Best Treatment for Proximal Hamstring Tendinopathy
What are your Options For Best Treatment of Proximal Hamstring Tendinopathy?
In order to ensure you are engaging in the best option in the treatment of proximal hamstring tendinopathy, discuss your pain with a Hip Pain Professional as early as possible. They will ensure that you have been given a correct diagnosis. Your Hip Pain Professional will look for reasons underlying your tendon condition. They will then develop a personalised recovery plan for you.
You can read more about what proximal hamstring tendinopathy is, its symptoms and causes, in our previous blog, “What is Proximal Hamstring Tendinopathy – A Pain in the Butt”
Best treatment for proximal hamstring tendinopathy almost always begins with Education and Exercise. Most people will get an excellent outcome with this approach. Early treatment is likely to lead to more rapid and complete recovery. For those that do not recover with education and exercise, there are extra options.
Gaining an understanding of what the problem is and how to stop provoking it, is the first important step. This is often called ‘load management’. Your Hip Pain Professional can identify specific aggravating factors and provide individualised advice. Things you do regularly may be making the situation worse. For example, hamstring stretching for proximal hamstring tendinopathy is usually not recommended. Seating advice may also be very helpful. Purchasing a “pressure cushion” specially designed to alleviate pressure at the area of pain can be beneficial. You can read more about these and purchase a cushion at our self help shop here.
A specific and individualised exercise program is the other main aspect of treatment. Improvements can occur quickly, particularly if you have caught the problem early. If you have had the condition for a long time, progress may be slower. In either case, it is a good idea to continue an exercise program for at least 3-6 months. This will allow time to see the full effect of treatment.
An exercise program can have many benefits such as:
- improving health and co-ordination of the hip and thigh muscles
- improving tendon health and tolerance of physical loads
- reducing pain
- improving ability to perform normal daily tasks
- increasing confidence in your tendon and your ability to do things
- returning to activity and sport
- improving quality of life
Cortisone (corticosteroid) injections usually only provide short-term relief. Cortisone may also reduce health of the tendons, particularly with repeated injections. So, it is usually best to commit to an education and exercise approach first. Platelet Rich Plasma (PRP) injections are sometimes suggested. The evidence for these injections remains unclear. They should rarely be a first treatment choice. Injections are rarely useful in isolation. Results are usually best when combined with load management and exercise.
4. Shockwave Therapy
Shockwave therapy is sometimes offered to those who are slow to recover. Further evidence for Shockwave is still required. Shockwave should always be provided with education and high-quality exercise.
Surgery is a last resort and is usually only considered after 12 months of other treatments. Surgeons rarely operate simply due to presence of a tendon tear. Painfree tendon tears are common in endurance athletes and older adults. Most tears do not need repair and recovery of full painfree function is still possible.
Always seek out a health professional with experience and up-to-date knowledge in this area. Visit our directory to find a Hip Pain Professional near you.
Need Help? A Hip Pain Professional Can:
- assess your injury to confirm if the diagnosis of Proximal Hamstring Tendinopathy is correct
- discuss how you can move forward in the treatment and rehabilitation of your injury.
- look for reasons underlying your tendon condition. They will then develop a personalised recovery plan for you. This will include progressing you slowly, within the recovery time of your tendon, back to a full return to activity/sport.
- help to reduce sitting pain by providing you with a pressure relief cushion – you can read more and purchase one from our self help shop here
- start with a specific education and exercise intervention program and progress to help you seek other treatment modalities and other Hip Pain Professionals, where needed, should this not work.
Search For A Hip Pain Professional Here.
1.Cook JL, Purdam CR. (2014). The challenge of managing tendinopathy in competing athletes. British Journal of Sports Medicine 2014;48:506-509.
2.Goom T, Malliaras P, Reiman M, Purdam C. (2016). Proximal hamstring tendinopathy: clinical aspects of assessment and management. Journal of Orthopaedic Sports & Physical Therapy, 46(6), pp.483- 493.
3.Lempainen L, Sarimo J, Mattila K, Orava S. (2009). Proximal Hamstring Tendinopathy – Overview of the problem with emphasis on the surgical treatment. Operative Techniques in Sports Medicine, 17, pp.225-228.
4.Lempainen L, Johansson K, Banke IJ, et al.(2015). Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy. Muscles Ligaments and Tendons Journal, 5, pp.23-28.
5.Puranen J, Orava S. The hamstring syndrome. (1988). A new diagnosis of gluteal sciatic pain. American Journal of Sports Medicine,16, pp.517-521.
This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced Sports and Exercise Physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.
Check Out More You Can Read on this Area at HipPainHelp:
- What is Proximal Hamstring Tendinopathy – A Pain in the Butt: Learn what this condition is (also known as high hamstring tendinopathy), and learn what are the causes and symptoms?
- Pain Locator Map click on this interactive map to learn what may be causing pain in your area
- Hip Related Sciatica (piriformis syndrome, deep gluteal syndrome): what, where, and how? Read more about possible causes of pain higher in the buttock muscles
- Top Tips for Hip Pain Relief Sitting, when Socialising or Travelling. If your nerve pain is exacerbated when sitting this blog may be extremely useful in suggesting ideas to help relieve this.
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