Q&A: PRPs, MRIs, Medications & Return to activity

Title: Proximal Hamstring Tendinopathy (PHT) – Your Comprehensive Guide


Proximal hamstring tendinopathy, often referred to as PHT, is a painful and frustrating condition that can affect athletes and non-athletes alike. In this blog-style article, we’ll delve into the world of PHT, addressing common misconceptions and providing answers to some pressing questions about this condition. Join us as we explore the causes, treatments, and strategies to overcome the challenges posed by PHT.

Understanding PHT: What You Need to Know

Subheading: What is Proximal Hamstring Tendinopathy?

Proximal hamstring tendinopathy (PHT) is a condition that affects the tendons in the hamstring muscles, specifically the area where they attach to the pelvis. This condition is characterized by pain and discomfort in the buttock region, particularly when sitting or during physical activities that engage the hamstrings.

Subheading: Meet Brody Sharp: Your Guide to PHT

Before we dive deeper into PHT, let’s introduce our expert guide for this journey, Brody Sharp. Brody is an online physiotherapist, recreational athlete, creator of the Run Smarter series, and a PHT survivor himself. With his expertise and personal experience, Brody is here to educate and empower you in your battle against PHT.

Common Questions About PHT

Subheading: Your PHT Questions Answered

In this section, we’ll address some of the most common questions about PHT, providing insights and practical takeaways.

Question 1: When Can I Apply Heat?

Carla asked about the use of heat as a treatment for PHT. Heat can be applied whenever you feel it brings relief. While there are no specific contraindications for using heat in PHT, it’s important to remember that heat primarily increases blood flow, which can aid in healing.

Question 2: Does Ice and Ibuprofen Impede Healing?

Ice and ibuprofen, commonly used for pain relief, may not be the best choices for PHT. Research suggests that ice provides only temporary relief by numbing the area, and anti-inflammatory medications like ibuprofen can hinder healing, especially when used long-term. Corticosteroid injections should also be approached with caution due to their potential detrimental effects on tendons.

Question 3: Can PRP Help PHT?

Brody points out that Platelet-Rich Plasma (PRP) and other injections may not offer significant benefits when compared to a placebo or sham therapy. Injections directly into the tendon are generally discouraged, emphasizing the importance of exploring alternative treatments.

Question 4: Can PHT Exist Without MRI Findings?

Cristobal raises an interesting question: Can PHT exist even if MRI scans show no issues with the tendon? MRI findings can vary, and some pathologies may not be visible on scans. The severity and location of the tendinopathy play a crucial role in determining whether it’s detected through imaging.

Question 5: How to Reintroduce Compression Activities?

Benjamin, Alicia, and Norma all share concerns about returning to activities that involve compression, such as cycling, gardening, or hill walking. Brody recommends approaching rehabilitation as a step-by-step process. Create a “rehab ladder” with specific goals, gradually increasing the load and frequency of activities as your tendon strengthens and adapts.

Question 6: Core Exercises and Heavy Exercises

Jen inquires about core exercises that won’t irritate PHT. Brody emphasizes the importance of trial and error, as each individual may respond differently to exercises. Suggestions include Swiss ball ab crunches and planks, while exercises that involve excessive compression under tension, like sit-ups from the floor, should be approached with caution.

Grace wonders about the frequency of incorporating heavier exercises. The frequency depends on your current capacity and the intensity of the exercises. As you progress, you’ll need more time for recovery, eventually settling into a routine of heavier exercises performed less frequently.

Question 7: Recommended Books for PHT

Alicia seeks book recommendations related to PHT and healing from sports injuries. Brody recommends “Rebound” by Kerry Jackson Cheadle and Cindy Kuzma. This book focuses on training the mind to recover from sports injuries, offering valuable insights into the psychological aspects of healing.


In this comprehensive guide to proximal hamstring tendinopathy (PHT), we’ve explored common questions and misconceptions surrounding this condition. From heat application to core exercises and book recommendations, we’ve provided insights and strategies to empower you on your journey to overcoming PHT. Remember, knowledge and expert guidance are your allies in the battle against PHT, and with dedication, you can pave your way toward a pain-free future.