Efficacy of Eccentric Versus Isometric Exercise in Reducing Pain in Runners With Proximal Hamstring Tendinopathy
NCT ID: NCT04683107
Last Updated: 2020-12-24
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
NA
42 participants
INTERVENTIONAL
2021-01-31
2021-09-30
Brief Summary
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PHT is a chronic degenerative injury that is produced by mechanical overload and repetitive stretch. Risk factors include overuse, poor lumbopelvic stability and relative weakness of the hamstring muscles. The phenomenon manifests itself with deep pain in the ischial tuberosity area and projection to the posterior thigh, pain during prolonged sitting, pain during hip flexion and knee extension and pain that increases or arises during running, especially during the swing phase.
Risk factors are divided into internal (systemic and biomechanical) and external factors. Internal factors associated with systemic characteristics, include advanced age, sex, obesity, genetics, inflammation and autoimmune conditions, diabetes, hyperlipidemia, and drug use. The external factors, which are more modifiable, are those that depend on the patient's external environment and include training errors such as increasing training volume and / or intensity too quickly and insufficient recovery that cause an overload on the tendon.
For PHT two conditions are considered provocative - energy storage, an action that is typical in the late swing phase while running and repetitive movements that cause compressive forces of the tendon on ischial tuberosity. Compressive forces increase as the hip or trunk flex which explains why training errors such as an increase in volume or intensity of the training and non-gradual change in training type, such as hurdle or hills training, are considered to be factors involved in PHT.
PHT treatment options include physiotherapy, shock waves, Platelet rich plasma (PRP) and surgical treatment. Non-surgical treatments for tendinopathy includes gradual loading of the tendon under the supervision of the level of pain. The load on the tendon causes an increase in collagen synthesis and an increase in the stiffness and capacity of the tendon which ultimately helps return the athlete to function and reduces the level of pain.
Although the injury mechanism is common among runners and athletes from various endurance disciplines (medium and long distance runners, triathletes, etc.) the phenomenon and its treatment has not been sufficiently studied within this population.
Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Eccentric protocol
Eccentric protocol
Participants in this arm will perform progressive eccentric exercise protocol
Isometric protocol
Isometric protocol
Participants in this arm will perform progressive isometric exercise protocol
Interventions
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Eccentric protocol
Participants in this arm will perform progressive eccentric exercise protocol
Isometric protocol
Participants in this arm will perform progressive isometric exercise protocol
Eligibility Criteria
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Inclusion Criteria
* over the age of 40
* With tendon pain lasting 3 months or more, at the location of hamstring insertion in Ischial tuberosity, that increases during or after running.
Exclusion Criteria
* Stress fractures of the ischium bone
* Radiated pain in the posterior thigh originating in the lumbar spine, hip joint or sacroiliac joint
* Other pathologies or rupture of the hamstring muscle
* Exclude people who have received therapeutic intervention in the last month
* Medication use for PHT
* Pain located medially or laterally to the Ischial tuberosity
* Pregnant women
40 Years
ALL
No
Sponsors
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Tel-Aviv Sourasky Medical Center
OTHER_GOV
University of Haifa
OTHER
Responsible Party
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Central Contacts
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Other Identifiers
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University of Haifa (UHaifa)
Identifier Type: -
Identifier Source: org_study_id