I have been attempting to understand (etiology) and treat the condition of right ischial tendonitis. In reading the Impingement and Instability manual, it describes left ischial tendonitis more difficult to manage because of the tendency of the Left AIC pattern and the left hip position putting the left hamstring (semitendinosus) on strain. I have seen a few people now with only right side or initially bilateral and now only right side that I am struggling to get resolved. When dealing with left side, I know it says that you want to take tension off of the right hamstring and develop left glute med and left quad together with right glute max. Is it safe to say that with the right side you want to inhibit left hamstring and develop right quad and right glute med with left glute max? How does the right ischial tendonitis develop…is it a right quad to right hamstring ratio deficit? What exercise have you had success using?
You would not want to reverse the treatment for Left Ischial Tendonitis to treat Right Ischial Tendonitis. Right Ischial Tendonitis is very common. This would be considered a “Myokinematic Restoration issue”. The tendon on the right side is being used for constant AF IR, it is long. The glute max on the right is gone because they are relying on their hip flexors and hamstrings for support in the sagittal plane.
To reduce this pull on the right hamstring, you would want to shift them to the left (left AF IR). The right glute max is a critical piece in this because the right glute max will help you gain frontal and transverse control on the right.
The exercises we would work on would be:
Left Sidelying IO/TA and Left Adductor with Right Glute Max
Standing Wall Supported Left Knee Flexion with Resisted Right Glute Max
Standing Supported Resisted Right AF ER with Right Glute Max
All three of these activities work on Left AF IR with Right Glute Max.
