Developing your PHT flare-up plan

Developing Your Flare-Up Plan for Proximal Hamstring Tendinopathy

Proximal Hamstring Tendinopathy (PHT) can be a challenging and painful condition to manage, especially for athletes. In this episode, we will discuss the importance of developing a flare-up plan for PHT, offering guidelines and tips for managing minor and major flare-ups. Whether you are a recreational athlete or not, understanding how to deal with flare-ups is crucial for your journey to recovery. Let’s dive into the topic of developing your PHT flare-up plan.


Welcome to this podcast episode focused on overcoming Proximal Hamstring Tendinopathy. I’m Brody Sharp, an online physiotherapist, recreational athlete, and someone who has battled PHT. In today’s discussion, we’ll tackle the essential topic of developing a flare-up plan for PHT. This plan is a crucial part of your overall management strategy, helping you navigate the ups and downs of this condition effectively.

The Importance of Tailored Advice

First and foremost, it’s important to acknowledge that tailored advice is always the best approach when dealing with PHT. Every individual is unique, and your flare-up plan should consider various factors, including your current strength, fitness goals, daily activities, and more. While we’ll provide generic guidelines, please remember that your specific circumstances should always be taken into account.

Understanding Flare-Ups

Flare-ups are an expected part of the recovery journey in PHT. When rehabilitating an injury, it’s common to encounter setbacks, especially if you push your tissues to their limits. Flare-ups can occur due to various reasons, such as mechanical factors (e.g., overexertion), under-recovery, or even stress. While experiencing flare-ups can be emotionally taxing, they are a natural part of the healing process.

Factors Influencing Flare-Ups

PHT flare-ups can be influenced by several factors, including mechanical stress, under-recovery, and even stress levels. Stress, both physical and emotional, can heighten pain sensitivity and trigger flare-ups. It’s essential to keep in mind that each flare-up is unique, varying in intensity and impact on your recovery.

Minor Flare-Up Management Plan

For minor flare-ups, follow these guidelines:

  1. Avoid Progression: Do not push yourself to increase your exercise or activity levels during the flare-up.
  2. Relative Rest: Rest or reduce your physical activities, such as running or intense workouts, for one to two days.
  3. Resume Loading: After a couple of days, gradually resume loading with low-intensity exercises like isometrics, monitoring symptoms.
  4. Gym and Rehab Exercises: Once symptoms improve, return to the gym and rehab exercises at about 70-80% of your pre-flare-up capacity.
  5. Monitor Symptoms: Pay close attention to how your body responds over the next 24 hours, adjusting your routine based on symptoms.

Major Flare-Up Management Plan

For significant flare-ups, follow these guidelines:

  1. Relative Rest with Optional Anti-Inflammatories: Rest for two to three days and consider using anti-inflammatory medication for no longer than two days.
  2. Low-Level Loading: After the rest phase, begin low-level loading exercises, focusing on maintaining tissue tolerance.
  3. Strength Training at Reduced Intensity: Resume gym exercises at 50-70% of your pre-flare-up capacity, with adjustments based on symptoms.
  4. Cardio and Plyometrics: Gradually reintroduce cardio and plyometrics at about 70% of your pre-flare-up capacity.
  5. Recovery Factors: Prioritize stress management, sleep, and proper nutrition during this phase to support your recovery.

Assessing the Severity of a Flare-Up

To gauge the severity of a flare-up, consider these questions:

  • How has your previous capacity changed compared to now?
  • What’s your current pain level and how does it compare to your baseline?
  • Is the pain localized or more widespread?
  • How does your body respond to low-level loading exercises like isometrics?

Personal Experience with Flare-Ups

As an example, I’ve had my share of flare-ups with PHT. I’ve found that heavy, slow loading works well for my minor flare-ups. For significant flare-ups, I prioritize rest, low-level loading, and gradual strength training progression. Every individual may have a unique response to flare-ups, so it’s essential to tailor your plan accordingly.

Remember that flare-ups are a natural part of the PHT recovery process. Developing a personalized flare-up plan, along with professional guidance if needed, can help you navigate these challenges effectively. Stay proactive, monitor your symptoms, and prioritize your overall well-being as you work towards overcoming PHT.

In the next episode, we’ll delve into more valuable insights related to PHT management. Stay tuned for more knowledge and practical advice to aid in your recovery journey.