RESUMO
Proximal hamstring tendinopathy (PHT) comprises a small but significant portion of hamstring injuries in athletes, especially runners. PHT is a chronic condition that is clinically diagnosed but can be supported with imaging. The main presenting complaint is pain in the lower gluteal or ischial region that may or may not radiate along the hamstrings in the posterior thigh. There is little scientific evidence on which to base the rehabilitation management of PHT. Treatment is almost always conservative, with a focus on activity modification, addressing contributing biomechanical deficiencies, effective tendon loading including eccentric training, and ultrasound-guided interventional procedures which may facilitate rehabilitation. Surgery is limited to recalcitrant cases or those involving concomitant high-grade musculotendinous pathology. The keys to PHT management include early and accurate diagnosis, optimal rehabilitation to allow for a safe return to preinjury activity level, and preventative strategies to reduce risk of reinjury.
Assuntos
Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/reabilitação , Tendões dos Músculos Isquiotibiais/lesões , Modalidades de Fisioterapia , Tendinopatia/prevenção & controle , Tendinopatia/reabilitação , Traumatismos em Atletas/diagnóstico por imagem , Medicina Baseada em Evidências , Tendões dos Músculos Isquiotibiais/diagnóstico por imagem , Humanos , Tendinopatia/diagnóstico , Resultado do TratamentoRESUMO
Returning to both recreational and competitive sport requires the patient demonstrate the ability to perform their activity without pain, without compensation and without apprehension. The primary focus of this article will be to provide progressive weight bearing phased treatment solutions and both objective and empirical return to play testing suggestions. In addition to satisfactorily completing the test battery with maximum effort, the patient must demonstrate the ability to meet the demands for competing within their respective sport specific environment. Returning to competition will most likely include early phase movement screening and clinical clearance followed by late phase athletic and field testing. Hip structure will and must influence training program design. It is therefore important to recognize that indications for return to play must not focus on a single rehabilitation or exercise variable, but rather a combination of clinical, functional and sport specific demands.
