High Hamstring Tendinopathy Exercises [Ep37]
High Hamstring Tendinopathy Exercises [Ep37]

Is it too cliched to say High Hamstring Tendinopathy
is a Pain in the Butt for Runners? Probably! Ok so in this video, I’m going to show you
five exercises we almost always give to runners who present with cases of high hamstring Tendinopathy. First we need to understand the nature of
the injury. The clue’s in the title here; high up at
the top end of the hamstring muscles we find their common origin, where their tendons insert
onto the ischial tuberosity of the pelvis, that’s the bony part towards the bottom of
your butt cheek. Being a tendinopathy we know that it’s this
conjoined tendon that currently in dysrepair. This is very much one of your typical overuse
type running injuries, and in my experience comes as a result of chronic overload of the
hamstring tendons, usually with a more acute trigger. What do I mean by overload? Well, if there’s one thing that tendons
don’t particularly enjoy it’s the combination of being compressed while under high tensile
loads. They are great at dealing with tension when in an optimal position, but when you
add compression, it’s a simple trigger for tendon problems. Now, because of the specific way in which
the tendon attaches to the rear part of the ischial tuberosity near your butt crease,
loading the hamstrings in increased amounts of hip flexion will begin to compress the
hamstring tendon against the bone. Repeat this excessively and you’re on a fast track
to high hamstring tendinopathy. So what kinds of exercises load the hamstrings
in this high hip flexed position? Well anything that’s going to force an increased
stride length, such as speed work and hill reps. These are also often the aggravating
factors that trigger symptoms when runners are trying to train-through cases of high
hamstring tendinopathy. Now, when it comes to rehabbing the injury,
it’s important we take this understanding of the injury and it’s anatomy into account.
As with most tendinopathies, we need to load the hamstring tendons to stimulate healing
and repair, and to build strength in the hamstring muscles themselves – muscular weakness is
also a risk factor to tendon problems, don’t forget! We need to ensure however that we load the
hamstrings and their tendons in such a way that doesn’t create this combination of
tendon compression under tension. In other words, while initially rehabbing the injury
we need to look for hamstring exercises that avoid working into too much hip flexion. I’ll leave a link in the description below,
so that you can find the free high hamstring tendinopathy
download on the kinetic revolution website, containing more information on this frustrating
injury, and video demonstrations for some ideal rehab exercises. Be sure to check that out! To begin with we focus on isometric exercises
such as a simple double leg bridging exercise to help engage the glutes and hamstrings,
and load the hamstring origin tendon without flexing the hip. Try varying the position of this exercise;
as you start with your heels close to your butt, the exercise becomes more glute focused.
Conversely, if you set-up with your heels further away, creating a longer-lever, you’ll
be placing more of an emphasis on hamstring loading. You can build up to this! Aim for 10 sets of 10 seconds holding the
bridge position. A simple progression is to incorporate a single
leg variety of this isometric hold exercise. The single leg bridge. Most runners find this
much tougher than the standard double leg version! Again you can aim for 10 sets of 10 seconds
on each leg. When these become easier, you can progress
to working the hamstrings through range of motion at the knee, while still avoiding loaded
hip flexion. To begin with, we can use an unloaded exercise such as prone hamstring
curls, then add resistance from the other leg to increase eccentric demand on the hamstring
muscles and tendon. Aim for 3 sets of 20 on each leg, while maintaining
core control. Don’t let your back arch excessively. We can then add more complex exercises such
as swiss ball hamstring curls and single leg hamstring curls which being to re-introduce
a loading into hip flexion. At this point working into knee flexion and hip flexion
combined should be far less irritating on the proximal hamstrings tendon than if we
were to combine knee extension and hip flexion. Again aim for 3 sets of 20 with each of these
exercises. Of course there are other factors to take
into account when it comes to rehabbing high hamstring tendinopathy, such as dynamic control
of the pelvis, and running technique. I’ll leave links in the description to other videos
you might find helpful on these topics. Don’t forget to head on over to the kinetic
revolution website to download your free high hamstrings tendinopathy rehab guide. Best of luck, and I’ll speak to you soon. Bye now!

53 thoughts on “High Hamstring Tendinopathy Exercises [Ep37]”

  1. chanialo181 says:

    Thanks for this, James! I've had symptoms of HHT for a few months in my left hamstring, and have mostly just been doing a lot of hamstring stretches in the mornings and before and after exercise, as it does make it feel a bit better, but I'll definitely incorporate those exercises! Do you happen to know much about ASTYM and Graston techniques, and how effective those are at helping treat/rehab HHT?

  2. Rick Martin says:

    Timely information for me. Thanks!

  3. hemetech says:

    Timely for me also! I've had this for a long time! Embarrassed to say how long. I do bridges as part of my ab routine, but I have found that foam rolling has helped the best! DON"T roll on the tendon directly, just roll the belly of the muscle only for a couple to a few weeks before trying to go higher toward the butt!

  4. Denise Mathers says:

    Hi James – Thanks for the informative info. Just like post below too embarrassed to admit how long I have suffered with this very frustrating condition. I have followed for months now various different hamstring strengthening exercises but there just seems no improvement to my high hamstring tendon. I am a ultra/ Mountain runner and have completed lots of long distance challenges but am now reduced to walking in my local mountains (the Mourne Mountains in Northern Ireland) and even that causes discomfort. I am afraid I think my problem has stemmed from my poor glute functioning as I sit all day at my desk – however I have recently purchased a standing desk. Would it be possible to contact you by email with some detailed information and some advice please

  5. ShammyLadoo says:

    TL;DR This is extremely valuable info and will cut recovery time by 80%. Trust me.
    I'm about to post a huge mini essay but it's valuable. However, tl;dr – This injury will heal in 2 months with 2-3 PRP injections, a lot of eccentric work, no stretching in the first 2 weeks and a lot of ice in the first 2 weeks, then use a lot of heat afterwards.

    PRP. Eccentric. PRP. Eccentric. That is the key.
    If you want to further heal it – search up "aidmyhamstring" I haven't used it, but it seems good I guess. The heat pad. Wear that religiously. Also nitric oxide patches will speed healing. You must get 2-3 prp injections, that will heal it so quickly. ART also helps.
    Read the essay below if you want further info but what I said there is really the best way to heal HHT. Please trust me! Don't fuckin waste time on physiotherapists who want you to spend 100 dollars each session 2-3 times a week for 6 months. SPEND IT ON PRP and Google eccentric hamstring exercises – I like the leg curl on the machine, glute bridges, and medicine ball curls. 3×12 reps every day , if it's a bit sore then do it every other day. If it's that bad pain then lay off and do easier exercises.

    Okay can I just say that for anyone who is suffering from this injury – I have cured it fully and was back to playing soccer in 2 months. This is how to prevent it and fully heal it. Comparatively to other soccer and general running injuries, high hamstring tendinopathy is really not a serious injury. It won't affect your quality of life too much. It will heal, always. I have gone through thousands of dollars and hours and hours of research and I have read almost everything there is to read about HHT and in general tendon issues.

    I am a 17 year old and I got this injury from 1) Running on a stupid treadmill – stay away from treadmills at all cost. They're just bad for everything. Your knees, your hamstring, everything. They suck. Use an exercise bike, rowing machine, step up machine, cross trainer, swimming, run on grass, even concrete, run on the streets, whatever. Just stay the fuck away from a treadmill!

    2) Wearing shitty adidas or puma casual shoes on a fuckin treadmill. WEAR the right shoes. Get orthotics and some good quality running shoes. Azics are the best.

    3) Don't over stride when running, shorten your stride length and don't fucking overly heel strike. Don't land on your toes either, should be a balance. If you overstride, your hamstring tendon is being killed constantly. You are creating microtears in your hamstring tendon if you over stride. This is how you get HHT. This is the #1 reason you get HHT, (besides being a fucking idiot)

    4) If you don't have HHT, get some good, tight compression shorts. If you do have it, buy it anyways for when you start running in a month and a half!

    5) If you don't have HHT, you can prevent it by stretching your hamstrings, quads, groin, calves, foam rolling, using a hot bath and stretching afterwards as well as following the previous points.

    6) If you don't have HHT, increase gradually. You're probably a marathon runner, in which that case I say increase your milage 10% each week. Don't be a fucking idiot shit cunt who thinks they are invinsible. You're not. I'm 17 and in the best shape of my life and I thought I could take a short cut by increasing run milage and pushing it every session 10% more every other day. Training 6-7 times a week then running on a treadmil for 30 mins after training, then doing leg work at the gym. No way. The best key to improving is consistency, otherwise your body will give up on you and burn out.

    If you do have it, IN THE FIRST 2 WEEKS OF HAVING HHT DO NOT STRETCH AT ALL! Don't stretch your hamstring at all. Compression wrap it, use a lot of ice everyday for 2 weeks – this is the reactive tendinopathy stage. This is a good sign because it shows your hamstring can still heal. If you wait a week and keep working through the pain that's not a good idea. Eventually you will reach a point where there is no reactive stage – the tendon won't heal its self. This is usually from running after 2-3 weeks and pushing through the pain. It will still heal with PRP shots which I will talk about later but you are doing some seriously irreversible damage by working through pain.

    The thing about HHT is at first you barely feel it, it's just an dull ache that you can definitely push through, and it hurts to stretch your hamstring a bit, you may think that it's a pulled muscle that you can work through but it's so important to just stop doing things that make it worse. HHT heals, pretty much always! It's not like a pulled muscle where after a few days you feel alright, a bit sore, yes/no/maybe, no. It's not like that. HHT is annoying but it heals, and most idiots spend 8-9 months treating this by being fucking idiots. I am going to tell you how to heal it in 2 months.

    So all points so far – no treadmills, good quality shoes, orthotics that are custom made (costs about 100 usd, custom made just for you, will last you for life. invaluable.) If you say some bull shit "oh I can't run outdoors I like the treadmill or oh I don't like the rowing machine THEN FUCK OFF! This info is invaluable, ya bish. I am giving you 15,000 dollars and 50 hours of time researching in 1 fuckin mini essay so please listen!

    Now this is the thing that heals your hamstring tendon. Without this, I think I would have had this injury for 6-8 months, maybe 2-3 years even. Platelet rich plasma injections will heal hamstring tendinopathy. I had an MRI and confirmed that I had hamstring tendinopathy. They said "Oh you're young let's go with a conservative approach. Let's ruin your life for 6 months so you can't do any sport. Fun!!!! Please spend 20,000 usd on 6 months worth of boring, bull shit, time wasting physiotherapy exercises. Please !!! You seem like a fucking sucker! " and I said Ok fuck off that's bull shit. I did my research. I'm not doing your bull shit physiotherapy, I'm getting 2 PRP shots and that's final. I got the 1st PRP, my hamstring pain went away after 3 weeks. FUCKING AMAZING!!!!! I was at about 80%, but for football you need to be 100% – the hamstring are always used. I didn't feel right, I didn't feel ready. It would hurt when I got into a deep stretch. The doctors told me to wait an extra 2 weeks of physio…for some stupid reason I listened to them – it didn't help. Got my 2nd shot, after 2 weeks of the injection (usually takes 4-6 weeks to fully see results) I was back. It was a bit sore after a 45 minute half, but just a dull ache. As a footballer, I started 45 mins, next game 60 mins, next game 80 mins, next game 90 mins – you have to build up.

    Now, it's not just PRP then back to running. You NEED to do eccentric exercises. I researched about nitric oxide patches, I never used them but I heard they're good – however I can't give annecdotal evidence. Oxygen is the key to healing tendon problems. Nitric oxide patches increase oxygen in tendons. Sounds logical. If I could go back in time I would ice for the first 2 weeks, get a prp injection, use nitric oxide patches, do eccentric exercises, get a 2nd prp injection, use nitric oxide patches, do eccentric exercises, then maybe use some shockwave therapy after the 2nd injection. If you're rich, get a 3rd injection to really solidify the healing. Also ART is so good, helps a lot. Make sure u do it like 3 weeks after you have HHT.

    Eccentric exercises : just google them. Leg curl eccentricly on a hamstring machine did wonders. My hamstrings have never been this strong in my life. Medicine ball leg curl is good too. Glute bridges are 100% the most important. Make sure you go down slow, 3 seconds. 3×12 reps every day of each exercise.


    TL;DR first 2 weeks : ice, compression, no fucking stretching at all.
    3rd week onwards – get a prp shot, do eccentric exercise. get a 2nd prp shot 3-4 weeks later. eccentric exercise. get a 3rd one 3-4 weeks after that. eccentric exercise. should be fully healed in 2 months. return to running or sport gradually.

    If I did help you, just let me know. This is priceless information in my eyes. Sometimes I wish I could go back in time, slap myself in the face and make my self read this paragraph, but I'm almost glad in a way because my hamstrings have never been so strong before. I'm more powerful and quicker from all the eccentric exercise which is a huge injury prevention tool for the muscles in the future.

    2 months is nothing. People are so self obsessed. It will seriously be over before you know it, but it could easily turn into 2 years if you keep training on it.

  6. Samantha H says:

    Excellent video.  Thank you.  I wonder whether you could do something on lower hamstring tendonitis (back and inner knee)?  I've seen a lot of information about high hamstring problems, but not much on lower.

  7. Alex Björg says:

    So do i just need to strengthen my muscle?

  8. Jessica Segreto says:

    I have been dealing with severe pain in my left buttocks for over 2 years now. Originally it was diagosed by my GP as bursitis. I had an ultrasound of the area which showed my bursa to be fine. The pain continued and I became used to trying to cover the pain with pain killers and anti-inflammatory drugs. I tried physio for a very long time, with no relief. Another physio diagnosed it as sacroiliac joint dysfunction. Again, I had treatment with no relief. I went to a specialist about a month ago who diagnosed it as a hamstring issue. I had a cots one injection there and then. A couple of days later and I felt great.. it lasted only 2 weeks before the pain came back and just as bad if not worse than before. I'm at my wits end. I'm severely depressed. My general wellbeing and lifestyle is destroyed by this pain. Like a hot knife permanently wedged in the crease of my butt. I can't sit and watch a movie, I can't even go to the toilet without pain. I've somewhat resigned that I'll live the rest of my life with it. Is there any other information you can share on this issue? And thank you for the above tips. I'm 24 and desperate for relief.

  9. Totally Raw says:

    Thanks very much for this video, James.Do you think that hamstring bridges as demonstrated in the video below would be useful, or do you think it could aggravate the tendon?In the video, he says that it's a good exercise for people with high hamstring pain. I was doing this exercise twice a week for a couple of months, combined with sprint training, in the hope that it would be a good exercise to do to prevent high hamstring tendinopathy, yet paradoxically, I have now actually developed high hamstring tendinopathy! I have never had it before and I wonder if this exercise was the culprit? Here is the exercise I'm referring to:https://www.youtube.com/watch?v=jVq7wFhaqykThanks again!

  10. Spid3Y says:

    when you got the high hamstring injury (cyclist), is it good to use the foam roller on the hamstrings?or do i need to take some rest untill it heals?

  11. oska david says:

    iv suffered for years with this, i strained my hamstring about 6 times so hamstring has become weak which was due to poor rehab the first time i strained it, its a very stubburn issue and has caused issues lower in the leg as the tendens and sciatic nerve run together at the very top of the hamstring so inflamatin and inury effect the nerve.

  12. Sebastian E. Morales says:

    GREAT INFO!!!!!!!!!!!!

  13. berzerk fury1 says:

    got this injury during muay thai had to pull out of an amatuer bout because of it. worst fucking inury.

  14. Pete Dailey says:

    Yes! This is what I have! I got it from cycling and ive had it for 6 months. Its just now starting to get better. I got a lot more rehab to do and this organization seems to have no shortage. Thank you.

  15. Ryan The Rock says:

    excellent video…got this injury from doing sprints…will taking anti inflammatories help during rehab?

  16. Paula Bradshaw says:

    Hi James, Thanks for the vid. Just wondering how long would you do these for before going back out running?

  17. Sarah Arnold says:

    Very common for ballet dancers as well
    ~ I appreciate the exercises! Thank you 🙂

  18. Tom Woolner says:

    Very good and concise video!

  19. Charlotte Dorris says:

    Thank you! Very helpful. Do you recommend any kinesiology taping to aid recovery?

  20. Tegan Williams says:

    Fantastic video. Wish I had found this sooner

  21. Cherie Neal says:

    Thank you! Valuable info/insight.

  22. Jeremy Ellington says:

    Are you fallen in the melancholy by using plenty of and distinct sort of treatments for muscle pains and your knee, shoulders, so considerably? It's going to let you fix your issues by doing some exercise. [Go Here >>>>>https://paper.dropbox.com/doc/PainFix-yO4UodsaHuSczz2JxwhGp ]  Thus, don’t begin now and be late.

  23. S. M. D. says:

    I'm not a runner but have had this issue with my hamstring in both legs, left leg being more worse. So bad that it literally feels like my left butt bone(The joint in my buttocks) is on fire!

  24. Neil Gardiner says:

    A trusted source of running technique advice.

  25. neeraj mewada says:

    Thanks for this information

  26. MIKE MCDANIEL says:

    On your YouTube “High Hamstring Tendinopathy Exercises [Ep37],” you show exercises using an exercise-ball. What size (cm) ball do you recommend for these specific exercises? I have a ball, but it appears to be about TWICE the size of the one you use in the YouTube! (I am 6’ 4 ½” tall, but I still don’t think my ball should be that much bigger than the one you use.)

  27. MIKE MCDANIEL says:

    You give 5 exercises and refer to them as a “progression.” Does that mean that as I conquer each exercise, then there is no need to any longer perform the one I’ve conquered… and therefore I’ll never be performing more than 1 of these exercises? For example, I’ll never be performing BOTH bridges and the ball-curls?

  28. aj Burican says:

    Intro too long. Skip to 2:15 and get to the exercises!

  29. Julia Smith says:

    Is it advisable not to stretch while going though rehab exercises on HHT? I am finding that doing something like a wall stretch – I have pain afterwards and wondered if stretching is actually making things worse.
    Also probably a silly question but when do you move on with your level of rehab exercises – when you have no pain at all or is it safe with some level of pain to move on?
    BTW love this website and all the videos – just want I need.

  30. jmsta2011 says:

    Brilliant video, thanks. The explanation of the specific mechanism (compression plus knee extension) helped me to identifiy the cause of my running related pain. I will try the exercises. I'm also wondering if sitting (e.g. desk work) is making the problem worse due to the compression of that area?

  31. EveN Texas says:

    I’ve had a high hamstring tendonopathy or tendinosis off and on for so many years now but it’s gotten to the point where I can’t function!

  32. Cronos090693 says:

    recovery time?

  33. Hassan Afzali-Kusha says:

    Very good. Thank you so much.

  34. Feel The Pain !!! says:

    Can this ever need operations to fix if it doesn't get better with physiotherapy..im trying to recover from athletic pubalgia having had torn adductor tendons and abdominal tears(bilateral) and I've got this hamstring tendinopathy going on making my rehab difficult

  35. taswildlife.com says:

    Thanks for this – I've got this injury from working our land and running down hills (I'm 51 and generally fit). Luckily my physiotherapist identified the issue rightaway. Trouble is there is no chance of resting. I've been trying hip flexor exercises and the 'tail-tucking' so I'm hopeful that in time this horrible pain will ease! Thanks for your obviously well-researched information.

  36. francisco torres says:

    Good practical advice for hamstring tendinopathy . I had repeated episodes of pain improved with this exercises

  37. terezita Ozone says:

    My right upper hamstring right underneath the buttock went PENG when I went into a split during ballet… scary sound. It feels short and stiff ever since, it has been 7 months now. Pain comes and goes. I can't even walk up a hill properly, my right leg feels too short. I can barely kick the leg to 90 degrees, used to kick it up to almost 180 degrees! How long does it take for the scar tissue to heal and stretch back to normal. Is it possible without surgery?

  38. Joedagg4 says:

    What about low hamstring tendinopathy?

  39. Patrick Renschler says:

    How "safe" is jump rope as an exercise while recovering from high hamstring tendinitis? I can feel the ache when I pedal on a stationary bike, but it doesn't seem to bother me while I jump rope.

  40. Travel Vlogsters says:

    short and sweet. full of good info. thanks

  41. Jim Frederich says:

    Exercises at 2:15. Thanks

  42. Suafelda says:

    I don’t recommend high kicks before warming up
    Thanks for the video- slow process getting this one fixed

  43. hadhad129 says:

    What if I don't feel my glutes on one side and the upper hamstring and adductors always takes over and is visibly bigger.

  44. doc lvs says:

    Хамстринг синдром http://doclvs.ru/medpop9/hamstring.php

  45. hensonkimberly says:

    I have been suffering from this for awhile; am looking forward to working with these exercises. FYI, I found the music rather distracting, a bit too loud. Thank you for the tips!

  46. MrMikeD28 says:

    The PDF download on kinetic-revolution is not working! It just says: "Thank you for subscribing!

    Return to the last page"

  47. Sophiemanning23 says:

    Can hamstring tendinopathy cause burning sensations in your legs when you are active especially while running or on a stationary bike?

  48. karl Shaw says:

    Nice simple informative video. Thanks

  49. Lisa Wray says:

    Very informative video. I've been suffering with this injury for a while now so hoping this will help. Thanks for the info and links James 🙂

  50. Hagsy79 says:

    How often do you recommend doing these in a very chronic case? Daily, bi-daily? Thank you

  51. Mansell5Senna8 5 says:

    People commenting that they have had this for a long time yet they have only rested the injury or used cortisol injections to take the pain away. I have had tendinosis in the quad for 2yrs, also in my achillies for 6 months and now hamstrings for 2 months so far. Doing nothing will not repair this injury. Taking painkillers will not repair this injury. You need to strengthen the tendon as described in the video with progress eccentric overload. Basically lengthening the tendon under load. That forces new tendon fibres to build and slowly repair the tendon. It takes a long time due to limited blood supply to tendons.

  52. Eric Bishop says:

    Mine was from deadlifting twice a week and squatting three times a week, being a 6'4 athlete, and moving mid-upper 400's for reps for both exercises and not eating enough.

  53. Diamond Sharba says:

    Hi am Diamond, am feeling a serious pain in my hamstring in my upper right thigh between the foot and private part.. my Gmail [email protected]

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