title: Conservative Treatment of Subacute Proximal Hamstring Tendinopathy Using Eccentric Exercises Performed With a Treadmill: A Case Report.
abstract: METHODS
  Case report.
  
  
  BACKGROUND
  Proximal hamstring tendinopathy in runners is characterized by pain with passive hip flexion with the knee extended, active hip extension, and pain with sitting. Relatively little literature exists on the condition, and publications on nonsurgical treatment protocols are even more scarce. Surgical intervention, which comprises the majority of literature for treatment of this condition, is an option for cases that fail to respond to nonsurgical treatment.
  
  
  METHODS
  The patient was a 34-year-old, otherwise healthy male triathlete with unilateral proximal hamstring tendinopathy diagnosed by ultrasound, who had pain only with running and prolonged sitting. After he failed to respond to 4 weeks of eccentric knee flexion and lumbopelvic musculature strengthening exercises, an eccentric hip extensor strengthening program using a treadmill was initiated. This treadmill exercise was performed on a daily basis, in addition to a lumbopelvic musculature strengthening program.
  
  
  RESULTS
  The patient noted a decrease in pain within 2 weeks of initiating the new exercise, and was able to return to gradual running after 4 weeks and to speed training after 12 weeks. He returned to competition shortly thereafter and had no recurrence for 12 months after the initiation of therapy. His score on the Victorian Institute of Sport Assessment-proximal hamstring tendons improved from 23 on initial presentation to 83 at 12 weeks after the initiation of therapy.
  
  
  CONCLUSIONS
  We described the management of a triathlete with subacute proximal hamstring tendinopathy, who responded well to nonsurgical treatment using eccentric hip extension strengthening using a treadmill.
  
  
  METHODS
  Therapy, level 4.
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cushman
authors.forename: Monica E
authors.initials: ME
authors.lastname: Rho
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D052256:Tendinopathy / Q000628:therapy*
keywords: running; tendon; triathlete