Hamstring tendinopathy

It is likely that you have pain related to small “micro-tears” within the tendon at the top of the hamstring muscle. This structure connects your hamstring muscle to your lower leg (tibia and fibula) and is important during most upright activity including walking/stairs/running/jumping. Find the “sit bone” in your buttock and then move 2-3cm towards your knee (it should feel softer than the bone). If this is tender the diagnosis is highly likely to be hamstring tendinopathy. Tendinopathies are usually caused by “overloading” the tendon with an increase in activities.For detailed information on hamstring tendinopathy see here noting that the correct physiotherapy treatment is highly effective in almost all cases (surgery or injections are rarely required).

If your pain is relatively low (less than 4/10 on average) and not having a major impact on your life consider the following effective physiotherapy treatments you can do on your own:

  • For a short period, stop doing anything (eg running, jumping or long walks) that significantly increases your pain by more than 2/10 during the activity or that results in more than 2/10 pain for more than 30 minutes after the activity

  • Sitting, particularly on hard surfaces, can also aggravate hamstring tendinopathy and should be avoided/kept to shorter durations. Using a cushion can help

  • Read these resources on “pacing” and “more on pacing” to ensure you have the right balance between activity and rest to optimise recovery

A graduated series of exercises (click on the links below to see a video description) to build up the strength of the hamstring and hamstring tendon is a very important strategy. Work your way through the list below step by step. The exercises should be done 2 times a day starting with 2 sets of 5 (no hold) and progressing to 2 x 12 over 3-6 days making sure there is no significant increase in pain (see bullet point above). Once mastered move to the next exercise in the list, starting again at 2 x 5 progressing to 2 x 12 over 3-6 days.

  1. Double leg bridge

  2. Progress to single leg bridge with bent knee

  3. Next is single leg bridge with straight knee

  4. Progress to the arabesque

  5. Next step is lunge

  6. Progress to jump lunge

When you can do 15 repetitions of a single leg bridge without a significant increase in pain, you should be able to also start grading up your activities by following the principles of rehabilitation described here. Running and sports involving running should not be graded up until you can comfortably do 15 lunges and higher intensity running sports until you can do 15 jump lunges.


Negotiating the above exercise and rehabilitation program can be complex. Or you may not be noticing any improvement over a two week period. If this is the case why not try a free telehealth consultation with one of our expert practitioners by clicking the button below. Ongoing treatment by telehealth or face to face can also be provided if needed to guide your recovery.