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.Â
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?
QUICK TIPS:
- 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
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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. Â
