Proximal hamstring tendinopathy (PHT), sometimes called high hamstring tendinopathy, is a painful condition of the hamstring tendons. Tendons are fibrous structures that join muscles to bones. This connection allows your muscles to move your bones and body. The proximal hamstring tendons are the tendons at the top (proximal means closer to the head) of the hamstring muscles in the back of the thigh. These tendons join the hamstring muscles onto the sitting bones (ischial tuberosities).
The pain of PHT may develop over time, without a clear injury.
This can be due to:
However, for some people the pain may come on during or after a sudden hamstring strain or stretch. This might occur during waterskiing, martial arts or a slip into the splits position.
While too much load can lead to tendon conditions, too little load also reduces tendon health. Tendons that are not regularly exposed to physical load will not be as conditioned. There may reach a point where the tendon is unable to tolerate even everyday activities. Physical inactivity due to sedentary lifestyle, illness or injury elsewhere may contribute. Age and hormonal changes in women postmenopause may also reduce tendon health.
PHT is most common in middle to longer distance runners and triathletes. It may also affect cyclists who spend long periods hill climbing and on timetrial bikes. The hamstring muscles and tendons are also placed under high loads in other sports. Some examples include football, rugby, hockey, martial arts, long jump, ballet and yoga.
But you don’t need to be young and athletic to develop this condition. Older and/or sedentary people can have PHT too, due to relative underloading (not doing enough) of the tendon. Less active people will be less conditioned and less able to tolerate physical load.
Our next blog will be looking at the Treatment of Proximal Hamstring Tendinopathy – please read this to learn more about your treatment options for this condtion, and how exactly a Hip Pain Professional can help you.
Visit our Pain Locator Map to learn more about pain in different regions around the hip and pelvis.
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Authors
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.