FAQ: Proximal Hamstring Tendinopathy

Max Hopes 26/11/25

What is proximal hamstring tendinopathy?
It’s irritation of the proximal hamstring tendon — the tendon that connects the three hamstring muscles to the sitting bone at the back of the pelvis.

Who does it commonly affect?
Runners are the population I’ve seen it in most – another group would be women around menopausal age, where hormonal influences are a factor.

What type of running tends to aggravate it?
Speed work is the most common aggravator.

Can proximal hamstring tendinopathy persist for a long time?
It can be a stubborn condition to get rid of, symptoms normally last for between 2-12 months but I’ve seen it persist for even up to 20 years if not managed well.

Can I keep running if I have this issue?
Generally, yes. Most runners can continue running, but almost always with some adjustments. This may include reducing weekly mileage, but more commonly modifying or reducing speed work.

How much pain is acceptable while running?
Aim for no more than 3–4/10 pain during the run, and the pain should return to baseline by the next day.

What if I feel worse the day after running?
A flare the next day is a sign the previous run was too much. Review what you did (speed, distance, intensity) and adjust accordingly.

What is “compressive load,” and why does it matter?
Compressive load refers to the hamstring tendon being pressed or “squished” against the pelvis during certain positions. These include:

• Hamstring stretching

• Long stride lengths while running

• Deadlifts and similar gym movements

• Sitting (a common aggravator)

Managing compressive load is important because these positions can sensitise the tendon.

How should proximal hamstring tendinopathy be rehabbed?
Rehab focuses on applying specific, progressive load to the tendon to build strength and resilience. This usually involves:

• Heavier, slower exercises as tolerated

• Finding an appropriate entry level

• Gradually increasing intensity

• Gradually reintroducing compressive positions rather than avoiding them long-term

If you’re dealing with this condition, Max is your guy. Let us know if you need help getting started with rehab.

Note: Dr Max Hopes is completing his PhD in proximal hamstring tendinopathies. If you would like to participate in this study, the study requires the following:

• Have one-sided proximal hamstring tendinopathy

• Have had symptoms for at least 3 months

• Are 18 years or older

Please contact Max at max@limbrhealth.com.au if you would like to participate.