Hamstring pain is common in runners, gym-goers and athletes. While many people think they have simply “pulled a hamstring”, the issue can sometimes be proximal hamstring tendinopathy.
This condition occurs when the tendon that attaches the hamstring muscles to the ischial tuberosity (sitting bone) becomes irritated and overloaded (Goom et al., 2016).
At Trilogy Physiotherapy in Sinnamon Park, we regularly assess and treat people with persistent hamstring pain that has not improved with rest alone.
If you have pain when sitting, running, or accelerating, proximal hamstring tendinopathy may be the cause.
What Is Proximal Hamstring Tendinopathy?
Proximal hamstring tendinopathy is a chronic tendon overload condition affecting the attachment of the hamstring muscles at the pelvis.
Unlike an acute hamstring strain, which usually occurs suddenly during sprinting or explosive movements, tendinopathy tends to develop gradually over time due to repeated loading of the tendon (Goom et al., 2016).
It is commonly seen in:
• runners
• cyclists
• CrossFit athletes
• football players
• people performing regular sprinting or hill training
Repeated loading without adequate recovery can lead to tendon irritation and degeneration, resulting in ongoing pain and stiffness.
Common Symptoms
People with proximal hamstring tendinopathy often report:
• deep pain in the lower buttock region
• pain when sitting for long periods
• discomfort during running or acceleration
• pain when bending forward
• stiffness after activity
Symptoms often start during sport or exercise but can gradually progress to pain during daily activities, including prolonged sitting (Goom et al., 2016).
Why Does Hamstring Tendinopathy Occur?
Several factors may contribute to the development of proximal hamstring tendinopathy.
Training Load
A sudden increase in running volume, speed work, or hill training can place excessive stress on the hamstring tendon.
Tendon injuries are frequently associated with rapid increases in load without adequate adaptation time (Malliaras et al., 2013).
Weak Gluteal Muscles
Weakness in the gluteus maximus and gluteus medius can lead to the hamstrings compensating during hip extension and running activities.
This increased demand may overload the hamstring tendon over time.
Reduced Hip Control
Poor pelvic and hip control can increase strain through the posterior chain, particularly during running or single-leg activities.
Prolonged Sitting
Compression of the tendon against the sitting bone during prolonged sitting can aggravate symptoms and delay recovery.
Exercises That Help Hamstring Tendinopathy
Research suggests that progressive loading programs are one of the most effective treatments for tendon injuries (Malliaras et al., 2013).
These programs aim to gradually increase the load tolerance of the tendon.
Examples include:
Isometric Hamstring Exercises
Isometric exercises can help reduce pain and improve tendon load tolerance during the early stages of rehabilitation (Rio et al., 2015).
Bridge Variations
Single-leg bridges and hip thrusts help strengthen the glutes and hamstrings.
Romanian Deadlifts
These exercises help build strength throughout the posterior chain while gradually loading the hamstring tendon.
Eccentric Strengthening
Eccentric loading exercises can improve tendon structure and resilience when progressed appropriately (Malliaras et al., 2013).
Rehabilitation programs should be carefully progressed, as excessive loading too early can worsen symptoms.
When Should You See a Physiotherapist?
If hamstring pain persists for more than two to three weeks, or repeatedly returns during running or exercise, it is recommended to seek an assessment.
At Trilogy Physiotherapy, we assess:
• hamstring strength
• hip and pelvic control
• running mechanics
• tendon load tolerance
Based on this assessment, we design a progressive rehabilitation program to help you safely return to sport.
Hamstring Pain Treatment in Sinnamon Park
If you are dealing with persistent hamstring pain, early management can help prevent the condition from becoming chronic.
At Trilogy Physiotherapy in Sinnamon Park, we provide:
• one-on-one physiotherapy sessions
• hands-on treatment
• strength-based rehabilitation
• return-to-sport programs
We regularly help people from Oxley, Darra, Jindalee and the Centenary suburbs recover from hamstring injuries and return to activity.
If your hamstring pain is limiting your training or daily activities, we would be happy to help. Appointments can be made online.
References
Goom, T., Malliaras, P., Reiman, M., & Purdam, C. (2016). Proximal hamstring tendinopathy: clinical aspects of assessment and management. Journal of Orthopaedic & Sports Physical Therapy, 46(6), 483–493.
Malliaras, P., Barton, C., Reeves, N., & Langberg, H. (2013). Achilles and patellar tendinopathy loading programmes: a systematic review comparing clinical outcomes and identifying potential mechanisms. Sports Medicine, 43(4), 267–286.
Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G., Pearce, A., & Cook, J. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. British Journal of Sports Medicine, 49(19), 1277–1283.
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