Condition Guide

Proximal Hamstring Tendinopathy Physiotherapy

High hamstring tendon pain can affect sitting, running and everyday activity. Assessment helps distinguish possible causes and agree a manageable rehabilitation plan.

Proximal hamstring tendinopathy affects the tendon near the sitting bone, where the hamstring attaches to the pelvis. It can cause a deep ache in the lower buttock, including in people who do not play sport. This is different from a sudden pulled hamstring, although the painful areas can overlap. Buttock pain is not a diagnosis: the back, hip and nerves may also need consideration. At our Newham clinic in Plaistow, assessment starts with your symptoms and goals, not an assumption that all pain here is tendon-related.

This guide is general information and does not replace a clinical assessment.

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Your clinic: Newham clinic & directions
Newham Leisure Centre, 281 Prince Regent Lane, Plaistow, London E13 8SD
Self-pay: £60 for a 30-minute physiotherapy appointment.
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Common Symptoms

A localised ache near the sitting bone, sometimes described as high hamstring pain.

Discomfort during or after running, particularly when training demands have changed.

Sitting that becomes uncomfortable, such as during a commute or desk-based work.

Symptoms that interfere with an activity you previously managed comfortably.

Seek Prompt Medical Advice If You Have

Go to A&E or call 999 for new numbness around the genitals or bottom, new bladder or bowel control changes, or severe or worsening weakness or numbness in both legs. Do not wait for physiotherapy.

Contact NHS 111 promptly after a sudden hamstring injury with severe or worsening pain, substantial bruising or swelling, or painful standing or walking. A major tear must not be assumed to be tendinopathy.

Contact your GP if pain is severe, disrupts sleep or daily life, or has not improved with self-management. Seek urgent advice through NHS 111 for a hot, red, swollen joint or fever with worsening symptoms.

If you are unsure, call NHS 111 or seek urgent medical care.

Assessment

Describe when pain began, any sudden injury, and changes in running, work or other activity.

Discuss symptoms beyond the sore area, including back pain, tingling, numbness or weakness, to guide appropriate screening.

Examine relevant movement and muscle function, then explain what the findings do and do not tell us.

Choose practical goals together: a comfortable work meeting, a regular walk or a return to your usual running route. Bring existing reports and a short activity history if available.

Treatment

Agree temporary adjustments to aggravating activities rather than a blanket instruction to stop everything.

Introduce progressive hamstring strengthening at a level suited to your current capacity.

Build back tolerance to sitting and movement positions as part of the plan, rather than avoiding them indefinitely.

Progress towards running or other goals using your response between sessions; no single exercise programme is best for everyone.

Aftercare & self-management

At your appointment, agree which exercises to do, how often to practise them and when to review your progress.

Note which activities provoke pain and how you feel later that day and the following morning.

Break up uncomfortable sitting and discuss changes that fit your work or travel routine.

Avoid repeatedly forcing a painful hamstring stretch to test whether the problem has gone.

Keep to an agreed, gradual progression instead of changing distance, speed and exercise difficulty together.

Frequently Asked Questions

Is high hamstring pain the same as a pulled hamstring?+

No. An acute strain usually follows an identifiable injury; tendon pain can develop without a sudden pull. Symptoms alone cannot confirm which tissue is involved.

Should I stretch it or do strengthening exercises?+

Repeated painful stretching is not a substitute for assessment. A rehabilitation plan can include graded strengthening, with exercise selection adjusted to your symptoms and activity goals.

Can I keep running, and how long will recovery take?+

Running may need adapting rather than stopping completely. Agree suitable activity with your physiotherapist; there is no reliable fixed recovery date or guaranteed number of sessions.

What should I ask at my first appointment?+

Ask what else could explain the pain, which activities to adjust, how to judge your response and when to review progress. Tell us what matters most to you, whether that is sitting comfortably or returning to sport.