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What is Proximal Hamstring Tendinopathy?

Proximal Hamstring Tendinopathy

By Laurence Schubert APAM


What is Proximal Hamstring Tendinopathy?

Proximal hamstring tendinopathy is an injury where pain is felt in the upper hamstring/glute region, typically due to over-activity. The hamstrings are group of muscles that are commonly strained during sporting activity. Albeit not as common as a hamstring strain, hamstring tendinopathy is a frequently encountered problem for those who perform repetitive running, jumping and hip flexion. Tendinopathy is commonly associated with over activity, so it is likely that if you are experiencing this issue you have had a sudden change in workload. 

For more information on tendinopathy, please see "Do's and Don'ts of tendinopathy".

What is the cause of Proximal Hamstring Tendinopathy?

The primary cause of proximal hamstring tendinopathy is mechanical overload of the tendon. Generally, this is accompanied with a sudden change in exercise volume or intensity. Due to the anatomy of the hamstring, running places a high eccentric load on the muscle, which is why it’s typically seen in runners of some type. Additionally, hockey players are susceptible as they are often in sustained hip flexion (when leaning over the ball), causing a constant loading through the hamstring.


What are the symptoms of Proximal Hamstring Tendinopathy?

Initially, symptoms will begin as mild pain during or following activity in the upper hamstring/lower gluteal region. Often the pain is described as an ache and progresses to a sharper pain. If the condition worsens, the pain will be too severe for the athlete to perform their chosen activity. The pain is often felt climbing stairs, walking up hills, sitting for sustained periods, or during stretch of the hamstring.


How do you treat Proximal Hamstring Tendinopathy?


  • Avoid stretching your hamstring
  • Avoid sustained periods of sitting (this compresses the tendon)
  • Administer ice to relieve your pain
  • Place a ball under your sit bone and gently massage the area


As with all tendinopathies, initially the aim is to reduce the load through the tendon. This may include modifying or resting from your current activities. Following this, a staged and progressive rehabilitation plan should be followed, this can be devised by your physiotherapist. Any bio-mechanical deficiencies will be assessed and targeted during the rehabilitation period. Soft tissue massage and other manual techniques can be used to assist in relieving pain in the short term. The most important thing to remember for this injury, is to slowly progress your activity levels.  

If you have any questions about proximal hamstring tendinopathy, please contact us or book online for an appointment.


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