Tendonitis in my semitendinosus, want to get back to triathlon training

by Ben

I am a personal trainer and triathlete and 2010 was a disastrous year for me, i have tendonitis of my semitendinosus (the tendon to back of the knee (medial), i first got it in December 2010 and had it for 4 months.


I have just spent time reading all your help and advice, i am very impressed, i hope you do not mind me contacting you for some further help and advice.

It was caused i think from swimming with a float (legs only sessions) and was overused, i am and was also very inflexible, tight hamstrings.

I have had steroid injections that helped but not cured it,come april last year it just wouldnt go, i had the pain all day long,the only time it went was first thing in the morning. i decided the only thing i could do as i couldn;t rest it for any longer is to just start biking again very steadily and build it up slowly.

I did this and always ensured i would stretch after the ride and always used cold water on it after in the shower. It went, great, i did a lot of cycling in t
he summer, and come mid september it flared up again! i have had it ever since,I had another injection(nov 2010) that lasted 2 weeks! I have just rested it for 6 weeks (dec-jan). I had a few niggles but it felt better so at least i thought so.

I did a 35 minute cycle ride and a swim session last weekend(first exercise in 6 weeks),guess what it is painful again! I am now so low and down i have had this for a year now and cannot seem to shift it. its definatley the tendon thats inflamed.

I have done very little training throughout 2010 and it seems tat 2011 is to be the same unless i can cure it.

If you can help i would be so grateful.

I am desperate to be injury free again.


Thank you.



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Joshua Answers:

1. Read through my site more. Make sure to read the Rest page, the Pain Causing Dynamic page, the Process of Inflammation page, and the Tendonitis page.

See: What Is Tendonitis?


2. Rest doesn't help, fix, nor cure anything, due to the above.


3. Yes, the tendon is inflammed, but that's not the problem, no matter how many times your doc wants to inject it with connective tissue weakening corticosteroid injections.

4. The tendonitis wasn't caused by the float swim/exercise. Your tendonitis dynamic was slowly, progressively forming for years, tissue getting tighter and tighter, your body compensating more and more, until you finally
passed a threshold where your body started to really lose and it said 'It's YOUR problem now!'

5. Here's what you do. Get a big pepsi bottle (plastic), one of the big 2 litre bottles. EMPTY it out. Fill it with water. Freeze it.

Then, open up all the tight tissue in the back of your upper leg. Might as well hit the lower leg too, and your quads. You need it.

Our instinct is to focus on the tendon. The tendon isn't the problem. That's where the pain ends up, but not where it starts.

Your muscle and connective tissue is TOO TIGHT. It's constantly putting tension on the tendon. Pull gently on your finger for 6 months and see what happens.....

Your tissue is bound up. It's constrictive. Your muscles are constantly working, even when at rest. Your quads have to work WAY too hard just to bend your leg opposite your hamstrings. Your muscles can't fire properly, so can't absorb force optimally, or perform work properly. Force has to go -somewhere-, and it seems it's your tendon. Better that than your ACL.

Rub, massage, pin and stretch, jab that frozen water bottle in there and move it around, jab it in there and hold it and move your leg around.


That's kind of a general concept, but jump in. Yes there's more specific stuff, like what you'll find on the Magnesium for Tendonitis and Magnesium Dosage pages, but start with this, and we'll go from there.

Go after it like it's a competition. It's you against your TOO TIGHT structures. Don't hurt yourself, don't do too much too soon. Work your way into it.

Just like training to get into shape, you're going to now train for a while to get your tissue soft and supple again.

Take the tension off the tendon, the pain will go away.

Get into it for a while, and then: more questions, more answers.




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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Tendonitis in my semitendinosus, want to get back to triathlon training

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May 09, 2013
Rating
starstarstarstarstar 		My semitendinosus hurts 6 weeks after a hamstring pull
by: Anonymous

Pulled my hamstring six weeks ago and stil have pain when i try to walk backwards sliding my feet on the grass or cement.. I think i hurt my semitendinosus..

Could the pain be scar tissue or inflamation??


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Joshua Comments:

Hi Anonynosis.

Yes, the pain could be from scar tissue, or inflammation, or both.

Is the muscle just tight and that's what's causing the pain, or did you actually tear something?
May 12, 2013
Rating
starstarstarstarstar 		What should I do next?
by: Anonymous

I dont know if its a Tare or a pulled hamstring, I was running and heard a pop but never got a bruise, Before i started to put ice on my hamstring I felt a sharp pain when stretching . Now since I started to put ice in the area of pain when stretching I feel a small pinch or poking with a needle sensation, is that a pulled or a torn hamstring symptom?... it's been six weeks since this happened, what should I do to get better?




Pulled my hamstring six weeks ago and stil have pain when i try to walk backwards sliding my feet on the grass or cement.. I think i hurt my semitendinosus..

Could the pain be scar tissue or inflamation??


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Joshua Comments:

Hi Anonynosis.

Yes, the pain could be from scar tissue, or inflammation, or both.

Is the muscle just tight and that's what's causing the pain, or did you actually tear something?
May 03, 2016
Rating
starstarstarstar 		Let's be fair
by: Anonymous

It doesn't really seem fair to assume that this person's doctor is trying to sell them corticosteroid injections that are going to destroy connective tissue.

A lot of the time, patients insist on injections from their doctor, even when the doctor advises against it.

Can't we work toward better health and fitness without throwing other practitioners under the bus? Aren't we all on the same team here, trying to maximize patient well-being?


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Joshua Comment:

Hi Anonymous.

Fair enough.


1. As I often say, I'm biased based on/due to the experiences/scenarios of the clientele that land here.

I very rarely get 'I really wanted a shot but it didn't work out'. It's primarily 'my doctor said i should so I did and it didn't work out'.

But yes, absolutely, people in general want shots and pills and and other magical silver bullet cures, but there are no actual silver bullet cures...


2. Sure we're all on the same team. But IMHO doctors that give repetitive corticosteroid injections are very unskilled players (I say that because they are giving repetitive corticosteroid injections, etc).

Good intentions are great, but I assert that people want results over good intentions.

I end up working with the people that didn't get results from their doctors etc. And often, those are also the people that (may or may not) get results for a while, but no lasting benefit or fix over the months and years they've been working with said doctors.

There's a reason that corticosteroid injections don't work...and that's primarily because they don't fix any of the factors that caused the problem in the first place.


I try to maximize patient well-being, etc. Thus it's important to point out that the corticosteroid shots they were given had very little to no chance of fixing the problem and iffy chances of helping symptoms more than temporarily.
Jul 22, 2016
Rating
starstarstarstarstar 		Semitendinosus injury?
by: Triathlon Coach

After reading your page and others comments I believe I have injured my semitendinosus. I went for an 8 mile run one VERY humid morning 3-4 weeks ago.

I had a lot of errands and chores to do that day and did not stretch or rehydrate as needed when finished. About 3-4 hours later I was sitting and went to stand up and felt a pull on the inside back of my knee.

I tried to stretch and only made it worse... pain wise. I tried to work through it for the next or so, but every time I ran it got worse. I took some time off, but it did not get any better.

I have started some strength exercises and stretching regiment. I did find that my hamstrings were much tighter than I thought.

After I stretch there is a more pain for a while, but it does go away and I feel better for a couple hours until the pain and pressure return.

Although the hamstring is getting looser and the pain seems to be less each day. The injury is still there and I am wondering what additional measures I should be taking. I read about the 2 liter bottle being frozen. Do you use that to roll on the hamstring?

Are there any additional stretches other than the seated and standing hamstring stretch that should be done? I have not been doing any running, but can I cycle or should I wait until the tendon is heal properly? There is only a slight bit of pressure when cycling and little to no pain.

I have had to pull out of the Age Group National Championship in August and am fearful I will have to pull out of my final race of the year in September.

Any thoughts or suggestions are greatly appreciated.

Russ D


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Joshua Comments:

Hi Russ.

See the Pain Causing Dynamic link on this page.

And see the Magnesium for Tendonitis link as well. That's going to be a critical factor.


Question: Do you know if there is, or is not, an actual rip or tear?

If there is, that's a very different conversation (though all the same factors are at play).
Jul 22, 2016
Rating
starstarstarstarstar 		reply
by: Anonymous

I don't believe there is a tear. There was no pop or snap when it happened. I really think, as some of your articles read, it was something that happened over time and it finally came to a head. I had just started upping my mileage without upping my recovery time and stretching... Which I know better. It has gotten better over the last few days, but wasn't sure if cycling would lead to extending recovery time.


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Joshua Comments:

Well, if cycling (or any other activity uses/adds irritation to the already irritated dynamic, then irritation will increase or maintain.

The real problem is, it sounds like you're ow locked/stuck in a pain dynamic.

If there's no rip or tear, that's a good thing. Actual damage complicates things (which may be an obvious statement, but is accurate and relevant).

You said "I have not been doing any running, but can I cycle or should I wait until the tendon is heal properly".

If there is no rip/tear, then the tendon doesn't need to heal. There is no 'injury'.

Even if there is some wear and tear, as long as there isn't a rip/tear, the tendon isn't the problem.

The muscle(s) and muscle function is.

You said stretching helps for a while but only a while. That's one clue to go after magnesium, as it takes calcium to fire a muscle and magnesium to stop firing a muscle.

It sounds like you're mostly stuck firing..and if you don't have enough magnesium available....just that can prevent or slow recovery.
Jul 22, 2016
Rating
starstarstarstarstar 		reply
by: Anonymous

Joshua,

I appreciate the information and I found ALOT of useful information on your web site. I will continue the stretching/strengthening of the muscle and will go by the drug store tonight and get some magnesium. Thanks again for the help and have a great weekend!

Russ


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Joshua Comments:

Cool. Make sure it's not magnesium oxide.
Jul 25, 2016
Rating
starstarstarstarstar 		Reply
by: Russ

Joshua,

I looked at a few places this weekend for magnesium and everything I found was Oxide. Which magnesium would you suggest? I did some reading after you said no Oxide and found it does not absorb very well. Thanks again for the help!

Russ


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Joshua Comments:

Hi Russ.

Anything but oxide. Malate, glycinate, chelate, citrate.

There is some debate about aspartate being problematic so I skip that one on general principal, and some people are irritated more by citrate (but in general it's fine).

Glycinate you can take about a third more than others before hitting Tolerance Level.

https://www.tendonitisexpert.com/tendon-supplements.html
May 08, 2018
Rating
starstarstarstarstar 		Excellent read on tendonitis
by: DB

After reading hundreds of articles on treatment of hamstring tendonitis and seeking treatment from PTs, I came upon your article on tendonitis treatment. The pain dynamic appears to be common sense, but you are the only one I've heard discuss this way.

I think I'm stuck in the pain dynamic with one of the hamstring tendons (semimembranosus of left leg?).

I've started your recommendations to rub, massage, pin and stretch and jab the frozen water bottle into connective tissue. Slowly feels better.

After pain goes away, what do I do to keep tissue soft and supple? Seems like there is an underlying issue causing the tightness (e.g., alignment, form).


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Joshua Comments:


Hi DB.

"but you are the only one I've heard discuss this way"

I know, right? Pretty weird. It's the basics of how the body works, I have no idea why I'm the only voice (that I know of) on the internet talking about it like that.

"After pain goes away, what do I do to keep tissue soft and supple? Seems like there is an underlying issue causing the tightness (e.g., alignment, form)."

Before I respond to that, what have you/the PT's done as far as alignment.

Has somebody checked/aligned your pelvic bones/hips/sacrum? And if so, what exactly happened then?
May 10, 2018
Rating
starstarstarstarstar 		Excellent read on tendonitis
by: DB

Joshua,

Regarding your question on PT and alignment, some work on hips but mainly focused on core and hamstring strengthening. Result - still have tendonitis.


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Joshua Comments:

Ok.

And, your hips/pelvis/sacrum is aligned? Yes/No

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