What is Proximal Hamstrings Tendinopathy (PHT)?
PHT is a common condition among runners and athletes. However, it can equally affect non-active populations such as overweight individuals and peri-menopausal women. Usually this condition is characterized by deep localized buttock pain which may occasionally radiate to the back of the thigh. The pain is often aggravated with sitting, running, squatting, deep lunges etc. and can have debilitating effects on sporting and even basic activities of daily-living.
"PHT is a common condition among runners and athletes."
What causes pain?
Activities requiring hamstrings muscle to contract and lengthen in flexed hip positions such as sitting, driving, squatting, forward bending, running etc. would provide repetitive stretch and compression to the hamstrings tendon at its attachment. In an irritable tendon these positions could provoke symptoms, to which the body responds by perceiving pain.
Signs and symptoms:
• The pain is typically associated with a recent increase in training volume or intensity and particularly sudden introduction of sprinting, hurdles or lunging work.
• Commonly deep localized buttock pain is felt which comes on during or after completion of activities such as sitting, running, squatting, lunges etc.
• The pain sometimes radiates to the back of the thigh.
• Occasionally pain could also be felt with climbing stairs up, walking uphill etc.
• PHT pain has different characteristics from most conditions and in many cases simple activities such as light jog or walking may not aggravate symptoms.
Physiotherapy and PHT
In majority cases, if identified early and not allowed to progress, PHT can be successfully treated conservatively. If you do feel any of the above symptoms, do visit your physiotherapist to advise you appropriately on a successful management plan for PHT.
Conservative exercise-based treatment for PHT has been proven highly effective. Key management strategy will b
e to provide progressive overload to the tendon to reduce pain and restore function. Another important aspect is to identify any aggravating factors and to avoid those.