Proximal Hamstring Tendinopathy
Updated: Oct 11, 2022
Proximal Hamstring Tendinopathy is an insertional tendinopathy.
This is when the hamstring tendon is compressed against ischial tuberosity during hip flexion or when hamstring is stretched.
Activities that involve compression of the hamstring tendon and are usually painful
• Stretching the hamstring
• Uphill running (and walking if irritable)
• Deep squats, lunges or deadlifts
• Forward lean standing (e.g. Leaning over a bed)
That does not mean you avoid these activities, like every pain or injury graded exposure to the painful activity is important to heal it. Each individual is different so do what feels comfortable for you but don't make the mistake and totally avoid the painful movements.
So runner would reduce the hill running to flat surfaces initially and gradually re-introducing, with sitting encourage a soft surface cushion and hips higher than knees but once again gradually reducing this over time.
Tendons need to be stressed in order for them to recover so rest will not help a gradual loading over time is important but not to rest it. With proximal hamstring tendinopathy initially in the rehab activities like squat, lunge and deadlift may be restricted but at the end stage of the rehabilitation should be introduced.
Initially you may start with some bridge exercises with an isometric hold with heel on a bench holding for 20-40 seconds x 3-4 reps over 3 to 4 days. Eccentric hamstring strength training is important therefore this is the lowering of the Nordic Hamstring Exercise. If you need assistance use a chair or gym ball in front of you and then over time move it further away from you. As the goal of the Nordic is to lower as low down as you can, loading the muscle with tension as it lengthens.
These are guidelines it is very important to work with a chartered physiotherapist to firstly diagnose the injury and then to guide the rehabilitation.
The Outlier Nordic T-Bar allows you to build strength and length in your hamstrings without the need of a partner.