Proximal hamstring tendinopathy; expert physiotherapists’ perspectives on diagnosis, management and prevention

Review written by Dr Seth O’Neill info

Key Points

  1. Proximal hamstring tendinopathy needs a thorough differential diagnostic work up involving excellent subjective and objective assessment.
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BACKGROUND & OBJECTIVE

Proximal hamstring tendinopathy (PHT) is the less common cousin of gluteal tendinopathy (GTPS/lateral thigh pain) and provides a diagnostic challenge. Sciatic nerve, hip and lumbar problems commonly manifest with pain around the ischial tuberosity and upper thigh making diagnosis difficult. Due to the limited number of people suffering PHT it is very difficult to develop robust studies investigating appropriate management strategies. Due to this, the authors deemed it appropriate to complete a study to investigate expert consensus related to the assessment, treatment and prevention of PHT.

Sciatic nerve, hip and lumbar problems commonly manifest with pain around the ischial tuberosity.
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All the experts agreed on progressive loading using a pain monitoring model to assess appropriate loads.

METHODS

The authors developed semi-structured interviews and purposefully sampled 13 expert physiotherapists. The geographic spread of the experts was mostly Australia with a smattering of other regions – Qatar, Scotland, Ireland, New Zealand all with n=1.

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