Proximal Hamstring Tendinopathy by Physiotherapist Lindsay Young
Proximal Hamstring tendinopathy
A condition where the hamstring tendon (attaching muscle to bone) begins to react or degenerate.
Symptoms:
- Pain over the buttock fold, right on the sitting bones
- Sometimes pain referral down the back of the leg
- Pain aggravated by running, stairs, leaning forward or sitting
Who suffers from Hamstring tendinopathy:
- The younger population who are playing sport or running and have recently increased their training load such as more hills or sprints.
- Older population, often pain can come on without any reason and never leave
Diagnosis:
Your physiotherapist can perform a number of tests that put the tendon under stress and will be painful or weak. Imaging is carried out via ultrasound and MRI with MRI being the gold standard.
Hamstring tendinopathy can also sometimes co-exist or be confused with sciatic pain. The sciatic nerve runs very close to the tendon and can also be irritated in a HS tendinopathy.
Recovery:
Can take anywhere from 3-12 months to fully resolve. This is natural healing time for tendons which are very slow to recover. Your pain should be under control however in the first 4-6 weeks.
Management advice:
- Running technique correction, particularly overstriding
- Reducing load on the tendon
- Reducing pressure on the tendon while sitting (eg foam with portion cut out of it)
- Reducing forward lean position
- Reducing hill or stair running
- No stretching of the hamstrings
- Restoring pelvic girdle muscle weakness – guided by your Physiotherapist over weeks to months of rehab
- Reducing hamstring muscle tightness- massage and acupuncture by your Physiotherapist and foam roller for home
What about an injection?
For those who have not responded to a good conservative management plan over 6 weeks a PRP may be indicated.
Cortisone injections are not appropriate for tendons and can cause damage to the tendon.
