Hi everyone, I am going to talk to you all today about hamstring pain. So if you are someone that has experienced hamstring pain in the past, or maybe you’re experiencing it right now, then this will be a helpful blog for you.

More specifically, we’re going to talk about proximal hamstring tendinopathy. So that is if you are having pain right around that butt bone. It’s going to be a series of videos. So in the first video we’re going to talk about what exactly is it? Can I keep running? And where to start. And then the following videos will be kind of progressions of where to go after you’re able to do the initial exercises.

So what is it? 

Proximal hamstring tendinopathy is pain that is localized around your ischial tuberosity (the butt bone). It’s typical behavior is that it might be present at the beginning of your activity. And then it’ll warm up, it’ll start to feel better. Then, towards the end of activity, it might become more painful. And then afterwards, it’s even more painful.

Any positions that you’re getting into that require a lot of hip flexion – deep, squatting, lunging, long periods of sitting on a harder surface, those can also all cause pain. Typically, if you’re lying down, or doing easy walking, those won’t be too painful. 

Can I keep running?

That’s a question that people typically ask right off the bat. And yes, you can keep running, as long as you are not really exacerbating your symptoms. So what I mean by that is pain is acceptable within less than three out of 10. So in a zero to 10 scale, zero is no pain, 10 is take me to the emergency room. If you’re living below below three out of 10 that is perfectly acceptable. And that is during your run and then after as well. So we want symptoms to go back down to your baseline within 24 hours.

With this type of pain, you’re likely going to want to avoid any speed work and hills. Those are things that can really irritate that area and make things worse. So keep running, if you can.

Where to start:

So if you are having a lot of pain, and activities that we talked about are hard, then what we want to do is to start with isometric work. That is loading that area without actually moving. These exercises can decrease your pain and improve your function, as well as start to increase that hamstring strength.

You can start with a basic bridge with two feet down. So the heels are nice and close to your butt. You’re going to squeeze your glutes and you’re going to lift up and you’re just going to hold.  The goal is to hold five reps for 45 seconds. Once this becomes easy, you can take it to one leg. Once those are fine, you want to increase the lever. So you’re gonna walk your feet out to make a really long bridge. And then it’s the same concept: lift and hold. Progress it by going to one leg. So those are places to start.

And again, living in those pain guidelines. So when you perform the exercise less than three at a 10 pain is okay. And we want it to resolve within 24 hours.

So hopefully this video is helpful if you’re someone that is out there dealing with that pain right around that ischial tuberosity. And then look for the next two to three videos to show you how to progress from what we just did here to things that are more challenging.