Proximal hamstring tendinopathy and avulsion injuries - assessment & treatment with Benoy Mathew

Proximal hamstring tendinopathy is common in runners and athletes. This masterclass will provide you with a complete understanding of the anatomy, pathology and presentation of proximal hamstring pain and injuries. You will then be taken through how to assess, diagnose and treat these conditions, including pain management, education, exercises, rehabilitation progressions and movement retraining to allow the proximal hamstring tendon to recover.

Proximal hamstring tendon tears and avulsion injuries are common acute injuries, and you will explore ideal management of these injuries along with post-surgical rehabilitation.

Aims:

• Overview of anatomy & pathogenesis of PHT

• Conservative Management of PHT

• Proximal hamstring avulsions

Part 1 covers

• Hamstring function and the role of the hamstrings during running and power activities

• Applied hamstring anatomy

• Location of common bursae around the hamstrings

• How does tendon length relate to function?

• Which hamstring muscles and tendons are more likely to be injured?

• The relationship of the sciatic nerve to proximal hamstring tendinopathy

Part 2 covers

• Synergy between hamstrings and adductor magnus and why this is important in your rehabilitation

• Who develops proximal hamstring tendinopathy or tears?

• Which muscles are most likely to be torn or develop PHT?

• What relevance does imaging have to injury?

• Common presentations of patients with PHT

• What clinical tests can you use to assess PHT?

• How can you assess PHT initially

Part 3 covers

• Further information on how you can assess PHT initially and to identify patient progress through the rehab process

• Which questionnaires can you use

• What exercises can you use initially in your rehab program

• Rehab exercise progressions

Part 4 covers

• Advanced exercise progressions and plyometrics

• Return to running program

• Important gait retraining components in PHT

• Effects of increasing cadence

• How you can help your patients increase cadence

• Common pitfalls when adjusting cadence

• How you can educate your patients on the pathology and recovery

• Expected timeframes for recovery

Part 5 covers

• What options do you have when patients are not progressing?

• Are PRP or corticosteroid injections a helpful addition to a treatment program

• Is Shockwave therapy a safe or effective treatment for patients with chronic PHT?

• Which patients are more or less suitable for ESWT?

Part 6 covers

• Proximal hamstring tears and avulsions

• What is the mechanism of injury

• Clinical presentation of acute proximal hamstring tears or avulsions

• MRI classification of tendon avulsions

• Operative vs non-operative treatment of proximal hamstring avulsions

• Post-op rehabilitation of proximal hamstring ruptures

• What do we know, and what further research is needed around the posterior hip & gluteal area