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Clinical Pilates For Chronic Hamstring Tendinopathy

A Case Study

Many people think of Pilates as really just for back pain, postural improvement and core stability. So we thought we’d highlight a success story for you to illustrate that when used correctly, pilates can be a very effective way to treat many other conditions.

In this real case description we talk you through how a structured clinical Pilates program helped resolve a very long-standing and stubborn proximal (upper) hamstring tendinopathy for a client of ours who we’ll call Mr G.

proximal hamstring tendinopathy - treatment surry hills, sydney

Mr G is a 45 year old male suffering from a left proximal hamstring tendinopathy and chronic low back pain. He originally saw a physiotherapist for his left hamstring tendinopathy which was giving
him trouble when running and sitting for any length of time. He came to physiotherapy because he wanted to kick the ball around with his young kids and both the low back and hamstring were preventing him to do so.

Any progression of rehab exercises that the physiotherapist tried would provoke Mr Gā€™s low back pain so it was difficult to gain any progress of his hamstring. They had worked on this for several weeks but his hamstring was just not improving. At this point, he was referred to Pilates to try a more active approach to his rehabilitation.

His initial assessment indicated that he was very guarded when performing any movements of his spine so the first step was to address his spine movement before moving onto any hamstring rehab. This involved doing exercises to allow Mr G to relax his spine to allow for natural movement.

Bridge exercise with ball

Once Mr G’s lumbar spine mobility problem was addressed we were able to successfully move on to strengthening his hamstring without worsening his low back pain. This was a slow and careful process where we used a variety of hamstring exercises in sitting and lying to progressively build his hamstring strength. We also used the reformer to do exercises while his back was supported. Once he was comfortable with this we then moved onto more functional exercises like deadlifts and squats.

Deadlift exercise for strength

The progression from purely Pilates exercise to integrate more functional strengthening is a highly effective approach that we often employ at Central Performance. It’s like having the best of both worlds – the support and stability gained with Pilates added to a strength program that focus on building the strength that we need for everyday tasks like lifting, carrying and running.

Mr G is progressing really well. He achieved his goals and is able to play with his kids without any low back or hamstring pain. He is comfortably lifting 50kg and is continuing to improve. He has no hesitation lifting heavy pots in the garden and is aware of his lifting technique. Graded deadlift training has played a big part in this area of his improvement.

Mr G is continuing on doing Pilates twice a week and is feeling fitter and stronger than he has in a long time. We are introducing more complex exercises on the reformer which gets him concentrating on body awareness, as well as progressing to more challenging strength exercises.

This post was written for you by Ruben Caetano, one of our physiotherapists and certified Pilates instructors. If you would like more information about how our Clinical Pilates program could help you recover from an injury and get back to doing the things you love please feel free to contact us or give us a call on +61 2 9280 2322.