Understanding Hamstring Tendinopathy: Causes, Risks, and How Physiotherapy Can Help
Have you ever experienced pain high up on the back of your leg? If you have, you may be experiencing a Proximal Hamstring Tendinopathy (PHT). PHT is a common condition causing pain and dysfunction at the upper attachment of the hamstring muscles near the pelvis. It often affects runners, athletes, and anyone involved in repetitive or high-impact activities. If you’re dealing with persistent pain near the top of your thigh, it might be time to consider physiotherapy. In this blog, we’ll explore the causes, risk factors, and how a physiotherapist in Victoria can help you recover.
What Is Proximal Hamstring Tendinopathy?
PHT occurs when the tendon that attaches the hamstring muscles to the pelvis becomes irritated or damaged. This leads to localized pain, especially during activities like running, sitting for prolonged periods, or bending forward. Tendons play a crucial role in absorbing and transmitting forces during movement, and when they’re overloaded, symptoms of tendinopathy can develop.
What Causes Proximal Hamstring Tendinopathy?
PHT is caused by repetitive or excessive stress on the hamstring tendons. It typically develops due to (1):
Compressive Forces: Prolonged sitting or deep hip flexion (e.g., deadlifts) places compressive stress on the tendons.
Tensile Stress: Activities like sprinting or lunges, which stretch the tendons, can lead to micro-tears and irritation.
Overuse or Overload: A sudden increase in running mileage, intensity, or frequency is a common trigger as can be a relative limit on recovery time.
Risk Factors for Proximal Hamstring Tendinopathy
Certain factors increase the likelihood of developing PHT. We can split these factors into intrinsic factors (things inside our body that are often more difficult or cant be changed) and extrinsic factors (things outside of our body that may be easier to adjust). Understanding these risks can help prevent the condition and guide effective treatment:
Intrinsic Risk Factors
Age: Tendon resilience decreases with age, making older adults more prone to tendinopathy.
Hormonal Changes: Women undergoing hormonal shifts (e.g., menopause) may be at higher risk.
Metabolic Conditions: Obesity, diabetes, and other systemic health issues are linked to tendon problems.
Extrinsic Risk Factors
Training Errors: A rapid increase in training intensity or volume can overload the hamstrings.
Biomechanics: Poor running technique, such as overstriding, puts excessive strain on the tendons.
Equipment and Environment: Inappropriate footwear or running on harder surfaces adds stress to the hamstrings.
How Physiotherapy Can Help Proximal Hamstring Tendinopathy
Physiotherapy is a proven, evidence-based approach for treating PHT. A physiotherapist at Pursuit Physiotherapy in Victoria will assess your condition, identify contributing factors, and design a tailored treatment plan to reduce pain and restore function.
1. Reducing Pain and Inflammation
The first step in recovery focuses on calming the irritated tendon. Strategies include:
Activity Modification: Avoid activities that worsen symptoms, such as prolonged sitting or deep hip flexion.
Isometric Exercises: Simple holds like wall hamstring bridges can provide pain relief while gently engaging the tendon.
Manual Therapy: Using massage techniques and dry needling can provide short term pain relief enabling you to get back to your rehab exericses.
2. Progressive Loading Program
Rebuilding the strength and resilience of the tendon is key to long-term recovery (2). A physiotherapist will guide you through a gradual progression of exercises:
Phase 1: Start with lower-load, isometric movements, such as hamstring marching.
Phase 2: Introduce slow, heavy exercises like an elevated single-leg bridge to improve tendon capacity.
Phase 3: Progress to plyometrics and sport-specific drills to simulate real-life demands such as dumbbell swings.
3. Biomechanical Assessment and Correction
A skilled physiotherapist or chiropractor in Victoria can evaluate your movement patterns and correct any issues contributing to tendon overload. For example, runners may benefit from adjustments to stride length, cadence, or trunk posture.
Why Choose Physiotherapy for Proximal Hamstring Tendinopathy ?
Physiotherapy not only addresses the symptoms of PHT but also targets the root causes. At Pursuit Physiotherapy, we combine manual therapy, therapeutic exercise, and education to empower you with the tools needed for recovery.
Recovery Timeline
Rehabilitation for PHT takes time, with complete recovery expected around 1-3 months (3). Early gains in pain reduction can occur within weeks, but full recovery requires a commitment to a progressive loading program. A physiotherapist will support you throughout this journey, ensuring you’re progressing safely and effectively.
Take Action with a Physiotherapist in Victoria
Proximal Hamstring Tendinopathy doesn’t have to hold you back. If you’re experiencing persistent pain or difficulty with daily activities, our team at Pursuit Physiotherapy in Victoria is here to help.
With a focus on evidence-based care, our physiotherapists can assess your condition, address underlying factors, and create a tailored treatment plan to get you back to doing what you love.
Ready to take the next step? Contact Pursuit Physiotherapy in Victoria today to book your appointment. Together, we’ll work towards your recovery and long-term tendon health.
References:
Cardoso TB, Pizzari T, Kinsella R, Hope D, Cook JL. Current trends in tendinopathy management. Best Pract Res Clin Rheumatol. 2019;33(1):122-140. doi:10.1016/j.berh.2019.02.001
Pavlova AV, Shim JSC, Moss R, et al. Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis. Br J Sports Med. 2023;57(20):1327-1334. doi:10.1136/bjsports-2022-105754
Lempainen L, Johansson K, Banke IJ, et al. Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy. Muscles Ligaments Tendons J. 2015;5(1):23-28. Published 2015 Mar 27.
