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Toronto, AL M5N 2M7
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Fax: 416-483-2654

Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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I was just diagnosed with semimembranosus tendinopathy. Strange name. What's the treatment for this problem?

Tendinopathy refers to any tendon that has been damaged in some way but is no longer in the acute inflammatory phase, which would be called a tendinitis. Examination of tendon tissue in patients who have had chronic pain over months and sometimes even years showed scarring and fibrosis but no active fluid, swelling, or white blood cells at the site needed for healing. Semimembranosus tendinopathy tells us the semimembranosus (one of three parts of the hamstring muscle) is affected. This portion starts at the base of your sit bone (called the ischial tuberosity). It travels down from the pelvis to the knee and inserts right along the posteromedial corner. The job of the semimembranosus is to flex or bend the knee. Overuse of this muscle from sports activities or degeneration from overuse with age is the underlying cause in two age groups: young endurance athletes and middle-aged (and older) adults. Treatment usually follows a conservative approach. The physician may prescribe medications such as anti-inflammatories. Physical therapy is the next step. You will be instructed in the proper use of ice to control pain, activity modification, stretching, and strengthening exercises. Posture and alignment will be assessed and corrected with exercises and/or shoe modifications. Sometimes a heel lift is all that's needed. In other cases, a specific shoe might be recommended. For cases that don't improve with conservative care, injection with a numbing agent may be tried. Up to three injections can be done spaced out over several weeks. Surgery is a final option for those who have bone spurs that need to be removed or when it is necessary to re-route the tendon. The physician who diagnosed you will have a plan of care in mind that may include some or all of these approaches. Results are usually positive and occur fairly quickly. Studies show that in 90 per cent of all cases, healing occurs with conservative care and without any further intervention.


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