We assess all of the contributing factors that lead to your injury and to swiftly address them and plan your return to sport.

We assess runners, soccer and basketball players and pretty much any other sport involving running and/or acceleration and deceleration. Today's post is about proximal hamstring tendinopathy (PHT) which is an injury at the hamstring muscle attachment to your ‘sit bones’ (ischial tuberosity).

In a clinical review of the literature regarding PHT, Goom (2016) took a look at this common and often persistent injury. The goal was to flesh out clinically relevant applications of assessment, management, and exercise prescription. They state that although further research is needed to fully understand the nature of PHT, it is “insertional tendinopathy, and compression of the tendon at its attachment during hip flexion/adduction”. In other words, it is irritation and/or tearing where the hamstring tendons commonly attach to the ischial tuberosity that is usually made worse bending your hip and bringing your thigh closer to the midline.

A quick list of potential causes of PHT identified by the authors includes:

  • increasing training volume/intensity too quickly
  • sudden introduction of sprinting, lunging, hurdles, or hills.

All of these activities require the hamstrings to contract or lengthen while in hip flexion and may result in provocative tensile and compressive load at the tendon insertion. They also suggest this may happen with excessive use of static stretches (many patients talk about how much they stretch their hamstrings but few talk about strengthening them). We need to be mindful of end range static stretching at end-range hip flexion (Goom et al, 2016). Even the compressive load from prolonged sitting can be irritating to some sufferers of severe proximal hamstring tendinopathy.

The authors cite other risk factors of PHT are:

  • age
  • body mass index
  • metabolic issues
  • hormonal changes
  • some medication side effects

It is of note that perimenopausal women may be at higher risk as the loss of estrogen can negatively affect tendon resilience.

Stay tuned for our Physiohaus RunLab post where we talk about simple tests you can use on yourself to look for differences between your injured and uninjured side.

If you want a more specific look at your leg pain, book online: https://physiohaus.janeapp.com/