5 Reasons Why Your Proximal Hamstring Tendinopathy (PHT) Rehab Might Be Failing

Proximal hamstring tendinopathy, often referred to as PHT, can be a frustrating and painful condition. Whether you’re an athlete or not, dealing with buttock pain when sitting or pain in the bottom when sitting can severely affect your daily life. In this blog post, we will discuss the five common reasons why your PHT rehab might not be delivering the desired results and how you can make meaningful changes to overcome this condition.

Reason 1: Resting Too Much

Resting might seem like the natural thing to do when you’re dealing with a painful injury, but when it comes to PHT, it can actually be counterproductive. Resting too much can lead to a cycle of pain, rest, and weakness, which can ultimately worsen your condition.

Solution: Instead of complete rest, focus on keeping your hamstring tendon within a healthy adaptation zone. This means gradually and carefully loading the tendon to stimulate adaptation and healing. Avoid staying well below your capacity, as this can lead to further weakening. Seek guidance from a healthcare professional to determine your optimal load levels.

Reason 2: Misinterpreting Symptoms

Interpreting your pain symptoms correctly is crucial in PHT management. Some individuals misinterpret symptoms, attributing them to activities other than running, or they aim for zero pain, which might not be necessary or even advisable.

Solution: Learn how to interpret your symptoms accurately. Understand that some level of pain during activity might be acceptable, typically ranging from one to three on a scale of ten. It’s essential to differentiate between acceptable pain and excessive pain that indicates overloading. Seek professional guidance to determine your specific pain threshold.

Reason 3: Ignoring Daily Aggravating Factors

Daily activities outside of running can exacerbate PHT symptoms. For instance, sitting for prolonged periods can irritate the condition, especially if your hamstring tendon is already sensitive due to running-related overuse.

Solution: Identify daily activities that worsen your symptoms and modify them accordingly. Adjust your sitting posture, take micro-breaks, or consider sit-stand desks to reduce irritation. Consulting a healthcare professional can help you make the necessary modifications for your specific situation.

Reason 4: Inadequate Strength Rehab Progression

Strength rehabilitation is a crucial aspect of PHT recovery. While isometric exercises can be helpful, they might not be sufficient to restore full capacity to the tendon, particularly for runners who require a significant load-bearing capacity.

Solution: Gradually progress from isometric exercises to slow, heavy loading exercises. Once a strong foundation is established, incorporate plyometric exercises to prepare the tendon for running-specific demands. Seek guidance from a physiotherapist or exercise specialist to ensure proper progression.

Reason 5: Overreliance on Passive Treatment

Passive treatments like massage, dry needling, or trigger point release can provide temporary relief from PHT symptoms but do not address the root cause or enhance the tendon’s capacity.

Solution: Combine passive treatments with active rehabilitation. Focus on building strength and resilience in your hamstring tendon through structured exercise programs. Passive treatments should complement, not replace, your active rehab efforts. Consult with healthcare professionals to create a comprehensive treatment plan.

In summary, overcoming proximal hamstring tendinopathy requires a multifaceted approach that includes appropriate loading, symptom interpretation, daily activity modifications, progressive strength rehabilitation, and a balanced approach to passive treatments. Remember that every individual’s condition is unique, so consulting with a healthcare professional is essential to tailor your rehab program to your specific needs.

By addressing these five common reasons for failed PHT rehab, you can take significant steps toward a pain-free future and regain control over your life. Knowledge is power, and with the right approach, you can overcome this challenging condition.