High hamstring pain develops slowly for distance runners and become nagging and chronic. It consists of inflammation at the attachment of the hamstrings (the Semitendinosus, the semimembranosus, and the long head of the Biceps Femoris) to the Ischial Tuberosity, or more commonly referred to as the sitz bones. That is why this condition will be aggravated by sitting for long periods of time in a car or more quickly on a hard surface. From my experience, unless it is extremely acute, this pain will fade out while running and come on again after running as the muscles tighten up. Running form and body use adjustments can heal this injury quite quickly in most cases without significant training loss.
Causes and Considerations:
I have found, having had this condition when running trail ultra-distance races, and working with a number of road runners and trail runners who have come to see me with these complaints, there are two common patterns often seen in a person’s running form.
The first is that the hips are pulled back, upper body often leaning forward (not always, it could be arched back and being pulled along), and legs over-striding out front. The second is “sitting back in the bucket,” the knees are bent in a crouching position, torso is upright with little, if any, forward lean or arched back. In both cases the force production for forward movement is generated from a pawing the ground, engaging the Hamstrings in a powerful concentric contraction pulling the body forward, at a point in the stride that they would be relatively inactive. A mild over-stride in combination with hill climbing will greatly increase the force requirements of the Hamstrings, as does speed work.
A third consideration is a one-sided muscle imbalance that could affect either side of the body in terms of compensations resulting in Hamstring pain. This will also respond favorably to form corrections.
As in most overuse injuries in runners, a strategy is adopted when the core of the body isn’t engaging correctly either due to muscle imbalance, body position and posture, or a combination of the two. In this case the strategy is to pull the body forward using the hamstrings.
Healing High Hamstring pain
Good focuses to use when running:
- Your feet should be landing under the body (not out front), with your heels planted down. This is especially important with uphill running. If the foot is out front uphill, the forces involved with pulling will be greater than on flat or down.
- When running uphill, keep your stride short and engage more hip flexion as if prancing. When you do this, your forward movement will come from the hip flexion, and this allows you to release and lengthen the back of your thigh and leg of the stance foot. This has a lengthening and healing effect on the hamstring.
- Run with good pelvic and torso alignment and have a slight lean forward.
- Relaxation throughout the torso and pelvis combined with the proper alignment will allow for more core engagement and relieve the hamstring from force production.
- Focus on being tall through the knees, keep your stride short, and lean forward from the ankles, especially in the case of deep crouching in the knees.
Other healing modalities that might help:
- Eccentric hamstring strengthening: You Tube has a number of good options.
- Gentle Eccentric stretching
- Postural correction of a one-sided or bilateral anterior pelvis.
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