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Proximal Hamstring Tendinopathy: A Pain In The Butt

Proximal Hamstring Tendinopathy: A Pain In The Butt
Proximal Hamstring Tendinopathy: A Pain In The Butt

High Hamstring Tendinopathy

Most commonly hamstring injuries are acute or chronic muscle strains somewhere in the “belly” of the muscle but the hamstring is also vulnerable to issues at their origin known as a high hamstring tendinopathy or proximal hamstring tendinopathy. This injury can be stubborn having a tendency to become a chronic condition if not managed appropriately.
Proximal hamstring tendinopathy in my experience is relatively common but not exclusively found in runners. During running the hamstrings are active and engaged during multiple phases of the running stride making them an essential muscle group for running and as a result any high hamstring tendinopathy will frequently at least cause a significant slowing of the individuals running speed if not put a complete halt to all their training.

The Anatomy Of Proximal Hamstring Tendinopathy

The ischial tuberosity often referred to as your “sitting bones” is the attachment point of significance in proximal hamstring tendinopathy. Your Hamstring muscles at the back of your thigh have their origin from this point and it is around this site where high hamstring tendinopathy occurs which is why it is literally a pain in the butt to suffer with proximal hamstring tendinopathy. Basically the area where the hamstring tendons join the ischial tuberosity (the bone) is the site impacted and the location of the pain felt right around these sitting bones.

What Are The Signs Of Proximal Hamstring Tendinopathy

If you have proximal hamstring tendinopathy then generally you may experience pain during simple activities such as bending forward when dressing yourself or sitting on hard surfaces. A physiotherapist can further assess the area using some special tests to more accurately examine and help diagnose the condition.

  • In some circumstances an MRI may be used. An MRI is very accurate in identifying changes in the tendon, bone and other soft tissues in the area, so when diagnosis is proving difficult, progress is slower than expected or more specific grading of the injury and rehabilitation planning is required an MRI may be requested.

As previously mentioned high hamstring tendinopathy can be a particularly challenging problem to deal with and because similar pain in the buttocks can be caused by other conditions such as pain referring from the lower back or pelvis or piriformis syndrome seeing a physiotherapist as soon as possible, getting assessed and starting on a rehabilitation program increases your chances of avoiding any proximal hamstring tendinopathy becoming a chronic problem.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Proximal Hamstring Tendinopathy: A Pain In The Butt should consult his or her physiotherapist or otherwise appropriately skilled practitioner.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.


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