Semitendinosis Rupture

Hello, Young 35 year old social socer player completely ruptured his semitendinosis tendon (by 12cm confirmed by ultrasound) in mid October. The GP sugested to continue rehab as per usual as this is the tendonused for ACL repairs anyway.

Treatment is going along fine, strength is improving, he is back to 90% speed at training in straight lines and proprioception work has also improved.

The patient is still complaining of slight ache and not felling "quite right' as if he is going to pull his hamstring again. On palpation the semimembranosis tendon is so tight. Frictions, active stretch, US all have not worked.

Does anyone have any suggestions on how to stretch out this tendon?

Michelle

Hi, just some questions to find out more info...

You mention rehab as usual but what exactly is his rehab specifically?

Can he actively relax the muscle?

Why did that muscle tear on that side and not on the other side?

How is his hip, pelvis and L/S? And his knee, ankle and foot for that matter?

Lastly, did he rupture his tendon or muscle?

Thanks

When you mentioned that active stretching and US didn't work and the tendon very tight felt on palpation, I thought it's worth while looking at the fascia as well as neurodynamics. With the traumatic semitendinosis rupture it's almost a given that the fascia loses its elasticity and most likely will result in restriction to the muscle. I find it very helpful to look at fascial release in combination with neurodynamics, kind of "winding up" to feel the soft tissue restriction. If it is indeed the case, ROM and stretching should improve after.
But I agree with the previous comment on checking all the joints above and below before going into soft tissue techniques.
Good luck.

I would say that at only 2 months following the injury a little tightness is to be expected. At 3 months the soft tissue healing will only be at about 85% of the tensile strength of the previously uninjured tissue. I would simply keep on with the stretching and strengthening work and give nature more time. if i was treating this patient i would be using the Glen Hunter soft tissue mobs which combine phsiological and accessory stretching (similar to frictions) . Good luck