Can a Hamstring Massage Help with Hamstring Tendinopathy?

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Question:

 

I caught the running bug a few years ago, and a couple of months ago I completed my first marathon. Soon after, I started to experience pain in my buttock and hamstring area that my doctor diagnosed as high hamstring tendinopathy. My doctor referred me to a physical therapist, and my physical therapist recommended massage therapy. Can a hamstring massage help with hamstring tendinopathy?

Answer:

Hamstring tendinopathy is a uncommon overuse injury for both middle and long distance runners. Many people report that you’re likely to experience thigh pain and deep buttock pain.[1] Massage therapy is one of many treatments used to ease pain and rehabilitate your tendons. However, there have been few studies on its effectiveness. Those studies that have evaluated massage noted little benefit to massage over other types of rehabilitative treatment, according to a review of tendinopathy treatment published in the Clinical Orthopaedics and Related Research journal.[2]

The most common type of massage used to treat hamstring tendinopathy is deep tissue massage. This type of massage uses deep pressure to target and release chronically tense areas in the deepest layers of your muscle tissue. Deep tissue massage is frequently used for injury recovery and the management of chronic pain. Though widely recommended by sports physical therapists and popular among athletes, there is little evidence of its efficacy.[3]

Despite the lack of studies, though, massage therapy remains popular, and you’ll find athletes and health professionals alike who swear by it. The only way to know for sure whether massage therapy will help you is to give it a try. If you’ve never had a massage before, you might want to start with a traditional Swedish massage, which is a bit more gentle than deep tissue massage. Then you can work your way up to deep tissue massage with a sports massage, which combines both deep tissue and Swedish techniques.

There is evidence that massage relaxes you and can help improve your mood, which may have an effect on your overall recovery.[4] Researchers generally believe that regular massages support healing and lower your blood pressure, which can have an immediate effect of reducing pain. This is especially true for inflammatory injuries, such as hamstring tendinopathy. The benefits of massage typically are short term, and you may not notice a big difference after a single session. If you want to get the full benefit of massage therapy, schedule a session once a week or once every two weeks over the course of several months.[5]

According to research published in the National Library of Medicine, rehabilitation involves soft-tissue mobilization, frequent stretching, and progressive eccentric hamstring strengthening and core stabilization exercises. In recalcitrant cases, an ultrasound-guided corticosteroid injection into the tendon sheath can be helpful, and, occasionally, surgery may be necessary to release the scar tissue around the proximal hamstring muscles and the sciatic nerve.

References:

[1] Australian Fitness Network: “Common injuries: High hamstring tendinopathy” http://www.fitnessnetwork.com.au/resources-library/common-injuries-high-hamstring-tendinopathy

[2] Clinical Orthopaedics and Related Research: “Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/

[3] North American Journal of Sports Physical Therapy: “The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/

[4] Id.

[5] University of Maryland Medical Center: “Massage” http://www.umm.edu/health/medical/altmed/treatment/massage

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