2025 Research: Treatment of Proximal Hamstring Tendinopathy: A Clinical Commentary

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In this episode, Brodie reviews a brand-new 2025 clinical commentary on the treatment of proximal hamstring tendinopathy (PHT) with an individualised physiotherapy approach. The paper, authored by experts including Jill Cook and Aidan Rich, outlines a comprehensive, stage-based rehab protocol grounded in tendinopathy principles and adapted for the unique demands of the hamstring complex.

CHECK OUT THE PAPER HERE

What youโ€™ll learn in this episode:

  • Why recent systematic reviews still show insufficient evidence for one superior PHT treatment.
  • The three core pillars of the proposed protocol: education, progressive strengthening, and graded exposure to compressive/sport-specific loads.
  • How the five rehab stages work:
    1. Isometrics โ€“ for pain relief and warm-up effect.
    2. Isotonics โ€“ to build strength and endurance.
    3. Kinetic chain training โ€“ targeting glutes, calves, adductors, and lumbopelvic control.
    4. Compressive load reintroduction โ€“ safely restoring tolerance to hip flexion positions.
    5. Energy storage/release drills โ€“ for athletes with high-speed or power demands.
  • The importance of pain monitoring, โ€œhurt vs harmโ€ education, and avoiding rapid spikes in load.
  • How to individualise the program based on goals, deconditioning level, and activity demands.
  • Practical tips for combining stages, structuring training cycles, and maintaining long-term tendon health.