Saturday, April 22, 2017

The hamstring conundrum

The corticosteroid injection made no difference and another attempt at a walk/jog programme resulted in increased irritation in the hamstrings. The Doctor then sent me off for an MRI to better assess the situation. Alas, as expected the hamstrings looked pretty crappola on the MRI. After that news I was ready to 'accept' my fate. After all, I'm in my 50s and seem to have genetic predisposition to tendon problems (I still have medial epidocondylitis after 6 months and have had other arm tendon niggles in the past). However, my doctor was not going to let me get off that lightly. She was adamant that if I take a rest, it may settle down, but it would flare up as soon as I increased the load on the tendons. Next step, a referral to see Craig Purdam, a physio with much experience with tendinopathies. I have read a number of his publications and he has been at the forefront of tendon research for some time. I was lucky to get an appointment with him as he is reducing his caseload as he heads towards retirement. It's been a bit of a wait and I will be seeing him at the end of April.
In the meantime a few things have seen me re-evaluate the situation. After taking a (complete) rest period, the hammies did seem to settle down, BUT going for some walks set them off again. The rest has resulted in them becoming even less tolerant of load than before! How frustrating! However, I did a bit more research and discovered that this apparently is a common finding. Jill Cook, a research colleague of Craig Purdam, strongly advises that exercise is the best treatment for tendinopathy. That is, the right programme of exercise. Of particular interest to me was Cook's recommendation that there should be at least 2 minutes rest between any tendon exercise repetitions. Well heck, I have not been doing that, it was not pointed out to me that I should be. I have been suspicious that my exercise programme has not been allowing for sufficient recovery, but I did not realise it was at such a microlevel. Oddly this gives me some hope. I know I can settle the hammies down again with isometric exercises, but this time with appropriate rest between repetitions. From there I am hoping Craig Purdam can help me with staging an exercise programme in a way that allows for sufficient recovery and forward progress. Now I'm just waiting for that appointment at the end of April.