My hamstring doesn't need more glute work. (Does my grip?)

Here's something I don't usually share: I've been dealing with a nagging injury of my own.

For the past 6 months, I've had persistent pain at the top of my hamstring - right at the sit bone. High hamstring tendinopathy. Or possibly something pelvic floor-related (the overlap is real).

And here's the part that's a little humbling: even with everything I know, my first instinct was to look everywhere except the hamstring. "Is it my glutes? My core? My hip mobility?" I started troubleshooting everything around the structure that was actually hurting.

Sound familiar?

This is a pattern I see constantly with clients - and apparently with myself. So this week I want to talk about why we keep looking in the wrong place, and what the research says we should actually be doing.

This one is a bit longer than usual. Skim for the 🟡 golden nuggets if you're short on time.

TENDONS: WE'VE BEEN LOOKING IN THE WRONG PLACE

We keep blaming the neighbours.

If you've ever been told your knee pain is from "weak glutes," your Achilles is from "tight calves," or your shoulder pain is from "something off elsewhere in the chain" - you've experienced the pattern.

And look - that framework isn't entirely wrong. Proximal and distal influences matter. But when it comes to tendons specifically, there's a principle that cuts through all of it:

Tendons must be directly loaded to adapt. You can't make a patellar tendon stronger with extra glute work. You can't fix a high hamstring tendinopathy with core exercises alone. You have to load the structure in question at the right intensity, with the right tempo, consistently enough for the tendon to respond.

The principle from tendon researcher Jake Tuura puts it best: No Strain, No Gain. For tendons, that strain isn't just helpful - it's necessary. VITAL, even 😉

🟡 Rest weakens tendons. Immobilization reduces collagen synthesis by ~80% in just 2-3 weeks. 90 days of bed rest = 58% decrease in tendon stiffness. Complete rest doesn't heal tendons. It makes them more vulnerable.

What I've been reading

I've been working through the first six chapters of Jake Tuura's Tendon Book, and it's been equal parts validation and reality check. A few things that landed for me:

🟡 The gold standard for tendon training is Heavy Slow Resistance (HSR): ≥70% of your 1RM, 3-second eccentric + 3-second concentric tempo, 2–4 times per week, for at least 12 weeks. Slow. Heavy. Consistent. This is what the research supports - not the light, fast rehab band work most people do.

🟡 Structural changes ≠ pain. Tendons can show degeneration on imaging and be completely pain-free. And you can have significant tendon pain with no structural changes visible at all. The image isn't the diagnosis - and it's rarely the whole story.

🟡 For high hamstring tendinopathy specifically: The hamstring tendons are trained by both hip extension AND knee flexion. Most rehab programs focus almost entirely on hip extension (Romanian deadlifts, hip thrusts). The knee flexion component - Nordic curls, leg curls — is often undertrained. If you've been doing all the right "glute work" and your hamstring still isn't responding, that may be the missing piece.

One more thing I'm mindful of with my own injury: sitting compresses the proximal hamstring insertion. So managing compressive load (how long I sit, the angle of my hip) is just as important right now as the actual loading protocol. That's another reason I'm seeing a physio rather than just treating myself.

If you want to pick up the book, Jake's at jaketuura.com — genuinely worth reading.

A few new faces at Vital this week

We welcomed three summer interns to the team last week - Ruby, Katie, and Andersen. If you spot them at the front desk or shadowing sessions, say hi!

What struck me right away was how intentional they are. In our first meetings, all three brought up leadership - not just career goals, but genuinely wanting to grow into the kind of people who lead well. Pretty impressive for a group stepping into the workforce for the first time.

We got into it a bit, and imposter syndrome kept coming up. That feeling of am I actually qualified to be here doesn't go away just because you get the degree.

So we gave them this podcast as homework. And figured - why keep it to ourselves. Go listen HERE!

HAND + WRIST FOUNDATIONS - LAUNCHING THIS SUMMER

Speaking of structures that need direct loading... we've been quietly building something.

Hand + Wrist Foundations is a 12-week, self-directed online program designed to build grip strength, wrist resilience, and hand function from the ground up. Same framework as Shoulder Foundations: progressive phases, pre/post testing, video-guided exercises, and team support throughout.

What recently sparked our passion for this program program

One of our clients came in with what looked like a manageable case of lateral epicondylitis - "tennis elbow" from a combination of tennis and skiing. Week to week, the sessions were moving things in the right direction. Small doses of the right loading, done well, were helping.

The problem was everything outside those sessions. The rest of her week carried significant load - tennis, skiing, daily demands - and once a week (or less, when the holidays made things inconsistent) wasn't enough to keep pace. When things kept flaring and tennis came to a stop, we realized the tendinopathy was more aggressive than it had appeared. At the worst point, even holding a weight was painful.

Usually what helps these people turn the corner isn't loading alone. The manual therapy piece is also important - not as the healing protocol itself, but as a necessary puzzle piece. Releasing the tight structures that had locked up around the injury created just enough pain relief to allow the loading to actually happen.

Releases to make room for loading. Loading to drive adaptation. That combination is what Hand + Wrist Foundations is built around - and why it's more than just an exercise program.

Why this matters beyond that story

🟡 Grip strength predicts lifespan. A 5 kg decrease in grip strength is associated with a 16–17% increased risk of all-cause mortality (BMJ, 2018). It also predicts cardiovascular events, cognitive decline, and functional disability in older adults. And yet - almost no structured, progressive hand and wrist training programs exist for the public.

Who it's built for: