Physio webchat with Paul Hobrough

Catch up on our webchat for expert advise from Paul Hobrough.

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Q. I have developed this really deep pain in my upper right hamstring I do lot of stretching and foam roller to ease the pain but just below the right bum cheek cant seem to shift it. I also bought new pair of running shoes couple of months ago and my last event I did was over 5K which is not my distance I do more 10miles - half marathons but it seemed to start when doing shorter distances last month. - daniel hornsby

A. Proximal or high hamstring injury is becoming much more frequent in my clinics of late. I have seen this increase with the number of people taking up more track running, although in most of these cases the issues has been on the left side (inside leg). Your issue may well be similar in nature as I have been finding high percentage of these runners have significant asymmetry in their pelvis. The hamstrings originate from the seat bones which are all part of the pelvic innominate bone, therefore asymmetry within the pelvis can lead to an increase rotation of one side and therefore the origin of the hamstring also moves, causing tension within the muscle.  It might be that the shorter distances you ran were on the track rather than straight line running such as the longer distances you usually do, or that your tech niche changes slightly when you run faster (higher leg kick for example - therefore more exertion on the hamstrings).

You have tried stretching already, so why not try some knee rolling, side to side whilst laying flat on your back to mobilise the lumbar spine. Then try stretching your piriformis (deep in the glutes) just to be sure you aren't slightly trapping the sciatic nerve and causing some coexisting nerve pain. Also to help the hamstring perform some eccentric repetitions on the hamstring (slow lowering against weight without the lift phase of the exercise). I use a specialist piece of equipment called a digital pelvic inclinometer in my clinic which helps me to diagnose if the pelvis is out of alignment.  Much has been written about the clinical benefits of identifying asymmetry and its relationship to pain and possible cure of sports injuries. Those who display asymmetry and have other key clinical factors to build the picture and therefore cause of the injury, often benefit from treatments which reduce this asymmetry, so a visit to your local physio may well be of use. Caveat: not everyone with asymmetry will have pain and not everyone with pain has asymmetry!! I hope this helpful and not confusing for you, in most cases what I suggest really helps.

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