Hamstring Strains and Hamstring Tendinopathy: The Acupuncture Solution for Relief

A typical scenario: you are out for a long run, and feeling enthusiastic, you decide to sprint the last 50 yards. Suddenly, OUCH!!  A sharp pain in the back of your thigh forces you to stop, and you limp the rest of the way home. You have no doubt “pulled” your hamstring, or more precisely, strained it. Hamstring strains occur frequently in sports involving explosive running.

A strain is actually a tear, and there are different degrees of tearing, which I will mention briefly below. The bad news is that hamstring injuries heal notoriously slowly and annoyingly tend to reoccur. The good news is that acupuncture can help with a more rapidly recovery. And combined with deep tissue therapy, it can help prevent recurrences of the injury.

There are two primary ways the hamstring can be injured. 

1) In the muscles. The hamstring, comprised of three muscles, can be injured in the belly of the muscles themselves, in the tissue approximately halfway between the sitz bone, or ischial tuberosity, and the knee. Two more common sites are in the musculotendinous junctions, either near the knee or near the ischial tuberosity. It is here that the muscle tissue interfaces with tendinous tissue. In a high hamstring strain near the ischial tuberosity, another muscle, the adductor magnus, is often strained as well.

2) In the tendons. The tendons of the three hamstring muscles attach directly to the ischial tuberosity above or to the tibia or fibula below, slightly distal to the knee joint.

Injuries to muscles heal more quickly than injuries to tendons. The reason is that muscles have a better blood supply than tendons. Tendinous injuries occur among older athletes more frequently than among younger ones, and unlike a common hamstring strain, which can occur suddenly, injuries to tendons are often more insidious—they develop slowly as a result of repetitive activities like running or cycling. In chronic cases, the tendon can thicken where it inserts at the bone, and it sometimes shows signs of calcification.

There are different acupuncture techniques for each of the two areas, tendon and muscle.

I have a 4-fold approach to treating hamstring strains

1) Activating the energy flow in the acupuncture channels that flow through the posterior thigh by treating more distal points on the channels. Other related points are used as well. This technique in itself speeds up the healing process and reduces pain in both the muscles and the tendons. 

2) Releasing any tissue constrictions by finding tight areas that contain trigger points. Interestingly, trigger points in the muscle bellies can refer pain upward toward the gluteal area or downward toward the knee, even when these two areas are not directly injured. And it is important to mention that I also employ specific needling techniques that directly target any tendinous areas affected. 

3) Employing manual myofascial release techniques to enhance the effect of the acupuncture, to increase range of motion, and to align scar tissue as the injury heals. 

4) Evaluating pelvic imbalances and sacroiliac joint dysfunction. This phase of treatment is only for those who proactively want to go to the next level in order to help prevent future injuries. People with an ipsilateral anterior pelvic tilt or ipsilateral SI joint problem are more prone to experience a hamstring strain on the same side. Acupuncture, myofascial release and exercises can help correct these two problems. 

The number of treatments necessary depends on the area of the strain, as discussed above, as well as the degree of the strain. Acupuncture helps grade1 and grade 2 tears, which are mild or moderate, but grade 3, a severe or complete tear, requires surgery.  

Many patients feel an improvement after the first treatment, and after a couple of more, provided there is further improvement, it will become more clear how long it will take to correct the problem. Again, chronic tendon problems will require more treatments than a purely muscular one.

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