Overcoming Proximal Hamstring Tendinopathy: A Comprehensive Guide

Welcome to another episode of the Run Smarter podcast, where we provide valuable insights to help you overcome proximal hamstring tendinopathy (PHT). I’m Brodie Sharp, an online physiotherapist, recreational athlete, and creator of the Run Smarter series. In this episode, we’ll delve into the latest updates on PHT, discussing recent revelations and insights into this condition, and sharing effective evidence-based treatments.

Understanding Proximal Hamstring Tendinopathy

Before we dive into the updates, let’s briefly discuss what PHT is. In PHT, the attachment of the hamstring to the sitting bone becomes irritated, leading to symptoms like tightness in the high hamstring, a dull ache in the glutes, and sometimes pain when sitting or engaging in activities like speed work, hills, or cycling. If left untreated, PHT can become chronic and significantly impact daily life.

Injury Update Episodes

In our effort to provide the most up-to-date information on running-related conditions, we recently conducted a poll in the Run Smarter Facebook group to determine which conditions our listeners wanted to learn more about through injury update episodes. PHT emerged as the top choice, even though we have a dedicated podcast for it.

If you’re looking for a deep dive into PHT with 70 episodes on treating, managing, and preventing it, you can visit the “Overcoming PHT” podcast. I apologize for not including PHT as an option in the poll initially, but I’m excited to provide valuable insights in this episode.

Key Insights from Previous Episodes

In previous episodes, we’ve discussed valuable insights from experts and my personal experiences with PHT. Let’s recap some of the key takeaways:

Tip 1: Addressing Compression

Addressing compression of the tendon is crucial in PHT management. Avoid compressive movements and exercises that aggravate the tendon initially, but gradually reintroduce compression as the tendon adapts and becomes more tolerant. Remember, some individuals mistakenly avoid sitting or stretching altogether, which can hinder recovery.

Tip 2: Exercise Choice

Choose your exercises wisely and avoid overloading the tendon. Gradually progress through acceptable loads and ensure you’re interpreting symptoms correctly. Some people make the mistake of doing exercises that are too challenging, leading to flare-ups.

Tip 3: Dosage

Consider the dosage of your exercises, including sets, reps, weights, and frequency. Recovery times vary among individuals due to factors like gender, age, and hormonal changes, so finding the right balance for your specific case is essential.

Tip 4: Realistic Expectations

Recovery from PHT is not linear, and progress may involve fluctuations. Expect that it may take at least 12 weeks of consistent rehab to see significant results. In chronic cases, recovery may extend beyond six months.

Tip 5: Belief in Recovery

Don’t let negative stories on social media platforms deter your optimism. Each person’s recovery journey is unique, and many factors can influence outcomes. Stay positive and recognize your individuality in the recovery process.

Recent Insights and Updates

Now, let’s explore some recent insights and updates on PHT:

Tip 1: Structured Weekly Routine

Consider managing your weekly routine based on a structured plan rather than fixed strength days, rest days, or run days. This approach allows you to adjust the intensity of strength and rehab sessions, promoting better recovery and adaptation.

Tip 2: Progression from Bridges

While bridges can be beneficial, don’t get stuck in the bridge phase for months. Gradually transition to more advanced exercises like deadlifts, weighted step-ups, and hamstring curls to provide your tendons with a greater challenge and promote recovery.

Tip 3: Introduction to Running and Speed

When reintroducing running and speed work, start with a structured plan. After achieving 40 minutes of continuous, pain-free running, progress to strides, then short intervals, and finally, hills. Ensure that each step is gradual and carefully monitored to prevent setbacks.

Tip 4: Resistance Exercises into Hip Extension

If resisted hip extension exercises are painful, they may hold the key to improving hip function. Begin with a comfortable level of resistance and gradually increase it over time. Adjust the range of movement to find a pain-free starting point and progress from there.

Tip 5: Double Leg Deadlifts

Double leg deadlifts are essential for developing strength and stability. Don’t abandon them in favor of single leg deadlifts, as double leg exercises provide more support and allow for heavier loads. Incorporate single leg exercises as needed but prioritize double leg deadlifts for strength gains.

By following these insights and tips, you can empower yourself to effectively manage and overcome proximal hamstring tendinopathy. Remember that everyone’s journey is unique, and a tailored approach to rehab is key to success.

If you’re a runner seeking additional resources and information on overcoming PHT, be sure to check out the Run Smarter podcast. Knowledge is power, and with the right strategies and guidance, you can overcome PHT and achieve your running goals.