Proximal Hamstring Tendinopathy in Mona Vale
Proximal hamstring tendinopathy is a common cause of deep pain around the lower buttock, where the hamstring tendons attach to the pelvis. Symptoms often develop gradually and may be aggravated by running, prolonged sitting, lunging or exercises that heavily load the hamstrings.
At Helix Recovery, we'll assess your strength, movement and activity demands to identify factors contributing to your symptoms and develop a personalised treatment and rehabilitation plan.
What is Proximal Hamstring Tendinopathy?
The hamstring muscles attach to the ischial tuberosity, commonly known as the sitting bone, through strong tendons at the base of the pelvis.
Proximal hamstring tendinopathy occurs when these tendons become painful and less tolerant of load. It is particularly common in runners and active individuals but can also develop in people who spend long periods sitting.
Symptoms are often influenced by both the amount of load placed through the tendon and compression of the tendon against the sitting bone.
Common Symptoms
Deep pain around the lower buttock or sitting bone
Pain during or after running
Pain with prolonged sitting
Discomfort during lunges or deep squatting
Pain when bending forward at the hip
Tenderness around the hamstring attachment
Pain during exercises such as deadlifts or hamstring curls
How We Assess Proximal Hamstring Tendinopathy
Pain around the buttock can arise from several structures, including the hamstring tendon, hip and lower back.
Your assessment may include hamstring strength, hip movement, resisted testing and functional movements relevant to your symptoms. The lower back, hip and neural structures may also be assessed where appropriate.
This helps determine whether the proximal hamstring tendon is likely contributing to your symptoms and guides your rehabilitation.
How We Treat Proximal Hamstring Tendinopathy
Treatment depends on how long symptoms have been present, their severity and the activities you want to return to.
Treatment may include:
Osteopathic manual therapy
Shockwave therapy
Progressive exercise rehabilitation
Hamstring and gluteal strengthening
Progressive tendon loading
Activity and load modification
Gradual return to running, gym and sport
Shockwave Therapy for Proximal Hamstring Tendinopathy
Shockwave therapy may be incorporated into treatment to help reduce pain and improve function in proximal hamstring tendinopathy.
Treatment can be directed around the affected tendon attachment and used alongside osteopathic manual therapy and progressive strengthening to improve the tendon's ability to tolerate load.
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Sitting can compress the proximal hamstring tendon against the sitting bone. Prolonged sitting, particularly on harder surfaces, can therefore aggravate an already sensitive tendon.
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Not necessarily. Deep hamstring stretching places both tension and compression through the proximal tendon and can aggravate symptoms in some people. Stretching should therefore be guided by your individual presentation.
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Often, yes. Running volume, speed or hills may initially need to be modified depending on symptom severity. Running can then be progressively increased as the tendon's capacity improves.
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Recovery varies depending on symptom duration, severity and activity demands. Longstanding proximal hamstring tendinopathy often requires several months of progressive loading to restore strength and tolerance.
Common Questions
Ready to Move More Comfortably?
Whether hamstring pain is affecting sitting, running, gym training or sport, we'll identify the factors contributing to your symptoms and develop a treatment plan tailored to your goals.