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Promimal Hamstring Tendinopathy

Are you experiencing pain in the upper aspect of the back of your thigh? Is it impacting on your ability to run, sit, squat, lunge, and walk uphill? Maybe you can no longer deadlift or even simply lean forwards.  

Proximal Hamstring Tendinopathy is ONE potential cause for limitations in these activities. It is often characterized as a well localised pain where the hamstring inserts (think of the sitting bones that contact with the chair when you sit upright) and is aggravated by compressive activities such as sitting or running uphill. You may find that the pain increases the day after an aggravating activity and causes early morning stiffness. 

Does this sound like your pain? 

It is important to seek professional assessment from your treating health professional to rule out other possible causes of upper thigh pain as this area of the body is quite complex. However, if it is confirmed that you do have proximal hamstring tendinopathy what can you expect? 

Proximal Hamstring Tendinopathy shows similar pathology to Achilles tendinopathy in that it tends to move through different stages. Symptoms you may experience will vary depending on which stage your tendinopathy is at. As previously mentioned, activities or postures that compress the tendon insertion will be most likely to contribute to flare ups in pain, such as sitting or activities that involve deep hip flexion. Examples of these are bringing your knee up towards your chest, squatting or leaning over your bed to change the sheets. It can also be influenced by the following activities: 

Training load and type:

  • Higher speed running (sprints, intervals, sudden changes in pacing) 
  • Hill running  
  • High Volume  
  • High Frequency 
  • Type of training

 General aggravating activities:

  • Running style
  • Work/lifestyle habits 
  • Prolonged Sitting 
  • Stress 
  • Sleep position 
  • Deficits in strength/control/flexibility 

There are many risk factors that can contribute to the development of Proximal Hamstring Tendinopathy such as age, hormonal changes, and rapid increases in tendon load through sport or daily activities. This can include: 

  • Rapid increases in training volume or intensity 
  • Excessive hill work 
  • Training that is too highly focused on high intensity training types.  
  • Returning to sport after a break 
  • Introduction of new exercises.  

If you identify with any of the above, then I suggest you take time to discuss this with your physiotherapist as they will help you identify the best treatment and management approach for you. This may include: 

  • Temporary modification to activities that aggravate your pain to allow any reactive symptoms to settle 
  • Progressive strength and conditioning exercises to help build your tendon’s capacity to tolerate load. The stronger your tendon is, the more likely it will tolerate changes in your training without having the pain return.   
  • Correcting and addressing any training load errors is also highly important to help avoid future injury or recurrence of your proximal hamstring tendinopathy.  

Your Physio will provide you with the tools that will help EMPOWER you to safely return to your chosen activity such as running, weightlifting or even daily life activities.  

How Can Physionorth Help?

Our running and sports Physio’s Melissa and Nicole can assess and diagnose your upper thigh pain and develop a training program specific to you, for your recovery. You can book an appoinment easily by clicking here.


Please note: the above exercise and information is general in nature. We recommend seeking individual advice before commencing any new exercises.  


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