount and intensity of training often increase quickly
- They generally don’t have a strong strength base yet
Ignoring tendon pain or relying on rest alone can turn a small issue into a chronic one that affects performance long-term. The goal isn’t just to get rid of pain, but to make the tendon stronger than before. Reach out to us at Free Motion physiotherapy to identify any strength deficits and create sport-specific rehab plans to get you back in tip-top shape.
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