Gluteus Maximus inhibition in proximal hamstring tendinopathy

Abstract

OBJECTIVE:The purpose of this study was to demonstrate the inhibition of the ipsilateral Gluteus Maximus in the presence of proximal hamstring tendinopathy and to collect information about its cause. DESIGN: We studied three subjects with clinical evidence of proximal hamstring tendinopathy previously submitted to conservative treatment with poor results and exhibiting severe hypotrophy and diminished strength in the ipsilateral Gluteus Maximus in comparison with contralateral Gluteus Maximus. INTERVENTIONS:Patients were submitted to evaluation of the Gluteus Maximus inhibition through handheld dynamometer strength measurements before and during neuromuscular electrical stimulation. RESULTS:The three subjects exhibited increased strength in the affected Gluteus Maximus (mean 43%; range 27%-62%) when neuromuscular electrical stimulation was added in the evaluations. CONCLUSION: This study demonstrates that individuals with proximal hamstring tendinopathy present ipsilateral Gluteus Maximus inhibition with hypotrophy and diminished strength. Neuromuscular electrical stimulation partially restores muscular strength. Further studies are required to evaluate the effects of this type of treatment.

Can we spread the risk? A demand-share perspective to sustained hamstring health

“…Suggestive a hip extensor synergistic hierarchy may be existent within the movement system, reduced force production and activation of the gluteus maximus is seen in the presence of increased relative contributions from the BFlh (Jonkers et al, 2003;Mills et al, 2015). This demand-share phenomenon may also come at a cost, accompanying hamstring tendon pathology (Jesus et al, 2015) and observed during sprinting within a greater number of footballers who subsequently experience HSI than those who remain injury free (Schuermans et al, 2017a). Enhancing the capacity of the largest muscle in the body, with such an expanse of attachment of the skeleton would appear to represent a significant opportunity to reduce demands upon BFlh.…”

Distal semimembranosus tendinopathy: A narrative review

“…Treatment involves progressive tendon loading performed within a pain‐monitoring framework to reduce pain and restore function 29 . Modifiable risk factors and training errors that could be associated with this condition are addressed, such as progressing activity volume or intensity too quickly, prolonged rest and inactivity, inefficient biomechanics, and hamstring and gluteal strength deficits 29‐32 . Initial rehabilitation for SMT focuses on developing a baseline hamstring load, pain modulation, and addressing impaired motor control.…”

Tendinopathies of the hip and pelvis in athletes: A narrative review

“…PHT is commonly seen in long distance and sprinting runners (Puranen & Orava, 1988), football and hockey players (Fredericson et al, 2005), since these activities involve frequent changes of direction. It is also common in sedentary people (Jesus et al, 2015). Key risk factors are represented by poor lumbo-pelvic control, thigh muscle imbalances and hamstring weakness (Jayaseelan et al, 2014).…”