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Physically active American Robert Gendler finds relief for hamstring pain at Hospital NEO

American physician Robert Gendler suffered from gluteal pain for a long time; it prevented him from exercising and made sitting down difficult. After a search for the top expertise in hamstring injuries led him to Hospital NEO, Gendler headed to Finland to undergo an operation by orthopedic surgeon Lasse Lempainen. Thanks to the surgery, Gendler is once again physically active and enjoying a pain-free life.

Robert Gendler has been very physically active his entire life.



Robert Gendler.

“As I got older, I started to experience some pain in my right hip that made moving difficult. I was diagnosed with arthritis of the hip joint, and as a result I underwent hip replacement surgery in 2012. That allowed me to be fully active again,” he says.

Two years after the hip replacement surgery, Gendler was again forced to limit his physical activity, as he began to have pain in his right gluteal region both during exercise and while sitting. Roughly a month later, he also began experiencing similar pain in his left gluteus.

“The pain was not unbearable, but it was constant. Even the smallest movement made it worse, and I was not able to properly cycle, hike or jog. It even hurt to sit. I eventually began to feel irritation also in my sciatic nerve,” recalls Gendler.

Source of pain in the hamstring

Doctors tried to find a solution to Gendler’s problem, and it took several months before he received the right diagnosis, as his condition was uncommon and its treatment not very well known among US orthopedic surgeons. The cause of the pain was high hamstring tendinopathy (HHT), which was finally confirmed by MRI.

In the US, Gendler was offered the same type of surgery that is performed for hamstring tears – a major operation with a long recovery period, as much as six months, and only one leg can be operated on at a time. High hamstring tendinopathy, however, requires a different approach using a different technique, and the recovery is faster.

Treatment in Finland

“I looked into the various forms of treatment for HHT and learned that much of the literature describing the condition came from Finland. The most recent articles on the subject were written by Lasse Lempainen. Encouraged by this information, I contacted Lempainen and described my symptoms and sent him my MRI image to examine. We discussed the various surgical options via email,” recounts Gendler.

Gendler and his wife travelled to Turku and the operation was performed successfully in November 2015.

“I was impressed by how nice and functional Hospital NEO is. The staff was really friendly and professional. I met Lasse Lempainen the day before my scheduled surgery. In my opinion the operation went well. The day after surgery, I was able to walk carefully and within just a few days I could walk without crutches. I was back at work three weeks after the operation,” he says.

In expert hands



Robert Gendler hiking.

“It has now been four months since my surgery at Hospital NEO. My recovery has gone well, and the best thing about it is that I am able to do the activities I did before my symptoms appeared. I am back to enjoying outdoor recreation and living an active life,” says a pleased Gendler.

Gendler has recommended Hospital NEO’s services to several of his patients and colleagues in the US. He has also written an article about his experiences, comparing treatment and healthcare costs in the US and Finland.

“Lasse Lempainen and Sakari Orava have world-class competence in hamstring injuries. As a physician, I have an advantage in accessing medical information. I was fortunate that I found the top surgeons and received targeted treatment for my HHT. I believe it is important to spread information about this condition in order to get the word out in the US about Finnish medical expertise in treating HHT,” Gendler sums up.

Read Robert Gendler’s article on the topic. (pdf)

From a surgeon’s point of view: Lasse Lempainen

US physician Robert Gendler suffered from chronic pain in both hamstrings, i.e. high hamstring tendinopathy (HHT).

Lasse Lempainen“The pain usually appears in the gluteal muscles and upper thigh. The symptoms present when moving and when sitting. HHT is common in athletes and very physically active people. However, even work-related physical strain can lead to the development of HHT,” says orthopedic surgeon Lasse Lempainen.

HHT can be treated with rehabilitation, but in prolonged situations surgery is often necessary.

“Of course surgery is not the most suitable option for everyone, and it is always determined on a case-by-case basis. In Gendler’s case, the pain had been getting progressively worse for a long time, and other forms of treatment had already been tried. Surgery considerably improved his situation,” says Lempainen.

Patience in rehabilitation

“Gendler’s operation involved a bilateral hamstring release, which relieved his painful condition. Recovery from this procedure is often rapid, and rehabilitation can start not long after the operation,” says Lempainen.

Together with his personal physician in the US and a physiotherapist, Gendler followed the rehabilitation plan that was drawn up for him after the operation.

“In rehabilitation, it is important to avoid excessively straining or overstretching the hamstrings.  The rehabilitation plan is supplemented by, for example, aquajogging at a rather early stage, as early as 3 to 4 weeks after surgery. We also recommend core exercises to improve, above all, hip, back and abdominal muscle strength in order to maintain proper posture,” explains Lempainen.

“Surgical management of hamstring syndrome was developed in Finland by Sakari Orava and Jaakko Puranen back in the 1980s, and as a result Hospital NEO has special experience in this form of treatment. We have conducted a lot of research on the subject, which is important also in terms of sharing this information worldwide,” he says.

Read Lasse Lempainen’s most recent article on the topic. (pdf)