Hi guys! In this video, I'm going to explain why you need to start thinking a little bit
differently about speed and what speed – or increasing your speed when running – means when
you've got high hamstring tendinopathy versus your old thought processes when you weren't injured,
and you were just training for performance. Because that can be the difference between
you getting back to running and causing yourself a flare-up. So, for those of you who don't know me,
my name is Maryke. I'm one of the physiotherapists from sports-injury-physio.com,
where we provide online physiotherapy assessments as well as treatments via video call. So, have a
look at the Description of this video if you want the link to the website. Okay, so what's the issue
with speed? Now, if we think of high hamstring tendinopathy; it's when you've got pain right
there, by your sit bone. And when we increase the speed with running, we naturally give larger
steps. So, that means the leg moves forwards, and you get a little bit more compression over … of
that tendon over the sit bone. But also, the hamstring has to contract more forcefully. So,
you're getting the increase in compression plus increase in force, and that can often be really
provocative for the high hamstring tendon. Now, I've had quite a few patients in the last few
weeks where – bless them – they've really just increased the speed of their run-walk sessions
and things with a tiny bit, which wouldn't count as a speed session when they weren't injured,
and it's really flared them up. And it's just made me realise again that I need to really
explain to you that, when we think of return to running from high hamstring tendinopathy,
we need to get quite a good volume of slow running, that it can cope with that before
we start increasing that volume of running with a few seconds of speed training. Now,
when you weren't injured … usually it's people with good performance and running that get this
type of injury. So, your fast running sessions would have been ... gosh, if you're a
male, it may have been three minutes 40 per kilometre or four and a half minutes per
kilometre. If you're a female, it may have been four and a half, around that, per kilometre – your normal
running. So now you may be running at something like six and a half minutes or eight minutes per
kilometre. Or if you're doing miles, it may even be some people running at 12-minute miles or
10-minute miles. So, it's really slow compared to what you’re used to. Now, if you increase
a 12-minute mile pace by half a minute per mile, that's actually a big jump for the hamstring
tendon with regards to force plus compression. If you increase it … Same goes
for … Say for instance you're running seven and a half minutes per kilometre. So, really slowly.
But now you're doing just a few of those run-walk sessions at six and a half minutes per kilometre;
that's a minute jump in speed, which makes a big difference again to the compression and the force.
So, a good way of building it up that you don't end up in that situation is ... Of course,
you've got to be doing your rehab alongside that; so, building the strength in that tendon.
But keep your runs really slow until you can easily do 40 minutes to an hour. So,
depending on the type of running you do; if you … if you're more a shorter-distance person; so,
you usually just do about 5Ks, that type thing; I would say 40 minutes. If you're
somebody who likes to do marathon running, we need to be looking at up to an hour of
easy running before … really easy running, before we start taking some time off that.
And then, when you start thinking of, “Okay I'm going to start speeding up a little bit”,
we approach it in the same way as a run-walk. So you’re now continuously running, really slow pace
of 40 minutes to an hour, whatever is appropriate for you.
You don't increase that whole run session with a slightly higher speed; you do a slow warm-up,
let's say … Let's take a 40-minute session. Say we do 10 to 15 minutes of really slow; then, for the
next 10 to 15 minutes, you do it in one-minute, one-minute; so, one minute, slightly faster. So,
10 to 15 seconds faster. Then you bring it back down to your normal pace for the next minute,
10 to 15 seconds faster, and back. Of course there will be people who can progress more quickly,
but if you've got one that's niggly and that's quite sensitive, I would say this approach will
really work for you. But you have to make sure that you get good strength training in there as
well at the same time. Excellent! Let me know if you've got any questions. And if you need more
help with an injury; always welcome to consult us via video call. Link to the website … I'll
put a link up here, but there's also a link in the Description of this video. Take care!