Proximal hamstring tendinopathy

Overload of the hamstring tendons where they attach to the sitting bone.

Overview

Proximal hamstring tendinopathy is irritation of the hamstring tendons at the sitting bone, causing deep buttock pain worse with sitting and loaded hip bending. It responds to graded loading and activity modification.

Symptoms

  • Deep pain near the sitting bone
  • Pain worse with prolonged sitting
  • Discomfort with running, lunging or stretching
  • Tenderness over the tendon attachment

Causes

  • Sudden increases in running or hill work
  • Repetitive loaded hip flexion
  • Tendon overload over time

Treatment

  • Load management and graded strengthening
  • Avoiding aggressive stretching early
  • Sitting modification
  • Gradual return to running