The Weekly Routine to Heal Your PHT: Isometrics vs Concentrics & Eccentrics • The Run Smarter Series

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If you’re trying to recover from proximal hamstring tendinopathy, you’ve probably come across plenty of conflicting advice around the “best” way to load your tendon. Should you focus on isometrics? Are eccentrics the gold standard? Or should you be doing heavy concentric and eccentric strength work?

In this episode, Brodie breaks down the different types of muscle contractions and, more importantly, explains how to combine them into a practical weekly PHT rehab routine.

You’ll learn why isometrics can be particularly useful for pain relief and tendon stress relaxation, why eccentric-only training doesn’t appear to have a unique advantage over combined concentric and eccentric loading, and why the amount of load you can safely tolerate may matter more than the contraction type itself.

Brodie also explains how your rehab should evolve as symptoms settle and capacity improves, moving from frequent, lower-load isometrics toward heavier and more functional strength training.

In this episode:

Isometric vs concentric vs eccentric contractions explained
The two major benefits of isometrics for PHT
Keith Baar’s concepts of stress shielding and stress relaxation
Why 20–30 second isometric holds can provide a useful tendon stimulus
Why eccentrics aren’t necessarily the “magic bullet” for tendon rehab
When eccentric-biased exercises may still be particularly useful
Why heavy loading appears more important than the specific contraction type
How to use pain and next-day symptoms to guide progression
When to progress from isometrics into heavier movement-based exercises
How to structure your rehab using a High → Low → Moderate → Rest approach
How running, cardio, recovery and individual goals fit into your weekly routine

Example weekly structure:

Monday – HIGH
Heavy strength work such as deadlifts, step-ups and hamstring curls. Typically around 3 sets of 6–8 challenging repetitions.

Tuesday – LOW
Lower-load isometrics using the Keith Baar-style protocol: approximately 3–4 sets of 20–30 second holds with 2 minutes rest.

Wednesday – MODERATE
Similar strength exercises to Monday, but at roughly 70–75% of your heavy-day load. This may also be an opportunity for some light running or cardio.

Thursday – REST / RECOVERY

Rest or very light activity that places minimal demand on the tendon.

From there, you can repeat the High → Low → Moderate → Rest cycle, or adapt the concept into a seven-day schedule based on your symptoms, running, equipment, recovery and goals.

The key takeaway:

Rather than searching for one perfect contraction type, focus on finding the combination of exercises that allows you to progressively expose the tendon to meaningful load without aggravating your symptoms.

Keep coming back to three simple pain rules:

Keep pain during exercise below roughly 4/10.
Symptoms should return to your usual baseline by the next morning.
Your overall symptoms and capacity should be improving week by week.

Your ideal routine will depend on your current symptoms, capacity and goals, but the underlying principle remains the same: challenge the tendon, give it time to recover and adapt, then progressively challenge it again.

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MEDICAL & EDUCATIONAL DISCLAIMER

The information provided in the Overcoming Proximal Hamstring Tendinopathy (PHT) Podcast, YouTube channel, associated websites, social media, and other educational content produced by Brodie Sharpe is provided for general educational and informational purposes only. It is not intended to constitute, and should not be relied upon as, individual medical, physiotherapy, diagnostic or treatment advice.

Although Brodie Sharpe is a qualified physiotherapist, consuming this content does not establish a physiotherapist-patient or other healthcare professional-patient relationship. Any discussion of symptoms, diagnoses, rehabilitation strategies, exercises, loading programs, running modification, medications, supplements, injections, medical procedures or other treatment options is general in nature and may not be appropriate for your individual circumstances.

Musculoskeletal pain can have multiple causes, and symptoms that appear consistent with proximal hamstring tendinopathy or another tendon disorder may arise from other conditions. Appropriate assessment, diagnosis and treatment depend upon an individual’s medical history, symptoms, examination findings, medications, health conditions, training history and other factors that cannot be adequately assessed through general online content.

Do not use this content as a substitute for assessment, diagnosis or treatment from an appropriately qualified healthcare professional.

Before starting, stopping or substantially modifying an exercise or rehabilitation program, medication, supplement, injection, procedure or other treatment discussed in this content, seek advice from an appropriately qualified healthcare professional who can consider your individual circumstances.

Exercise, rehabilitation and medical treatments carry inherent risks. These may include increased pain, symptom flare-ups, aggravation of an existing condition, new injury, adverse reactions or other complications. Individual responses vary and no particular outcome, improvement, recovery timeframe or return to sport can be guaranteed. If an activity or intervention causes significant, unusual or worsening symptoms, stop and seek appropriate professional advice.

References to research, clinical studies, treatment approaches, products or opinions of guests are provided for educational purposes. Scientific evidence evolves over time, may be incomplete or conflicting, and findings from research populations may not apply to every individual. Discussion of a treatment or product does not necessarily constitute an endorsement or recommendation for its use. Views expressed by podcast guests or other contributors are their own and do not necessarily represent the views of Brodie Sharpe.

To the extent permitted by applicable law, Brodie Sharpe and associated businesses, contractors and contributors accept no liability for loss, injury, damage or adverse outcomes arising from reliance upon or use of this general educational content. Nothing in this disclaimer is intended to exclude, restrict or modify any right, guarantee, remedy or liability that cannot lawfully be excluded, restricted or modified under applicable law.

If you believe you may have a serious injury or medical condition, or you develop severe, rapidly worsening or otherwise concerning symptoms, seek prompt assessment from an appropriately qualified healthcare professional. In an emergency, contact your local emergency service.