Our stories: Elen’s running again

“I’ve got this pain. It hurts all the time and nothing has worked so far. Can you help?”

I often hear this from patients coming to see me for the first time and it usually comes from someone who has been trying to find relief for months with multiple practitioners.

In this case, my patient had pain high up in the back of the leg, right where it meets the buttock, which can be difficult to shift. When it persists despite treatment, it's nearly always because something about the way the body is loading and the muscles are recruiting hasn't been spotted yet. The tendon itself is rarely the whole story.

More than a year of pain

One patient came to us after fifteen months of pain high in the back of her leg. She'd already had physiotherapy and shockwave therapy elsewhere, with no improvement in her symptoms.. By the time we saw her, the high hamstring tendon was still angry and quick to flare, which is unusual for an injury that old. That pattern normally points to something quietly keeping it going.

In her case, a few things were driving her symptoms. The way she positioned her pelvis while seated put her body weight straight onto the sore part of the high hamstring tendon causing compression. The way she stood shifted load through her hip in a way that prevented natural recruitment of her hip muscles. And the muscles that should have been sharing the work, her gluteals and the ones on the inside of her thigh had gone quiet and become weak, leaving the hamstrings to cope with the high forces involved in running on their own. An MRI scan confirmed the bone where the hamstring tendon attaches was inflamed suggesting a chronic injury.

Each of these was holding the problem in place. None had been the focus of her earlier treatment.

A plan built around the real cause

We started by taking the pressure off the tendon, with small changes to how she sat, a wedge cushion, and working out which everyday positions had been keeping things sore. Gentle isometric exercises settled the pain down before any harder rehab began.

From there, we strengthened the muscles that had switched off, with work for the inner thighs, glutes and calves and we corrected how she was holding her pelvis when standing. That last change also cleared up the low back pain she'd been living with at the same time.

It took four sessions over three months, with enough space between them for her body to properly adapt.

Where she is now

Elen’s pain has gone. She can sit, stand, walk and run comfortably again all things that had been painful for over a year.