Krueger Kayla, Washmuth Nicholas B, Williams Tyler D
Samford University, Birmingham, AL, USA.
Int J Sports Phys Ther. 2020 Oct;15(5):814-822. doi: 10.26603/ijspt20200814.
Proximal hamstring tendinopathy is a chronic, overuse condition that commonly develops in athletes. Eccentric exercise has been widely accepted in the clinic as the treatment of choice for the management of tendinopathies. However, this form of treatment has seldom been compared to other forms of load-based management for hamstring tendinopathies. Heavy slow resistance training, which consists of both concentric and eccentric phases, increases the loading time experienced by the tendon compared to eccentric only exercises. Heavy slow resistance training has achieved positive clinical results in the management of Achilles and patellar tendinopathy.
The purpose of this case report is to describe the outcomes of a powerlifter with proximal hamstring tendinopathy who responded favorably to a heavy slow resistance biased rehabilitation program after traditional, conservative management failed to alleviate symptoms.
A 31-year-old male competitive powerlifter was seen in physical therapy for the management of proximal hamstring tendinopathy. The subject had experienced long duration pain localized at the ischial tuberosity combined with hip weakness that limited his ability to lift weigtht and sit for longer than 30 minutes. Treatment included a 12-week heavy slow resistance program with the focus of increasing load intensity.
Numeric pain-rating scale was assessed at baseline, after a 12-week heavy slow resistance protocol, and 12 months post protocol. Within four weeks of starting the heavy slow resistance program, the subject noted a meaningful decrease in pain. The subject experienced clinically important improvements in numeric pain-rating scale immediately after the protocol and these improvements remained 12 months after completing the protocol. The subject was able to return to competitive powerlifting after the 12-week program.
A meaningful change in pain occurred within four weeks of starting the program and continued improvement throughout the remainder of the 12 weeks with outcomes maintained 12 months after completing the program suggests that increasing the loading strategy with a heavy slow resistance program was helpful for this subject.
腘绳肌近端肌腱病是一种慢性过度使用性疾病，常见于运动员。离心运动在临床上已被广泛接受为肌腱病的首选治疗方法。然而，这种治疗形式很少与其他基于负荷的腘绳肌肌腱病管理形式进行比较。重负荷慢速抗阻训练包括向心和离心阶段，与仅进行离心运动相比，增加了肌腱承受负荷的时间。重负荷慢速抗阻训练在跟腱和髌腱病的管理中取得了积极的临床效果。
本病例报告的目的是描述一名患有腘绳肌近端肌腱病的力量举运动员的治疗结果，该运动员在传统保守治疗未能缓解症状后，对以重负荷慢速抗阻为主的康复计划反应良好。
一名31岁的男性竞技力量举运动员因腘绳肌近端肌腱病接受物理治疗。该患者长期感到坐骨结节处疼痛，并伴有髋部无力，这限制了他举重的能力以及每次坐超过30分钟的能力。治疗包括一个为期12周的重负荷慢速抗阻训练计划，重点是增加负荷强度。
在基线、12周重负荷慢速抗阻训练方案结束后以及方案结束后12个月时，对数字疼痛评分量表进行了评估。在开始重负荷慢速抗阻训练计划的四周内，患者注意到疼痛有显著减轻。在训练方案结束后，患者的数字疼痛评分量表有了临床上重要的改善，并且在完成方案12个月后这些改善仍然存在。在12周的训练计划后，该患者能够重返竞技力量举运动。
在开始训练计划的四周内疼痛出现了显著变化，并在剩余的12周内持续改善，且在完成计划12个月后仍保持这些结果，这表明采用重负荷慢速抗阻训练计划增加负荷策略对该患者有帮助。
4级。
