Hamstring Tendonitis – Proximal

What is Hamstring Tendonitis – Proximal? 

Proximal Hamstring Tendonitis is commonly seen in long distance runners and athletes taking part in sprinting or hurdles. It is also common for sports people in football and hockey, which involves a repeated and ongoing change of directions. It does seem this tendinopathy can be caused by static sitting as well.  

Symptoms 

• Deep pain at the very top of the leg coming into the hip / buttocks, typically felt more on the back of the leg

• Pain comes on gradually and may be aggravated by repetitive activity

• Pain with activity (usually worse during or after activities such as running, lunging, or squatting)

• Pain increases over time

• Deep pain on sitting

Causes 

For activity-released cases, training errors such as an increase in training volume and intensity too quickly can cause or accelerate progression. Another cause of symptoms may be excessive static stretching,e.g. yoga or pilates. Long periods of sitting can also be a cause in some patients.

Treatment 

Proximal hamstring tendonitis is a common problem that can be successfully treated using focused shockwaves with ultrasound guidance during treatment, to stimulate a healing response - lithotripsy shockwaves’ higher energy content helps increase blood vessel formation and collagen creation in the treated areas, as well as having a pain relieving effect. 

Patients will usually experience a gradual decrease in pain over a period of around 10 weeks following treatment. 

We usually require an x-ray to have been performed prior to treatment. This is to check that there are no other bony or soft tissue problems that may be causing the pain.

Sources and Related Links

• Wikipedia - Hamstring 

• Physiopedia - Proximal Hamstring Tendinopathy 

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In-depth Information

Proximal hamstring tendinopathy is also referred to as hamstring origin tendinopathy or high hamstring tendinopathy. 

With activities such as sprinting, lunges, hill running or hurdles, the hamstring needs to contract or lengthen when the hip is in flexion. This can lead to a higher tensile and compressive load at the tendon insertion. If this continues over a period of time or with improper technique, an inflammatory response occurs as the body’s self-protective mechanisms come into play. 

For prolonged sitting or static stretching, there is sustained end range hip flexion postures, which can stress this point of articulation and also lead to self-protective inflammation. 

The 3 hamstring muscles are located at the back of the thigh and are responsible for moving you forward.

• The semimembranous muscle

• The semitendinosus muscle

• The biceps femoris