Mission Wellness Clinic Dr. Alex Jimenez, DC, FNP-BC P: 915-412-6677
Complex Injuries

High Hamstring Tendinopathy: EP Wellness Doctor Rx

The hamstring muscles attach, through a tendon called the proximal hamstring tendon, to the ischial tuberosity, the bones used to sit deep in the buttock muscles. When the tendon is subjected to overuse/repetitive stresses and strains, the internal structure can become compromised, leading to weakness and pain symptoms. This is known as proximal hamstring tendinopathy. Tendinopathy is an overuse injury where the tendon is repeatedly strained until microscopic tears form. It is common in athletes that do a lot of running but also in individuals that sit for prolonged periods. If left untreated, high hamstring tendinopathy can lead to progressive degeneration of the tissues, leading to chronic weakness, pain, and dysfunction.

High Hamstring Tendinopathy

The hamstrings are a powerful muscle group that extends the hip and flexes the knee. They experience stress and pressure during activity and inactivity/sitting and are susceptible to strain injuries. Tendons attach muscle to bone and are designed to take compressive and tensile weight/loads that stretch or flex. A tendon is made up of fibrous tissue containing organized type 1 collagen. Tendons receive blood; however, the supply is less where the tendon attaches to the bone and is commonly where tendinopathy occurs.

Injury

A hamstring injury involves the bruising, irritation, or tearing of the hamstring tendon or muscle tissue. Severity can range from:

  • Microtears that cause stiffness and pain symptoms but heal fast on their own.
  • Severe ruptures that cause debilitating pain, dysfunction and require medical intervention.

The tendon attaches to the ischial tuberosity or sitting buttock bone. Tendons can have a spasm-like reaction to sudden or quick shift changes. A sudden change can cause adverse changes to the tendon. Too much load on the tendon beyond its ability to recover can cause the structure to change and the collagen to break down/tear like a rope tearing and unraveling. High hamstring tendinopathy happens around the hip area and presents as buttock or upper thigh pain. Individuals report deep, dull, radiating buttock pain during walking, running, and prolonged sitting or driving. Sometimes the sciatic nerve can become irritated or entrapped by an affected tendon’s scar tissue, causing sciatica-like symptoms.

Stages of Tendon Pathology

Reactive Phase

  • Caused by an acute overload of physical activity or inactivity.
  • The tendon will thicken temporarily to decrease the stress; however, there may be no inflammation.
  • The tendon can return to normal if the load is reduced or sufficient time for recovery and repair is allowed.

Disrepair

  • Chronically overloaded.
  • Unsuccessful healing.
  • More negative tendon changes occur.
  • Reversibility is possible with load management and targeted exercises to stimulate the tendon and surrounding tissues.

Degenerative

  • Continual progression of adverse tendon changes.
  • More common in older individuals.
  • Continue load management and strength training to maximize the tendon’s tolerance.

Chiropractic Treatment

A chiropractic therapy team will develop a personalized treatment program to improve tendon structure and strengthen the hamstrings, gluteal, and side abdominal muscles. They will begin with tendon symptom-relieving massage to loosen the muscles and get the blood circulating, MET-targeted stretches to lengthen the muscles, and spinal and pelvic adjustments to realign the body.


Sciatica Explained


References

Buckley, Mark R et al. “Distributions of types I, II and III collagen by region in the human supraspinatus tendon.” Connective tissue research vol. 54,6 (2013): 374-9. doi:10.3109/03008207.2013.847096

Lempainen, Lasse, et al. “Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy.” Muscles, ligaments, and tendons journal vol. 5,1 23-8. 27 Mar. 2015

Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments, and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248

Ono, T et al. “Estimation of tensile force in the hamstring muscles during overground sprinting.” International Journal of sports medicine vol. 36,2 (2015): 163-8. doi:10.1055/s-0034-1385865

White, Kristin E. “High hamstring tendinopathy in 3 female long-distance runners.” Journal of chiropractic medicine vol. 10,2 (2011): 93-9. doi:10.1016/j.jcm.2010.10.005

Wilson, Thomas J et al. “Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.” Orthopedic Journal of sports medicine vol. 5,7 2325967117713685. 3 Jul. 2017, doi:10.1177/2325967117713685

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General Disclaimer, Licenses and Board Certifications *

Professional Scope of Practice *

The information herein on "High Hamstring Tendinopathy: EP Wellness Doctor Rx" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Welcome to El Paso's Premier Wellness and Injury Care Clinic & Wellness Blog, where Dr. Alex Jimenez, DC, FNP-C, a Multi-State board-certified Family Practice Nurse Practitioner (FNP-BC) and Chiropractor (DC), presents insights on how our multidisciplinary team is dedicated to holistic healing and personalized care. Our practice aligns with evidence-based treatment protocols inspired by integrative medicine principles, similar to those on this site and on our family practice-based chiromed.com site, focusing on naturally restoring health for patients of all ages.

Our areas of multidisciplinary practice include  Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols.

Our information scope is multidisciplinary, focusing on musculoskeletal and physical medicine; wellness; contributing etiological viscerosomatic disturbances within clinical presentations; associated somato-visceral reflex clinical dynamics; subluxation complexes; sensitive health issues; and functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist follows their professional scope of practice and licensure jurisdiction. We use functional health & wellness protocols to treat and support care for musculoskeletal injuries or disorders.

Our videos, posts, topics, and insights address clinical matters and issues that directly or indirectly relate to our clinical scope of practice.

Our office has made a reasonable effort to provide supportive citations and has identified relevant research studies that support our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.

For further discussion on how this information relates to specific care plans or treatment protocols, please ask Dr. Alex Jimenez, DC, APRN, FNP-BC, or contact us at 915-850-0900.

We are here to help you and your family.

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Dr. Alex Jimenez DC, MSACP, APRN, FNP-BC*, CCST, IFMCP, CFMP, ATN

Email: coach@elpasofunctionalmedicine.com

Multidisciplinary Licensing & Board Certifications:

Licensed as a Doctor of Chiropractic (DC) in
Texas & New Mexico*

Chiropractic Licenses:
Texas DC License #: TX5807, Verified: TX5807
New Mexico DC License #: NM-DC2182, Verified: NM-DC2182

Nurse Practitioner Licenses:
Texas APRN License #: 1191402, Verified: 1191402 *
New Mexico CNP License #: 90560, Verified 90560
Florida APRN License #: 11043890, Verified: APRN11043890 *
Colorado License #: C-APN.0105610-C-NP, Verified: C-APN.0105610-C-NP
New York License #: N25929, Verified N25929
Georgia APRN License #: GAA-NP005701

Multi-State Advanced Practice Registered Nurse (APRN*) Texas & Multi-States 
Multi-state Compact APRN License by Endorsement (43 States)
Compact Status: Multi-State License: Authorized to Practice in 43 States*
Nursing Licensure Compact: Updated Here

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All medical (MDs) and family practice providers (FNP-APRN) are registered and licensed to offer various levels of medication.
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License Verification Link: Nursys License Verifier
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Board Certification:

ANCC FNP-BC: Board Certified Nurse Practitioner*

Education:
Graduate with Honors: ICHS: MSN-FNP (Family Nurse Practitioner Program)
Degree Granted. Master's in Family Practice, MSN Diploma (Cum Laude)


Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
(Board Certified: Family Practice Nurse Practitioner—Multistate)*
(Licensed Nurse Practitioner & Chiropractor - Multistate)*
Clinical Director
DC & FNP License (Review Above)
Digital Business Card
NPI: 1205907805

Dr. Maria Cardenas, MD
(Board Certified: Internal Medicine)
(Licensed Medical Doctor)
Medical Director, Clinical Director & Collaborative Physician
NPI # 1164426748
MD License #: J2933

 

Licenses and Board Certifications:

MD: Medical Doctor
DC: Doctor of Chiropractic
APRNP: Advanced Practice Registered Nurse 
FNP-BC: Family Practice Specialization (Multi-State Board Certified)
FNP-BC: Family Practice Across Life Span (Neonatal to Geriatrics)
RN: Registered Nurse (Multi-State Compact License)
CFMP: Certified Functional Medicine Provider
MSN-FNP: Master of Science in Family Practice Medicine
MSACP: Master of Science in Advanced Clinical Practice
IFMCP: Institute of Functional Medicine
CCST: Certified Chiropractic Spinal Trauma
ATN: Advanced Translational Neutrogenomics

 

Family with Primary Care Focus (Family Nurse Practitioner or FNP)

  • The Family Nurse Practitioner (FNP) promotes, maintains, and restores health for individuals and families across the lifespan. FNPs also identify health risks, promote wellness, and diagnose and manage acute and chronic illness.
  • The FNP focuses on comprehensive primary care, promoting healthy lifestyles for patients across the lifespan in settings such as private practice, physician offices, and community health centers.

 

Memberships & Associations:

TCA: Texas Chiropractic Association: Member ID: 104311
TNA: Texas Nurse Association: Member ID: 06458222
TNP: Texas Nurse Practitioner Association ID: 2025091511
AANP: American Association of Nurse Practitioners: Member ID: 2198960
ANA: American Nurses Association: Member ID: 06458222 (District TX01)

 

Primary Taxonomy Selected Taxonomy State License Number
No 111N00000X - Chiropractor NM DC2182
Yes 111N00000X - Chiropractor TX DC5807
Yes 363LF0000X - Nurse Practitioner - Family TX 1191402
Yes 363LF0000X - Nurse Practitioner - Family FL 11043890
Yes 363LF0000X - Nurse Practitioner - Family CO C-APN.0105610-C-NP
Yes 363LF0000X - Nurse Practitioner - Family NY N25929
Yes 363LF0000X - Nurse Practitioner - Family NM

90560

Yes 363LF0000X - Nurse Practitioner - Family GA GAA-NP005701

 

Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
(Board Certified: Family Practice Nurse Practitioner—Multistate)*
(Primary Care Across Lifespan—Neonatal / Pediatric / Adult / Geriatrics)
(Licensed Nurse Practitioner & Chiropractor - Multistate)*
Clinical Director
Digital Business Card
NPI: 1205907805

 

Dr. Maria Cardenas, MD
(Board Certified: Internal Medicine)*
(Licensed Medical Doctor)*
Medical Director, Clinical Director & Collaborative Physician
NPI # 1164426748
MD License #: J2933

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