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Manage High Hamstring Tendinopathy with Various Treatment Options


Dealing with persistent issues like long-lasting proximal hamstring tendinopathies can pose a challenge. These types of problems might not easily get better with typical approaches like gentle tissue manipulation, improving flexibility, and strength exercises. When it comes to chronic tendinopathies, the healing process can extend to 3 to 6 months, and many individuals may still feel some pain and discomfort afterward. Nonetheless, identifying and handling these injuries correctly through proper high-hamstring tendinopathy treatment has proven to enhance the chances of returning to sports and lower the risk of getting injured again.

What is high-hamstring tendinopathy?

High hamstring tendinopathy, although not a widely recognized injury, can be a significant contributor to persistent gluteal pain. It is frequently underestimated as a cause of chronic discomfort in the gluteal region. This injury is frequently observed in individuals engaged in long-distance running, manifesting as enduring deep pain in the gluteal area that intensifies during running and acceleration. The prolonged nature of chronic high hamstring tendinopathy is characterized by persistent deep buttock pain, attributed to compromised tendon healing.

Symptoms of High Hamstring Tendinopathy

Here are a few signs that often come with the pain from high hamstring tendinopathy. If you spot these symptoms, it’s a good idea to think about getting treatment for proximal hamstring tendinopathy to sort out the problem quickly.

Pain when sitting

Experiencing discomfort or pain when applying pressure or sitting on the ischial tuberosity, commonly known as the sit bone, is not uncommon.

Pain with repetitive activity

Engaging in activities like biking, hiking, running, and other repetitive motions can worsen the pain in the posterior region. Individuals with high (proximal) hamstring tendinopathy frequently observe a consistent pattern in their pain. For instance, they may notice the pain emerging at a specific point during their workout.

Pain when bending at the hip

Much like acute hamstring strains, persistent tendinopathy can result in pain around the ischial tuberosity, commonly known as the sit bone, particularly when the hip is fully flexed. For instance, individuals may experience discomfort while bending at the waist to tie their shoes or pick something up from the ground.

Pain with acceleration or sprinting

Runners may observe the onset or intensification of pain during acceleration or sprinting. The discomfort usually peaks just before the heel strike, as the hamstring engages to decelerate the body. In certain instances, athletes may experience such intense pain that it hinders their ability to sprint.

Various Types of Treatment for Hamstring Tendinopathy

Below are some non-invasive, minimally invasive, and surgical treatment options for hamstring tendonitis:

Icing and heat

Icing, using methods like cold packs, ice baths, or ice massage, can be advised to alleviate pain and inflammation. Usually, applying ice packs for 10 to 20 minutes after activity and/or every 2 to 4 hours during the day is recommended. Heat and massage may also be beneficial for loosening fibrotic or scarred tissue, followed by stretching. Some patients find relief with alternating heat and ice. It’s important to exercise caution to prevent cold or heat injuries. Seeking advice from a qualified medical professional is advisable for more information and guidance.

Non-steroidal anti-inflammatory drugs

Common over-the-counter medications like aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), and other NSAIDs can be useful in relieving pain and reducing inflammation. It’s essential for patients to adhere to the recommended dosages and promptly discontinue use or seek medical advice if they experience adverse reactions, such as gastrointestinal bleeding or stomach irritation.

Ultrasound-Guided Needle Tenotomy

In this office procedure, done with ultrasound guidance, patients with persistent symptoms have an option. The doctor numbs the area and the needle path with local anesthesia. Then, using ultrasound, a slightly larger needle is inserted into the tendon, creating controlled damage to encourage blood flow and platelets, promoting healing. This ultrasound-guided needle tenotomy has shown success in treating chronic tendinopathies, providing an additional option for patients with stubborn symptoms.


Since limited flexibility increases the risk of chronic high hamstring tendinopathy, it’s a good idea to create a stretching routine for tight hamstring tendons and muscles. With a therapist’s help, a patient can learn stretching exercises to enhance flexibility and range of motion. It’s important to know that seeing improvement may take some time, possibly months.

Extracorporeal shock-wave therapy

ESWT happens in a doctor’s office and is done in a single visit. The doctor or therapist places a probe on the skin over the problem area, delivering shock waves through an electrical charge. It might be a bit painful, especially in the first days after the treatment. The idea is that these shock waves may help heal by boosting blood flow and breaking up scar tissue.

Steroid Injections

Giving a corticosteroid shot into the ischial bursa can help some people with persistent hamstring tendinopathy. The ischial bursa is a small, fluid-filled cushion between the gluteal muscles and hamstring tendons near the sit bone (ischial tuberosity). Doctors use ultrasound to guide the injections of pain-relieving and corticosteroid medicines into the bursa.

Complete tenotomy

Tendon release, also known as tenotomy, includes cutting and reattaching the tendon to the bone. If the sciatic nerve is stuck in scar tissue due to tendinopathy, the surgeon may release it during the surgery (neurolysis). This complete tenotomy surgery needs a lengthy recovery and is best for patients who have tried other treatments without success.


The debridement procedure removes unhealthy tissue, aiming for new, better tissue to grow. Using similar technology as tenotomies, it can be done minimally invasively for some patients. If you’re curious, talk to a qualified practitioner.

Solve High Hamstring Tendinopathy with Proper Treatment

If you’re facing persistent discomfort from high hamstring tendinopathy, take action now to explore effective treatments. Whether it’s simple measures like icing, stretching routines guided by a therapist, or more advanced options like ultrasound-guided needle tenotomy or shock-wave therapy, there are various approaches to alleviate pain and promote healing. Remember, early intervention is crucial, so consult with a qualified medical professional to determine the most suitable treatment for your specific situation.


  • Diane Silva

    Diane is a travel enthusiast, content creator, and master storyteller, capturing her adventures through captivating blogs and engaging vlogs. With a passion for the great outdoors and a love for literature, she brings a unique perspective to the travel world. Whether she's exploring hidden gems or discussing the latest trends, Diane is your go-to source for all things travel and beyond.