5 why's, 5 do's and 5 don'ts of proximal hamstring issues

Proximal Hamstring Tendon issues are common to distance runners, trail runners, sprinters and hurdlers. It's not the classic , clutching the back of your leg hamstring injury that you might see on a football field but rather a chronic problem that has been niggling at runners for a while

It is a deep, localised buttock pain, right on your ischial tuberosity (think sit bone) People suffering it will often describe it as an intense ache.  

Tendons don't like compression or tension and activities that require the hamstring to contract or lengthen whilst in hip flexion can result in too much  tensile  and compressive  load  at  the tendon  insertion - think sprinting, hill work , jumping lunges. The hamstring tendon can sometimes be irritated by too much sustained stretching (tensile stress) in hip flexion (warrior pose and the classic hamstring stretch) or compressed by excessive sitting on hard surfaces

Sometimes you might have lower back pain, sciatic pain or sacro-iliac joint pain as well - so it is always worth getting checked out by a professional 

Why do we get it?

1. Sudden increase in sprints, hill work or lunges,. 
2. Over striding or forward trunk lean when running 
3. Weak Glutes
4. Tight Hip Flexors
5. Unfortunately Peri-menopausal women are at greater risk to tendon injury with the decrease of oestrogen ....

Don't

1. Stretching - you'd think stretching would make it better but it increases tension at the hamstring insertion which tendons HATE  so avoid yoga and sustained hip flexion positions
2. Run with a forward trunk lean, anterior pelvic tilt, over striding -  again too much traction on the hamstring with increased hip flexion
3. Run hills or do sprints,  deep squats or lunges are also a no no as they can all increase tension on the hamstring insertion
4. Excessive sitting on hard surfaces - if you've got insertional hamstring issues you know this hurts! 
5. One legged pedalling drills - again too much tension on the hamstring in a compromised position 

Do

1. Hip extension strength , start with static holds (isometric) in a neutral hip position, We want to strengthen both the glutes and the hamstrings
2. Improve hip mobility and address any hip flexor tightness 
3. Increase your cadence which will help any over striding
4. Steady runs. These should be ok - just avoid hills and sprints (pain should not be worse 24 hours later)
5. Use a cushion when sitting : )

Keep an eye out for our videos for glute and hamstring strengthening 

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