Proximal hamstring tendinopathy (PHT) is a relatively new diagnosis in the research that describes pain at the hamstring origin on the pelvis (ischial tuberosity) - a literal pain in the butt.
This issue occurs when the hamstring tendon cannot meet external demand and is usually associated with situations where the tissue is repeatedly compressed against the pelvis and often begins after running hills, sprinting or sitting for prolonged periods. Running uphill and sprinting both place the hip in a position of increased flexion (increased tendon compression) and place increased demand on the hamstrings.
Symptoms associated with this diagnosis will be very local to the ischial tuberosity and provoked with isometric contraction of the hamstrings while the hip is in flexion, stretching the hamstrings or by palpation.
If you have this pain, a progressive tendon strengthening program, that is designed to increase tendon capacity, is best supported in the research. Massage and stretching may be helpful temporarily, but will not most likely not lead to permanent symptom resolution. Behavior modification is also important and should include rest from running (returning gradually with level running first), avoiding prolonged sitting and temporarily avoiding other activities such as deadlifting, lunges and deep squatting.
📚Goom TS, et al. Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management. J Orthop Sports Phys Ther. 2016.
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