Hamstring Tendinopathy: Causes, Symptoms, and Physiotherapy Treatment Options

Hamstring tendinopathy is a frustrating and often lingering condition that can significantly affect your ability to walk, run, or sit comfortably. 

Whether you’re an athlete or someone who spends long hours seated, understanding this injury is the first step towards effective recovery.

Summary: Hamstring tendinopathy occurs when the tendons that attach your hamstring muscles to the pelvis become irritated or damaged, typically due to overuse, poor biomechanics, or prolonged sitting. Common symptoms include deep buttock pain during activity or while sitting. Fortunately, with proper physiotherapy, targeted exercises, and a progressive rehabilitation plan, most people can recover fully and prevent future flare-ups.

What Is Hamstring Tendinopathy?

Hamstring tendinopathy refers to inflammation, irritation, or degeneration of the hamstring tendons, most commonly at the origin where they attach to the sitting bones (ischial tuberosity). It’s often seen in runners, footballers, and people who engage in sports that involve sprinting or sudden accelerations but it can also occur in less active individuals, especially those who sit for prolonged periods.

Common Causes of Hamstring Tendinopathy

Several factors can lead to the development of hamstring tendinopathy:

• Overuse from running or sports involving repetitive hip flexion and knee extension

• Weak glutes or core muscles, placing more strain on the hamstrings

• Poor running technique or biomechanical imbalances

• Sudden increase in activity or training intensity

• Prolonged sitting, which compresses the tendon at its attachment point

Over time, these factors can create microscopic tears and tendon degeneration, which leads to chronic pain and reduced function if not properly managed.

Symptoms to Look Out For

The symptoms of hamstring tendinopathy usually build gradually rather than appear all at once. Here’s what to watch for:

• Deep, dull ache in the upper hamstring or buttock area

• Pain while sitting, especially on hard surfaces

• Discomfort during or after running, lunging, or squatting

• Stiffness in the back of the thigh, especially in the morning

• Weakness or tightness when bending forward or stretching the hamstring

If any of these symptoms sound familiar, early physiotherapy intervention can help you avoid more serious injury.

How Physiotherapy Can Help

Physiotherapy plays a key role in both diagnosing and treating hamstring tendinopathy. At Elite Health & Performance, your treatment will typically begin with a comprehensive assessment to understand the underlying cause and severity of your condition. From there, your physiotherapist may use a combination of:

Manual Therapy

Hands-on techniques such as soft tissue massage or dry needling to relieve tension, improve circulation, and reduce pain.

Exercise Rehabilitation

A tailored strength and mobility program to target weak glutes, tight hip flexors, and hamstring muscles. Eccentric loading exercises (where the muscle lengthens under load) are particularly effective for tendon healing.

Posture and Movement Correction

Your physio may address imbalances in walking or running gait, improve your posture, and correct any mechanical contributors to the issue.

Activity Modification

You may need to temporarily reduce high-impact activities or sitting time, replacing them with low-impact alternatives like swimming or walking.

Education and Long-Term Prevention

Your recovery plan will include strategies to reduce the risk of recurrence, including warm-ups, cooldowns, and technique correction.

Sample Exercises for Hamstring Tendinopathy

Here are a few gentle exercises commonly used in treatment (always consult a physio before starting):

• Isometric Hamstring Holds: Contract your hamstring without moving the joint to build base strength without aggravating the tendon

• Bridge Holds and Progressions: Activates the glutes while lightly engaging the hamstring

• Nordic Hamstring Curls (Later Stage): Advanced eccentric loading for tendon rehab

• Glute Strengthening: Clamshells, band walks, and hip thrusts to reduce hamstring overload

When to Seek Help

If your pain has lasted more than a few weeks, is affecting your daily life or sport, or if you’re unsure how to treat it on your own, it's time to see a professional. Delaying treatment can turn a simple irritation into a more complex injury.

Ready to Move Pain-Free?

At Elite Health & Performance, our expert physiotherapists are trained to diagnose and treat hamstring injuries with tailored care that works. Don’t let persistent hamstring pain hold you back, book a consultation today and start your recovery with confidence.

Key Takeaways

• Hamstring tendinopathy is commonly caused by overuse, poor biomechanics, or prolonged sitting.

• Symptoms include pain in the upper hamstring or buttock area, often aggravated by sitting or exercise.

• Physiotherapy offers targeted treatment through manual therapy, strengthening exercises, and movement correction.

• Early treatment leads to better outcomes and faster return to normal activities.

FAQs 

Q: Can I keep exercising with hamstring tendinopathy?
A: Low-impact and modified exercises may be safe, but high-impact movements should be avoided until guided by a physiotherapist.

Q: How long does recovery usually take?
A: With proper treatment, recovery can take anywhere from 6 to 12 weeks, depending on severity and commitment to rehab.

Q: Is rest alone enough to fix it?
A: Rest may relieve pain temporarily but won’t address the underlying weakness or dysfunction causing the issue.

Q: Do I need surgery for hamstring tendinopathy?
A: Surgery is rarely required. Physiotherapy is the first-line, evidence-based approach for most people.