Proximal hamstring tendinopathy

• Proximal hamstring tendinopathy:

  • Common in sprinters
  • Compression of the tendon against the ischial tuberosity
  • Onset usually after sudden change in training e.g. increased incline
  • Dull, achy pain that intensifies with activity
• Proximal hamstring tendinopathy - Differential diagnoses:

  • Sciatic nerve compression
  • Referred hip/lumbar spine pathology
  • Deep gluteal syndrome
• Proximal hamstring tendinopathy - Findings:

  • Pain on stretch and resisted contraction
  • Pain on palpation local to the ischial tuberosity
  • Can be confirmed with MRI/Ultrasound = Swelling/matrix breakdown
• Proximal hamstring tendinopathy - Treatment:

  • Distal eccentric strengthening away from hip flexion
  • As per rehabilitation principles