Dealing With High Hamstring Tendinopathy – A Practical Guide

High hamstring tendinopathy forced me out of running for about five months. That’s a really long time for someone who usually runs at least seven times a week.  Only now am I slowly getting back into it.

Unfortunately, there is little information about high hamstring tendinopathy out there.  If you google it, you will find a good, but very academica-ey paper and a bunch of (mostly) useless stuff on message boards.

I’m no doctor, but I have some first hand experiences that, hopefully, can be of use to others. This injury is fairly rare, so some of the things that worked me for were discovered purely through experimentation.


First off, how do you know you have high hamstring tendinopathy?  I initially was misdiagnosed with a simple hamstring “pull”, an injury that lasts 4-6 weeks, I think.  Here were my symptoms

  • Pain in the upper hamstring area, most notably where the hamstring connects with the sitz bone
  • The pain is deep in the muscle, not at the surface
  • Pain came on slowly over time (as opposed to suddenly due to a traumatic movement of some sort)
  • Pain while driving a car
  • Pain when sitting a long time, especially at a desk or on hard surfaces
  • Pain when sitting on an airplane
  • When trying the ‘touch your toe’ stretch, I could get my knuckles down to my knees (uh oh!)
  • Pain at the outset of a run, but going away once ‘warmed up’…then coming back later on
  • Numbing of entire leg while running (this is when I realized I had to go see someone to get this fixed)
  • Occasional glut pain
  • It hurts most when getting out of bed in the morning
High Hamstring Tendinopathy

It hurt right there

(Note: I do not recommend self-diagnosis, but finding the best sports physician possible to help you figure out what you really have)


I’m not sure what the actual cause of my injury was.  My best guess: Running 10,000 miles on mostly mountainous terrain for over four years and never stretching.  That’s the kind of thing you can do in your 20s, but not, as it turns out, in your 30s.

There may be other causes, but I’m going with the above.

How to Get Better

Essentially, you’re trying to heal an inflamed muscle, so rest is your best friend.  I committed early on to not patch up my injury and come back quickly but to take as much time as necessary to heal.  My main goal is to run into my 70s and 80s and not to run as soon as possible with a high likelihood of re-injury.

Loosen Your Hamstring, in particular, and leg muscles in general – I have a foam roller (black; the color indicates how hard the roller is) and would roll out my hamstrings, quads, IT bands and glutes every single day for the first two or three months. (I mean: every. single. day.) I hated this.  Watching the Mavs win and listening to Western States podcasts made it a bit more bearable (yes, that’s how along ago all this started).

Eventually, I started stretching – lightly – and increasing my flexibility.  I can now touch my toes at any point in the day, which is a huge accomplishment considering where I started.  Eventually, I was able to start doing yoga (after about 4 months), which I consider invaluable in my recovery (more on that later).

Also, the wonderful Mrs. Golden Trails would massage my hamstrings two to three times a week during months two and three.  If you have someone who can do this for you on a regular basis, I would highly recommend taking advantage of that.  (We started this about 4-6 weeks in and maybe should have done it sooner).

Ice – I didn’t think this would work, but icing did help quite a bit at the beginning to calm down the inflamed muscle.

Strengthen Your Core – My PT insisted on this.  I would (still) argue that my core was pretty strong to begin with.  I passed all strength tests with flying colors.  Doing several 60 second planks should be *very* easy.  Anyways, just mentioning it, because it may help the reader.

Compression – I own one pair of compression shorts.  For a while, I wore those to bed which helped alleviate some of the pain I felt in the mornings.

Everyday Issues and How to Solve Them

Rest. Rest. Rest. – At first, my hamstring hurt all the time.  After a few weeks (4-6 weeks), I got to the point where I would have a few pain free hours during the day and could even walk a few steps without pain.  Avoid walking, standing and sitting on a desk (or other hard) chair for long periods of time. Easier said than done, I know.  “Avoid” = “minimize as much as you can”.

Do what you can.  I used to live half a mile from the subway and Mrs Golden Trails would sometimes drop me off/pick me up from there.  It’s pretty sad for me to even think about, but any walking would re-aggravate the injury.  Also, Mrs. Golden Trails rocks.

Sit On a Pillow While Driving – I don’t know how I figured this out, but after weeks of bad pain any time I drove, discovering this was an absolute game changer.  I would also bring something soft to sit on airplanes, at sporting events, etc.  Sitting on soft surfaces puts less pressure on your hamstrings, so that made me feel better.

Get a Standing Set Up at Work (if possible) – I realize, this is not possible for most, but if your employer pays for such perks – take advantage.  Regularly being able to switch between sitting and standing is gold.  Also, if you get a really fancy chair (Herman Miller!), you can bend the chair bottom (the part you sit on) forward.  Again, less pressure on your hamstrings = happier hamstrings.

Helpful Exercises

Bridges – I don’t like this exercise, but I did it anyways.  It helped.  Here is an example.

If that’s boring, try doing it with a stability ball.

Swimming – After a while (6 weeks or so), I started swimming.  At the beginning, all I did could do was pulling.  Swimming is boring to me, but was great for getting my heart rate up on a regular basis.

Bikram Yoga (the hot kind) – OK, so you may have done yoga before.  Forget all about it.  This is not the same.  This is no granola, “ommmmmm” yoga you may imagine or have done before: this is a *workout*.  I’ve been doing it for two months now, and it’s changing my body in a hurry.  If I had to name one single thing that helped towards recovery, it’s Bikram.

Let me tell you: it’s hard.  Most newbies I’ve seen, don’t make it through the first class (count me as one of them).  Even my mother-in-law, who had been practicing yoga for 10 years before I took her for the first time, ended up throwing up 25 minutes into her first class. She also came back and finished out the session.  Sound a bit like ultra-running?  It’s not too different.  It’s extreme and pushes your body to a place you likely haven’t been before.  Try it.

If you have additional questions about my experience, please ask in the comments.  I will try my best to get back to you.

Get well soon!

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631 Responses to Dealing With High Hamstring Tendinopathy – A Practical Guide

  1. Thanks for sharing. This is awesome – thanks! I have the same issues and am literally heading out to buy a foam roller today per your rec right now.

    • Anais says:

      Thanks for the post. I am having a very difficult time healing from high hamstring tendinopathy myself. I have finally found a combination of exercises that are helping me to heal, although I am not yet back on the trails. First, I would suggest Yamuna balls (I use black), they are tremendously helpful to lengthening the tendon and loosening it up. Hurts an awful lot in the begining, but really invaluable. Also, I’ve had to strengthen my core and stabilizers (hips), my glutes and adjust my posture. Starting to change my running gait, so I am more upright, use shorter strides and tighten the glutes to take the load off the hamstring. (I’m running on a treadmill for very short periods of time.) Pilates has been great because the focus is on doing the exercise with proper posture and form, with a focus on core and glutes. As you said, I am taking it slow and easy, doing what I can not only to heal the injury but also to change my form and posture to make sure this injury does not reoccur. As my PT said, one needs to be open to exercising, moving a different way. So my mantra is be open to the possibilities, be patient and you will heal and enjoy movement in the outdoors once again. Thanks for the post!

    • Anonymous says:

      Thanks for this. I feel like I just read about myself. I have had my injury for 11 months. I was in PT for 6 months but I do not feel it heeled it so I am no longer going.

      I am going to try the above. I do have a Hermann Miller chair so I am going to adjust it and I have been standing up for the past 2 days.

      I am so frustrated at this point…I am trying anything.

  2. olgav100 says:

    Ditto on Bikram. Been doing it for 11 years now.

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  4. Anonymous says:

    thanks so much for a great post. i dont think i have a severe a problem as you did, but i think ive got a minor form of it. so ive decided to put my marathon plans on hold till this thing heals…not running is gonna suck!

  5. Poppet says:

    Yes thank you!
    like the above i’ve got a mild dose compared to you (sympathy to your rear end!) I have a good physio who’s given me lots of exercises to do, Its just have the patience to stick with it – and the disicpline not to go for a run on the odd good day 🙂 (yes it does make it worse).

  6. Anonymous says:

    At what point (time-wise) in your recovery did you begin to go to Bikram?
    I have been dealing with high hamstring tendonopathy for nearly a year now, but didn’t stop running until November. Stopped riding the begining of February. I would love to go back to Bikram. Did you wait until you were pain free to go to Bikram?

    • goldentrails says:

      Great question! I wouldn’t start Bikram until you’re pain free in everyday life. The first couple of months of my injury, my hamstring hurt *all the time*. It wouldn’t have made much sense to do Bikram then. Over time, it would only hurt when I stressed it (sitting too long, etc.).

      I did do a lot of gentle stretching while I was injured and before I started Bikram.

      Hope this helps.

      • Julie Jameson Benay says:

        I just found this and it’s really helpful. I haven’t been officially diagnosed but from all the symptoms, I’m sure this is my problem. I do not run but do Bikram, and have done it for 9 years. This summer I did a 30 day challenge 30 classes in 30 days) and also several long road trips. I’m very depressed about taking time off from Bikram, but it seems unavoidable. What can I do? Can I hike? Bike? Swim? Help!

      • Anonymous says:

        What type of pillow did you use in the car and in the office? I am dealing with almost mirror symptoms/situation like yourself. Thanks in advance!

      • kristin says:

        if you’re having a great deal of trouble when sitting, as i was, i would suggest getting a convoluted wheelchair cushion. it looks like a foamy egg-crate. i ordered one from amazon for around $15. i’m sure there are more sophisticated things out there, but this has helped me greatly. i have a desk job and i think my recovery was hampered by having to sit most of the day so i wish i would have done this sooner. yes, you may look a bit silly and i’ve had many questions from (sedentary) coworkers, but it has minimized the pain!

      • Julie Jameson Benay says:

        Consider buying or getting creative with a stand up work station. I figured out a box that I put on my desk, and my friend is using a step stool. Standing for part of the day is all around better for you anyway. If you have money, there are lots and lots of standing workstations to buy.

        Sent from my iPad


  7. technoqueen says:

    I am soooo glad that I found this article. I have had an issue with my right hamstring since 2007. Nothing severe, just a bit of an ache in the high hamstring area after long runs. Since the ache would go away and my mobility was not compromised I didn’t think too much of it. BIG MISTAKE! I now know that this ache was a warning that something was not right and I should have paid attention to it when it was minimal.

    In April 2011, I was doing some speed work and lost my footing. I fell awkwardly and felt a searing pain in my right hamstring right at the insertion point to my buttocks. I had all the symptoms mentioned above. Not only could I no longer run (or sit comfortably), I couldn’t walk my normal speed (which is pretty fast). Anytime I tried to walk at my normal speed I would feel severe muscle fatigue in my lower right leg. My chiropractor told me that was a result of my over compensating for the tightness and pain in my hamstring. I was engaging other muscles just to make the movement of walking fast. I was also told that I had a weak core, tight hip muscles, and a muscular imbalance between my hamstrings and quadriceps. All of these things played a part in ache I had been feeling for the previous four years. My fall only exacerbated the issue.

    So I slowed things down, I didn’t run, and didn’t work out for about 4 months. I underwent Graston and ART with my chiro for about 8 weeks and I was cleared to use the elliptical trainer for short periods in September. Then by October I starting taking spinning classes. It all felt great! No strain or discomfort in my hamstring at all. In January of this year I started taking a weight training class where we use barbells for squats, lungdead liftsifts, etc. It’s a low weight, high rep class. In February, I started doing run/walk intervals on the treadmill. I would run for one minute at 4.5 mph and walk for a minute at 3.5mph for 30 minutes. I still feel a slight twinge (tightness, no pain) in the hamstring when I run but it goes away after I have been moving for about 10 minutes, and I have been able to increase my running speed bit by bit. I have just taken my intervals outside and find that I feel a bit of discomfort when running on an incline. Taking it slow or stopping and walking helps with that. I also do not do the intervals everyday. I always have a day of rest in between. Resting is hard, but it’s so important! I always, always stretch after any type of physical activity now (I’ll admit that I was not so good at doing that before). I feel that the weight training class has helped me with the muscle imbalances. I also do core work at the end of the class. The plank used to be the enemy. Now that I know how important it is to my overall muscular stability, I have grudgingly embraced it.

    Yoga is the next thing I am going to add to my arsenal for healing. While I am much more mobile now than I was 11 months ago, I would like to be more flexible and reading your story has helped see how important that can be to my recovery (over and above the pre and post workout stretch that is)

    My questions is…do you have any discomfort in your hamstring anymore?

    Thank you so much for sharing!

  8. goldentrails says:

    I’m glad this article was helpful. To answer your question, every once in a while (*rarely*) do I feel a slight, slight discomfort. It is usually due to one of two things: 1) I have dramatically increased physical activity to a level beyond anything I have done since the injury or 2) slacking on the stretching/yoga thing. The latter happens when life gets “too busy”, which is really no excuse.

    Overall, however, I have been progressing nicely, and I can easily run 3-4 hours or go on 8-9 hour snow show trips in the mountains. (As reference, I run ultra-marathons, so that’s normal activity for me).

    Your note about the twinge going away after some activity worries me. I had that for about a month and continued to run through it until I really aggravated it during a race. I did not run for 5 months after that.

    You may really like Bikram, because unlike the other forms of yoga (which are fine), the heat element drives up the heart rate, so it feels a lot like an aerobic activity like running or walking briskly.

    Good luck!

  9. Anonymous says:

    Thank you so much for this post. It’s given me hope that I can recover from this injury. I’m going to try your suggestion of the pillow in the car as well as the compression shorts in bed. Just this week I got set up with a standing desk at work so I’m hoping that will help. This ‘resting’ phase is so difficult but I’m determined not to rush as I want to be able to run in my 70, 80s too. Thank you for the encouragement.

  10. Anonymous says:

    I have the same type of injury you describe. How long did it take until sitting in the car etc. became more tolerable?

    • goldentrails says:

      My healing was very gradual. Riding in a car was pain free as soon as I started sitting on a very soft pillow. I continued that practice well until after I felt I had healed. No need to stress the hammy.

      That being said, it took over 3 months for me to be able to walk a pain free mile. Maybe even four. I slowly built from there with increasingly longer walks. Eventually I added short runs. 1 block at first building up to a mile. This took a lot of patience.

  11. Anonymous says:

    Just want to chime in with the others and say thanks for the informative post. So many sports medical experts have had trouble diagnosing this one for me and finding info like this has confirmed for me what the problem is, especially when you mentioned how you’d get the pain at the outset of your run, then it would go away after you’ve warmed up, but then it returns. Everybody I’ve mentioned this phenomenon to has been mystified. Thanks again, and I’m going to try your suggestions.

    One question: are you still wearing the compression shorts (during runs)?

  12. goldentrails says:

    I do not wear compression shorts during runs. I only wear them to recover from long runs as well as during Bikram yoga.

  13. Erin says:

    Thank you, thank you Mr. Golden Trails for the great post, I have been dealing with my injury since Oct 2010 which is a long time. I did most of what you did, except the yoga, I tried it, and will give it another shot. I have been only swimming for about 4 months and I tried running twice and everything came back again. It is so amazing that I finally came across an article that is exactly what I have been experiencing. I also did ART and Graston, would you do that again if the symptoms are coming back? Thank you-

  14. goldentrails says:

    Hi Ernin,

    I’m sorry to hear about your struggles. Frustrating!

    If you try yoga again, make sure it’s Bikram. It’s the same everywhere, every time and is sure to stretch your hammies but will also strengthen glutes and abs. The heat helps losen everything up.

    I did ART and Graston as well. To me (!), ART felt like a waste of time. Graston was good. As always, that’s just one man’s opinion.

    Good luck!

  15. Kevyla says:

    Hi, Thanks for you blog, it’s really informative. I’ve been suffering with this injury for 18 months now and that was the last time I did a competitive race. Before that I regularly did 10k’s and half marathons.
    I’ve been to 3 different Physiotherapists who all suggest eccentric exercises are the way forward. I’ve mostly been doing one called the Nordic hamstring exercise and another where you lean forward stood on one leg, perhaps with a weight of some sort in your hands.

    I think I’m gradually getting better, but it’s so frustrating. I don’t normally have any pain during the day, only after running and after an “outdoor” 6 miler last Sunday, it’s been quite sore since, but it always eases off as the days go by and I’m hoping to do a gentle 4 miles or so on my treadmill on Thursday .

    I can run up to about 5 or 6 miles slowly, but nothing like the pace I want to.

    I’m seeing a chiropractor for an assessment next Monday, just to see what their take is on my situation.

    I have a foam roller but haven’t really been using it much. I’m going to try and use it daily in front of the TV if I can remember!

    I’ve looked into Bikram yoga but there doesn’t appear to be anyone holding classes anywhere near where I live.

    Any other suggestions…

  16. Brandon says:

    I encountered the same thing in Jan of this year, although not as severe. I did 2 months of pool running to stay in somewhat good condition until i could run again… finally could put in miles on the road about 4-6 weeks before Boston and was able to run it… no pain during the race and none after, although im starting to have some flareups now, 2-3 weeks post race, not sure why. PT recommended the same stuff… core strength and i also was getting some ultrasonic therapy at the insertion point and that seemed to help push some of the inflammation out of the area although at times it was painful.

    • Brandon says:

      Ive also been using a groin/hamstring compression sleeve on the affected hamstring and even the compression shorts over that at times. I think it definately helps the bulk of the hamstring but nothing really helps to support or prevent the insertion point irritation.

  17. mizunogirl says:

    Nice post here. I have a left high hamstring issue which waxes and wanes. I did also have a labral tear, hip issue which was “surgicalized” and is much better, my adductor tendinopathy is gone but the hamstring….is just killer, even with weekly massage. I just switched from a movement based job to a primarily sitting situation, and perhaps this is actually what has aggravated it…. grrrrr.

    I probably should go back to just the regular yoga….I’m not an ultra runner (yet) so i am sure regular yoga would make me quite happy. That and I have not been icing so will go stick the ice pack in my compression shorts!!!

  18. Bev says:

    Hi goldentrails this post has been so helpful, it fits with my symptoms to a tee, did you stretch your groin area, I feel that this aggravates the pain.

  19. Michele says:

    How long did it take to return to ultra distances after the injury?

  20. Tricky question to answer, because my return to ultra distances has been delayed for other reasons (family, work). It took about 8 or 9 months to get back physically to a point where I could have competed. I just haven’t because of other circumstances.

  21. karen says:

    Thanks so much for posting this. I have been struggling with this same injury for 3 months now. I just got the “ok” from the sports med doc to TRY running (short distances, etc). I had heard about bikram but never tried it and lo and behold there is a studio only 4 miles from my house. Thanks again.

  22. I, too, have been feeling pain since Oct. 2010. I’m a 70-85 miles/week runner. I took 8 months off for the first onset and now just three weeks ago, I had to stop again. I have been biking, swimming, and doing the elliptical. Should I not be doing those exercises? Am I making it worse? I have a foam roller and would use it daily before the pain came back. I would stretch and sit in ice baths. I was doing all sorts of preventive measures but the pain came back anyway. I also did yoga, but it seemed to aggravate so I stopped. At the yoga studio I attend, they do not do Birkam. Would it still be beneficial to buy a DVD and do it at home without the heat? For compression shorts, where did you get yours? What brand? I also perform planks and find 60 seconds easy. I do other core strength as well. My core probably could use more work; I just wouldn’t know what else. Aside from my comments and questions above, any other recommendations?
    Thanks for your blog and willingness to helping other runners. 

    • Brandon says:

      My physician highly recommended i continue to deep water run as long as it didnt hurt… even said i could run as long as it didnt get uncomfortable (i.e. staying in the 1-3 range of a 1-10 pain scale). My compression shorts are just your run of the mill under armor thigh length compression shorts. The only caviet is that there are some generic thigh length spandex out there that some people use just out of modesty… you want something thats tight and supportive not just covering your legs… but like i said.. i dont think it helps with the irritation i have at the hamstring insertion, only keeping the hamstring belly warm and loose.
      I recently took a 5 day high dose of oral steroids and it doesnt seemed to have done anything at all… was hoping that it would be a help since my prescription for naproxin didnt help at all either. I continue to run, i can do 80-85% of my race pace without too much discomfort so i continue to work on my base while hoping that this will work itself out. In the next week or so i do intend on visiting my physician again and talking with him about an MRI to be sure its not a tear or something more serious than tendonopothy, as well as other treatment methods ive read about… i.e. dry needling and/or local cortizone injection and also a treatment that seems to be garnering some success with other forms of tendonopothy… PRP injections (Platelet Rich Plasma).

      Working on 6 months now dealing with it.. had pretty serious pain when it first hit in Jan… a small relapse a couple weeks after running Boston in April… and just a steady irritation at the insertion point the last month or so… up to 30-40 miles/wk again despite the low grade irritation.

      Hope everyone is on the mend.

      • I continue to follow this post, though I admit, for 3 weeks now I have finally been free of my High Hamstring irritation. My Massage Therapist did something to it. It was very very painful, and I thought I might faint, but it seems now with stretching and such to be remaining free of pain…

        My Compression shorts are from Zensah, and I hate to be an advertiser, but they do work much better than the regular ones, they are sort of rubberized and really grad at that hamstring insertion area and put some compression there, rather than just the thighs. Just a thought. Best wishes to all….

    • goldentrails says:

      The one element that I have adjusted since I’ve come back and is not mentioned in the post is that I’ve adjusted my running form. Pre-injury I was a big-time heel striker. That’s the part of the shoe sole that always wore off first. If you put your foot down just pressing on the heel, you can feel how that puts pressure on the upper part of the hamstring. Now, put your foot down and press on your forefoot and note how the hamstring pressure is now spread more evenly.

      That little experiment led me to change my running form. It was a bit painful at first, because I was using my muscles differently (particularly my calves), but it’s been working out great. Plus, I feel that I’m faster, because I run more efficiently.

      Hope this helps!

      • karen says:

        Thanks. My sports med doc actually said that I might benefit from barefoot/minimalist shoes. go figure

      • Marko says:

        Thinking out loud here … Do you think running shoes selection could have anything to do with the issue? btw, I’m having the same symptoms (not that drastic, but the same)

  23. Kevyla says:

    I’ve now progressed to 7 miles outdoor at about 9 to 10 minute mile pace, when I could only run about 1.5 miles at one stage at 10 minute mile pace. I’m doing Nordic hamstring eccentric exercises and am fairly sure these are the most effective. I’m also doing lots of planks and another eccentric hamstring exercise where you stand on one leg (the bad side), with your arms out to the side and lean forward with your other leg straight out behind you, with this one you can really feel the area get a stretch.

  24. Jose says:

    Any suggestion abt what running shoes should be recommended for HHT?
    Thxs vm

  25. goldentrails says:

    I wear the NB MT 101s. Minimalist but not too much so.

  26. Kyle Ramirez says:

    Did you not do any hamstring strengthening excersies?
    I have been diagnosed with MRI for proximal hamstring tendinosis, and on the 3rd PT :/

  27. Kevyla says:

    Hi Goldentrails, Do you have any tips to beat the soreness the day after a run? I’ve used ice, foam roller and a tennis ball. Any exercises you can recommend to give relief in the short term? Many thanks for your excellent blog, it’s giving lots of us hope.

  28. karen says:

    So I finally tried bikram and unfortunately it seems to have irritated my high hamstring even though I was very gentle with the poses. Did you find this to be the case ? Just curious.

  29. bob says:

    Great Blog..thanks for the info.
    I’ve been suffering from a similar issue that started in early April, “12”. Crossfit five, six times a week and running three,four time a week- Some speed work put me over the edge. I’ve been doing nothing but walking and stretching for the last 4 weeks and it’s slowly getting better (SLOWLY!!!).
    I am a SW engineer and sit all day. The only way it get thru the day is using one of these
    I really helps the alleviate the pain from sitting for hours on end .. or as a friend of mine and long time HHT sufferer put it: ” a toothache in the butt”



  30. collin says:

    Hey there, I have had this bilaterally for over 2 years, i couldn’t run for the first 3 months then i got better from that, but were you guys able to squat?? because thats how I had a severe tweek in both hamstrings about 8 times in 1 year, which I think I got a crazy amount of scar tissue, now I am able to hurdle at 100% speed sprint at 100% squat at 100% do everything!! except when I rest, when I sit i have severe pain in both legs like you have had but the weird thing is I have severe pain now standing sitting laying everything I have pain but when I go full on sprint training i have no pain during or 3 hours after, but it comes back to what it was before,so I am wondering what the pain is from, extra tension on the hamstrings from scar tissue, or i have heard of hamstring syndrome where the sciatic nerve is tethered and entrapped with the hamstring with scar tissue, do you guys have pain in the entire hamstring or just at the ischial tuberocity, I have it on the entire hamstrings,

  31. FSOJ says:

    I injured my left hamstring back in 2009 while working with a trainer. I think it was just a strain at that point. I went to see a sports chiropractor who was very aggressive, and after a few sessions, I had more pain than when I started and now it was bilateral. I switched to a sports PT, and by this time, both my hamstrings hurt a lot. She dry-needled both my glutes and did a lot of stim therapy, both of which were very painful. I remember that after one very painful session, it started hurting whenever I sat down for long periods. I had stopped running, and I don’t think I was re-injuring it, but I do think that between the chiropractor and the PT, tissue was injured. Anyway, I now have bilateral high hamstring pain. And so many of the previous posts are correct, there is very little known about this. I have seen an orthopedist who told me my problem was ‘exotic’ and referred me to a physiatrist. The physiatrist did tendon injections with steroid, ischial tuberosity bursae injections, and did PRP twice on both hamstrings. Everything only helped temporarily. I think the main issue for me at that point was that I was sitting too much, especially if I was in my car, which was a Mini Cooper. Those seats were brutal, and the suspension was very limited (but the car sure was cute!). I switched to a Volvo with heated seats, and that is more comfortable. I have a hydraulic stand-up desk, which helps a lot, but I am still struggling with this every day. I don’t go out to eat with my family due to pain in most restaurants, even when I take a cushion. It has affected my quality of life in a big way. I don’t even want to run anymore; I just want to be able to sit without pain. I haven’t even really been given a clear diagnosis, as an MRI I had two years ago was read as “normal”, although the physiatrist said there was some fluid around the tendons. I am trying to accept the pain and move on, but it’s hard. I did start Cymbalta, which helps about 20%. Anything else you’d suggest? I eventually saw another PT who was much more gentle, and she did a ton of dry needling. I was recently diagnosed with hyperparathyroidism, and had two adenomas removed. I was hoping this would help with the pain, but too soon to tell. Really appreciate your blog and the posts.

    • Anonymous says:

      I understand how you feel I am struggling everyday. But I use a heating pad for 15-20 mins. Do so stretches laiding in bed or sitting. I use tiger balm sport for pain, I take 800 mg of iburophen one a day if the pain is unbearable. I use ice, all these things help but the stretching is the best. I use a rolling pin to rub out pain it helps. I dont even know how this happen to me. I woke up like this on jan 28 2013 and I am still walking with a limp. I also have two braces, wear them sometimes. Compression stockings might help, but you have to find what helps you.

  32. Ben says:

    Goldentrails, did you ever try dry needling? What about a steroid or cortisone shot? If so, did you find any of them to be effective? Thanks. Ben

    • FSOJ says:

      I did have the steroid injexs and a ton of dry needling. Also Platelet Rich Plasma injexs twice. each helped temporarily, but pain always came back. And it seemed like the specialist got annoyed with me when I didn’t get better. I finally got tired of procedures. Tried thai massage. Helped, but pain came back after awhile.

  33. Anonymous says:

    Thank you for your post….I’m a colligiate track and field athlete and I’ve been struggling with hamsrting tendonopathy for about 8-9 months and quite running 5 months ago. I have been to PTs , orthos, two MRIs, two X-rays etc. Finally found out from an MRI that it is in fact “proximal hamstring tendonosis” a month ago… Nothing has worked for me, the PT has had me doing mainly gentle stretching and strengthening (like the exercises you mentioned)…my problem is I’m in such pain every single day (mainly in the glutes) that sitting down is excruciating and standing aches and walking hurts too. I basically cannot move without pain so it is difficult to even do strengthening exercises. I recently go a steroid injection into the ischicial tuberosity area but so far my pain has gotten worse…. do you have any suggestions on how to get ride of the pain at least enough so I can start rehabbing properly? Thanks so much!

  34. Karissa says:

    Oh btw my name is Karissa, forgot to put it in the above comment. Thanks again!

  35. FSOJ says:

    I find that I now have pain when sitting crosslegged on the bed or floor. the back of my thighs go numb. Do you know if that’s typical?

  36. wally says:

    Very informative post…I saw this link from RW. Anyways, here is the low-down on my situation…injury 2 years ago running downhill. Thought I had a calf strain but its progressed much further than that. main areas of injury are directly behind my knee (Popliteus), posterior calf AND the elusive high hamstring tendon or piriformis area (where hamstring connects to butt). Basically hurts to walk, sit, lie down and of course no running, hiking, biking. Have seen 4 docs, 3 different PT people, 3 MRIs, x-rays. Am currently going to a Chiro guy who’s very good and adjusted me for some leg length differences and has been going to town on piriformis (he believes its sciatica). Also seeing acupuncturist and have been needling all the way down the leg and IT band, he thinks its sciatica too. I’ve heard so many different ideas about this injury and frankly am at a loss. To stretch or not to stretch? Nerve damage or tendon damage? Strained muscle or build up or scar tissue? Not one single PT person, ortho doc can actually figure this out definitively. Have had very little relief from hands-on massage and what little relief I get from chiro or acupuncture goes away in a day. Sciatica is possible but I have no lower back issues. I can only think that it is nerve issues near piriformis AND possible muscle/scar tissue injury lower down the leg. No numbness though. Ice, biofreeze do help, stretching with a black foam roller results in MORE pain. Totally at a loss. Thanks for all of your help. Chris

    • FSOJ says:

      Since my last post, I have discovered lidocaine patches. They are awesome! You place them on the area of pain (the top of the hamstring) and the lidocaine (topical anesthetic) gets absorbed through the skin. They are not a solution, but they are very helpful. I sit a lot during the day, and with the patches, I can sit almost pain free. They are available by prescription, aren’t habit forming, and have few side effects. Hope this is helpful as you try to find a good treatment for your tendonitis.

  37. baborka says:

    Hello Goldentrails,
    thanks for this post. I have this hamstring tendinitis as well — had discovered foam rolling and was wondering if it will work in the long run. Had not yet discovered Bikram yoga, but it makes sense to exercise in a heated room. I used to sit in the warm bathtub just to get all those muscles warm and loosened up.
    Only one thing — _everybody_ says that muscle stretching is a no-no, especially if the muscles are injured. Long-term muscle injuries are little tears in the muscle tissue which only get worse when stretching. In fact, my first episode of this tendinitis came on after some overstretching because of yoga. In my case, it’s confirmed via MRI that there are tears in the tendon that connects the hamstring to the bone. The reason is apparently weak glute muscles which should have protected the tendon. But sitting all day as a software engineer means that the glutes are always stretched and relaxed and don’t get any work to do and so become weak. I had two autologous blood injections and am still hoping they will make it better.

  38. Mike says:

    My tubing injury occured in 12/2010. Hit a rock at a high speed. It was very painful for a week, got all kinds of bruising from my left butt down to mid-hamstring, and I thought that was the end of it. A few months later the painful sitting issue began. The office chair and car are awful, but no pain standing or lying down. I can manage on a couch. Saw 2 orthos, 2 physios, my chiro and accupuncture, none of which helped. MRIs and Xrays are negative. One of the orthos tried 3 cortisone injections in the SI joints (not sure why), that did nothing. Beginning to have ankle and hip issues in the affected leg. Intensive physio seems to make it worse and stretching doesn’t seem to help. Considering a cortisone injection in the tuberosity if a doc will do so. All the docs say 49 yrs old is too young for this, but none can help. I’ll report any progress. Thanks for this forum!

    • FSOJ says:

      I just started seeing a new PT, and he thinks my problem is an asymmetrical pelvis. He actually discerned a functional leg length discrepancy. I had no idea I had one. He feels that if we correct the asymmetry, the length difference will resolve. After the first treatment, my legs did look closer in length. Anyway, he said this kind of injury is very common when there is hard impact on the butt, which sounds like what you had. I know you said you saw some PT’s. Did they detect any tilting of your pelvis?

      • Mike says:

        Sorry for the delayed response FSOJ. They did not mention any tilting of my pelvis, but I will ask at my next appointment. In was told by a PT that the tightness in my hamstring was causing a change in my gait and that my legs were not symmetric due to the accident. Thanks for the info! I have since seen a new ortho and he twice injected cortisone at the sit bone. No better, I’m afraid.

  39. Alley Cat says:

    Hi GoldenTrails, am a fellow mad long-distancer, have all the symptoms you describe, just been diagnosed (with MRI) as having high grade close to full thickness tearing of the conjoint tendon of biceps femoris and semitendinosus, and tendinopathy of semimembranosus. I’m a bit lost as to rehab plan so am really interested in your experience. Did you also have tearing like this? Cheers, Alley Cat

  40. UltraObsessed says:

    I just came across this blog entry because I’m suffering from the same thing. I am on week 6 of no running, and I’m going crazy. I’ve been swimming and biking, but it’s not the same. I am getting frustrated because I’m not pain free. Before I came across your blog I planned on running soon, but I guess I should give it the 6 months that my sports doctor recommends?

    • Anonymous says:

      I am right there with you. Three months ago this started for me. I decided if I couldn’t run, then I would stay in shape in other ways, swimming, biking, suspension training. I didn’t want to lose my physical fitness that I have spent years working on. But that proved to be a mistake. I am three months without running and just as bad as I was months ago:(

  41. Hello Goldentrails,
    I found your blog through a Google search for insertion point hamstring tears. I tore mine 14 years ago while waterskiing but never did anything about it until three months ago. I didn’t realize how prevelant this injury was until I started trying to do something about it and find out what and where the injury actually is. I have all of the symptoms that you describe and have been doing physical therapy for three months now. I have started a blog as well to track my progress and the therapies that I am receiving

    Are you back to running? Have you fully recovered? I would love an update on your progress!

  42. KBUFFS says:

    Really enjoed the article as well! I have been having a similar problem since May. I ran a half marathon and the next weekend ran a marathon relay (only running 6.1 miles) yet that was all my hamstring needed. I have a question- did you ever go see an doctor to look over your injury? I am debating if I should. I think once it passed the 6 month mark, I started to get nervous- would love to hear your thoughts! Thank you!

  43. Janny says:

    So glad I came across all this wonderful information. Has given me optimism that I can recover and get back to running. Albeit I was just a beginning runner but was improving and enjoying the experience. My pain is in my butt area also. Especially painful to sit at work and in the car! I will look into the yoga – hope I can find it offered in my neck of the woods. Thanks everyone for sharing your experiences and suggestions to heal.

  44. Jenny says:

    I am researching High Hamstring Tendinopathy and came across your blog. Awesome information! I have most of the symptoms you mentioned with a few differences/additions. What is the best way to determine if this is the problem? I have been to two doctors already. One in a Sports Medicine practice (back specialist) and the other Neurosurgery. Both have said different things.

    1st stated I had 2 bulging discs and beginning stages of arthritis. He did a lumbar epideral which helped none.
    2nd stated that I do NOT have bulging discs that he believes it is not “Structural”. He recommended I do 3 weeks of PT and take anti-inflam meds. If this does not help he stated to go to an Internal Med doctor.

    The following are my symptoms
    ■Pain in the upper hamstring area, most notably where the hamstring connects with the sitz bone
    ■The pain is deep in the muscle, not at the surface
    ■Pain came on slowly over time (as opposed to suddenly due to a traumatic movement of some sort)
    ■Pain while driving a car
    ■Pain when sitting a long time, especially at a desk or on hard surfaces
    ■Pain at the outset of a run, but going away once ‘warmed up’…then coming back later on
    ■Numbing of entire leg occasionally.
    ■Occasional glut pain
    ■Sometimes hurts when getting out of bed in the morning
    ■Started out with a tender spot on back
    ■Hamstring feels tight most always
    ■Deep ache from glute down side of leg all the way to my foot at times.

    Any idea? What type of doctor would be best?

    Thanks for any input!!


    • Anonymous says:

      Im currently seeing a Physical Therapist that specializes in soft tissue work. For me, shes identified some extreme limited mobility in my R Hip which could be causing the L Hammy to overwork/aggravate/inflame. So far ive been having some good results visiting her twice a week for the last 2 months. The doctor that Im seeing is in a pain management clinic but hes known around town as ‘The Running Doctor’ as he specializes in dealing with injured runners and thats how my injury was started. Someone with these interests/abilities/focuses may be able to help.

    • Duncan says:

      Hi Jenny

      If you’ve got pain going from the glute all the way down to your foot, it could be sciatica as the sciatic nerve runs from the base of your spine, through your glute and down your leg. Mine has been irratated many times over the years and can be a really sharp pain that is almost impossible to relieve. I can’t recall exactly what I’ve done in the past as I was never one for sticking with exercises given to me, but along with strengthening your core, there is a specific nerve stretch you can do. Perhaps ask your Dr or physio about it?

    • Lea says:

      I just came across this post. I am suffering with all of your symptoms. My symptoms are set off when I try and run at an increased speed or run 6 or more miles. Are you still having symptoms? What did you end up doing?

    • Judi says:

      I have been dealing with HHT for over 7 months. I switched to a sports pt a few months ago and she insisted it was a sciatic nerve problem from past back injuries. I was having no progress so got an MRI which diagnosed me with HHT…the initial diagnosis from 7 months ago. Get an MRI for accurate diagnosis, or you may waste your time.

      • Brenda says:

        Will the body naturally repair over time though? I’m debating MRI but the cost is crazy, and thinking what point, I know I have HHT- just hoping time and some PT will help. I was better, started running, then must have reinjured. To Cooper I have heard of some type of injection, but more cortisone, even dry needling to stimulate blood, who knows, willing to try anything! I now have Aline inserts, supposed to help alignment, but right now just causing lots of calf pain. Trying to stay positive but difficult. Anyone try those inserts?

  45. Bob says:

    Hi i have had the same issue but was not as severe. As i do sports it tends to bother me but do not now if i should contact the docters. As i do teakwondo there is lots of kicking involved and leads to issues in my upper hamstring. What should i do?

  46. JB in SD says:

    I am also a runner suffering from high hamstring tendinopathy. Prior to the injury, I was averaging 70 mi/week for a period of 4 or 5 years with only a few weeks of recovery after races scattered among that time. I have been working on this injury since April 2012 and have had ups and downs along the way. At times it seems to really be fading, then certain things make the pain flare up. I have had three PRP injections (May, July, early November), but only stopped running completely in early September. I have really been only swimming with a buoy the last two months or so, so I am wondering how to manage the recovery phase. I am curious – when starting the recovery process, any suggestions from others on how much pain is ‘ok’ and how much is too much? My sports doc and PT are trying hard to find the best course of treatment, so we are keeping things pretty basic and taking it easy on the hamstring until the pain level is gone, but even minor increases seem to cause some pain to return. The doc says he has seen 80-90% improvement since July based on the ultrasounds during the PRP injections, but the pain just seems to not follow that. Any help is appreciated! For all those suffering without the friend that is running – I fully understand your pain!

    • Brandon says:

      My DR says its fine as long as the pain stays below a 2-3 on a 10 point scale (with 10 the highest). Ive been mixing jogging and walking on the advice of my PT, some days are better than others… Usually 3miles total distance starting with a light jog to loosen things up and then some walking, then running, then walking (each week or so increasing running and decreasing walking). i had a pretty good recovery going until we started to ramp up the core strengthening a bit more and then had a setback (pain returned), this led to the DR doing an image guided steroid injection last week in an effort to reduce the discomfort while we strengthen the hamstring and some other core components.


  47. Pingback: Self-diagnosis and the Internet: good idea or bad idea? | Robby Robin's Journey

  48. Anonymous says:

    Thanks good to know I am not the only one with a bad hammy. I have been dealing with my self inflicted injury since Labor Day weekend 2010.( I was a spry 41yr old at that time.). I was doing Cartwheels with my daughter on the beach. The first one felt weird and my leg was tight above my knee in the back of my right leg. The second Cartwheel was more achy… my third Cartwheel.. Yes THREE was going to be better. Because I was warmed up you know. That one left me on the beach with my hamstring throbbing and I felt like I was going to throw up. Brilliant!!

    I was hobbled for weeks. I iced, rested, elevated and ate vitamin I. Ibuprofen becomes a vitamin your in your forties. I did not have any bruising so I thought maybe 4 weeks recovery. Nope… After 2yrs + Yoga, one 10k, long bike rides, water running and lots of vitamin I. Plantar Faciatias(sp?) on left foot opposite side of bad hammy and a hip problem from muscular imbalance…. I tell my friends no marathons for me… I have a bad hammy. They still can’t believe its the same one. I tell them not to do Cartwheels. Duh!.

    In 2012 I gave up running longer then 5k and biking longer then 20miles. I also gave up yoga. I feel like less is more. Love my foam roller. Love the curves type 30min w/out at my gym. It is a circut. I do that 2 or 3 times in one day great workout. I train for one sprint distance Tri a year with my teenage girls. .3 swim,16mile bike and 5k at the end. My hammy is good for about one hour of exertion. The swim on a tri is a great warm up…Forget flip turns in my swim practices… don’t need them in a race. Forget hills it flares up right away but calms down on the flats on my bike. Hills on runs can be walked up backwards. or galloped side ways.

    I can’t believe I haven’t gotten a pillow for my car. I will do that next time I am in the car for more then 30min. I will also get some compression shorts from Zensha?? I have a friend that has gotten some reflexology treatments for her bad hammy. Reflexology… anyone had any luck with that?? Thanks again former Triathalon and distance bike rider. Silly Mama in Florida

  49. RNR365 says:

    Thanks to Golden Trails for initiating this very helpful thread. About a year and a half ago I decided to really get back into race shape to compete in Masters track and field and came across Phil Campbell’s excellent book Ready, Set, Go! Unfortunately I ignored Phil’s advice on the Sprint 8 (running 8-70yard sprints 2x/week) to take 6-8 weeks at 50% to let your fast twitch muscle fibers get back into shape. I felt so good I immediately started running full out… and wham! quad on the right and calf on the left pulled. Also, I had this high hamstring pain on both sides. I’ve been running for over 30 years and have never pulled a muscle. The muscles healed in a few weeks but the high hamstring pain would not go away. Every time I tried to sprint even at 50%, the high hamstring pain returned. I gave it up and just ran at a moderate pace with the tolerable high pain. Eventually it went away. Recently I decided to make another attempt at racing. This time I started out at 50% and kept it that way. The third week I added some 150yd intervals. I noticed some discomfort on the outside of my left knee like it was strained. I started stretching after these sprint workouts and they really seemed to cause weird pains after. The high hamstring pain started again on my left side. I noticed the pain on my warmup lap. It stayed the same throughout the Sprint 8. I did two 150yd intervals and on the second, and I was closer to 80% effort, the pain increased somewhat. I stretched after and 10 minutes later I was in a lot of pain. That’s when I started looking for answers and found this thread. I knew it wasn’t the hamstring muscle because there really isn’t any muscle pain. I took Sat. off and for the first time I iced it by sitting on a bag of frozen peas(directly on skin) for 20 minutes. Painful at first. Major change. Pain all but went away for walking around. Sunday I decided to do my weight lifting routine and see if my hamstring could take it. I wrapped an ace bandage really tight up as high as I could. The exercises of concern: I did squats, reverse extensions and dead lifts with no pain. I know I need professional help to determine the cause of this. That’s my next step. I have had some hip discomfort and knee inflammation on my left side in the past and someone on this thread mentioned the hip. One stretch that really hits the high hamstring spot, meaning i feel pain, is the torso twist (similar to the half lord of the fishes pose in yoga). So I now suspect that, part of the issue is a very tight hip flexor on the left. Stretching my hamstrings does not seem to aggravate the problem so I continue to work on that. As for running I plan on wrapping it up tight and seeing what I can get away with in a day or two. Just when I was really getting into my new training routine and I thought I was going to start competing again… Unbelievably frustrating.

  50. Armando says:

    Question. I think I have what you described. I went to the gym and might have overdone it with the leg curls and other excersices. I had pain in the adductors, abductors, hip flexor, and tronchanter down the IT band. It’s been about 10 days of ice and anti-inflamitories. I want to stop the anti-inflamatories and the ice, its driving me crazy. If I stretch just a bit, it comes back. Should I continue to ice the hamstring area where it connects to the bone or start to use some heat pads. I just dont know how long ice is needed. Also, like you, I find it uncomfortable to sit down and laying down flat on my back I feel best. I can actually walk with no problem as long as I keep my stride short. I am getting all pissed off as I feel I should ice the hip flexor and tronchater but not that hamstring connection. Any advice would be appreciated.

    • Brandon says:

      Generally, its recommended to ICE for the first 24 hours and then heat thereafter. Ibuprofen at high levels, if thats what your taking, takes time to work… but 10 days should be plenty to see the benefits (a week is usually what ive heard)… i dont think i would continue it for too much longer as it does have its side affects.

      My advice: Your at almost 2 weeks post injury with, what sounds like, no progress toward recovery… make an appointment with your family physician. They’ll probably start you off with some naproxin or other prescription anti-inflammatory and get some xrays to check structure… then probably refer you to someone more specialized in dealing with the injury or give you a prescription for physical therapy. One thing about PT that ive noticed in the two people that ive seen… the first person was very unfamiliar with injuries at the high hamstring and his initial series of tests to evaluate me were underwhelming, but i didnt realize this until i gave up on him and went to someone else. The second therapist i visited was much more thorough in evaluating my hip and lower body mobility, flexibility, and structure. She also specializes in soft tissue work (lots of somewhat painful deep tissue massages to stretch and encourage blood flow in the deep areas). I suppose what im getting at, is if you do PT, dont settle for someone that you feel isnt getting the job done… get second opinions/evaluations from other therapists to make sure your confident they know what theyre doing… generally best to have someone experienced rather than someone learning as they go.

      Im 12 months past my first pain… still not been able to get rid of it. I can run and do everything day to day, but i have an occasional (several times a day) ‘shooting’ pain at the glut/hamstring crease, somewhat inner thigh as well. It allows me to run in general but holds me back from any speed work or anything other than conversational pace. Ive had Xrays, steroid injections, MRI, MRI/Arthrogram, around 30 PT visits and nothing definitive found to be causing the pain or a fix for it… but theyre still calling it high hamstring tendonopathy.

      Good Luck with the recovery!

      • Anonymous says:

        I’m so glad for the info you’ve provided! I’m in so much pain daily til I wanna cry from anxiety! Okay so I’m a pretty tough chick but this pain has gone on since this past May. I’ve tried ICE along with pt, painkillers, and extensive stretching. Only relief is running. Im 5″3′ 130 lbs size 2 and I work out 3x a week (now minus running becuz our trainer knows some of our group can’t run in the winter as well I do) PLUS I’m a letter carrier for the USPS. I don’t get a lot of down time at all. Lately my hours have decreased drastically per week but no relief. I’m going to try the pillow in my truck but I’m at the end of my rope! I wanna quit everything but even when I do get days off my feet no relief. Ughhghhh. Do u have anymore recommendations?? AJ, thanks in advance.

      • Jan B. says:

        I know what you are talking about! Sitting is the pits! I have had my hamstring injury for 3 months now. Still not great but improving infinitessimally. I did PT and learned some exercises to strengthen my core and all areas surrounding the injury. The one thing lacking were hamstring stretches. I think the idea is to strengthen my ‘foundation’ while letting the hamstring heal. Then gradually will begin stretching and easy running again. Walking is definitely encouraged however. I guess patience is the key to this healing process. Sucks though.

    • I agree with Brandon about finding a good Physical Therapist. It isn’t worth your time or money if you aren’t getting results. Brandon’s suggestion to see your Primary Care Doctor is a good idea as well.

      In the mean time here are some suggestions from our sports specialist Physical Therapist. Typically speaking, the “acute” phase of soft tissue injury/healing time can last for 24 hours all the way up to several weeks. However, since the ice is not helping with the pain, you can likely stop. I do not see a problem in trying the heat at this point, especially if the heat helps. Stretching is indicated at this time, however, in a painless range so that the collagen in the tissue is undergoing controlled and graded stress which is needed for things to heal correctly and strong. You also need to start to do some GENTLE resistance to these muscles, again, pain free. As far as sitting, using a pillow or softer surface for a couple weeks has helped a lot to offload the tendon and allow it to heal.

      To your health,

      Cherry Creek Wellness Center

  51. Anonymous says:


    Thanks for the info you have shared. I like others posting here began to have issues with exactly what you have described. I woke up this morning and wow was my left hami sore right were it meets the bone. I’m going to take it easy for a few weeks then start back slowly. Once again thanks and Happy New Years and running to you!

  52. Duncan says:

    Thanks for the post Goldentrails. My problems might even extend back to 2009. In the early stages I was too stubborn to admit I needed help and that whatever it was would just go away like any other ache or pain used to when I was in my twenties (now in my mid thirties). Silly me, other than not running for a while and icing my hamstring when I did, I didn’t do anything. I withdrew from a run I was really looking foward to as I the pain persisted which was not easy to swallow as I only enter a couple a year. Eventually I went to see a sports Dr who sent me for a scan which revealed signs of tendinopathy in my upper right hamstring.

    Needless to say that over the past few years I have barely run as the pain just seems to linger. I had a physio give me some exercises and did some treatment which helped rid me of the everyday pain, especially sitting in the car or at work. However I always put off looking after myself until everything else was done (2 young kids nightly routines, general household stuff and trying to run a small business while working full time).

    As time goes on I realise just how much I miss running as I find it very much helps relieve stress and just generally makes me feel good (something I haven’t felt much of lately). In the past few months it has been flaring up again as I run around with my kids and lift various things with very poor technique. I have written down your tips (the limiting walking one was a surprise, but makes sense as I often feel pain when walking, especially fast walking) and will try to make a much more concerted effort to following through.

    Thanks again and thank you to others that have shared your stories and tips.

  53. Mom2naynay says:

    I am now on month 4 of recovery from this injury. My physical therapist has said I can resume running as long as the pain stays at a 3 or below, and more importantly, it doesn’t hurt the next day. I resumed “light” running in November, and I’m currently up to 7 miles once a week with a couple of 3 mile runs weekly. I recently started Bikram yoga after reading your post, and I have to say it makes me feel like I have run an ultra! I haven’t felt this euphoric since July when I ran my last ultra. Thanks for this post!

  54. AJ says:

    Hi Golden Trails: Wow. Thanks for this post. It’s really helpful, and you describe exactly what’s going on with my hammy too. I don’t run, although I used to, but I do do Bikram, and I agree it’s a godsend. I do have to note, however, that, possibly because I don’t listen to my body well, that Bikram was where I actually hurt my hamstring. (I spent a few weeks really working hard and reaching out on standing head to toe and the standing series, particularly triangle.) I thought my ham pain was just stiffness, so each day I’d try a little harder until eventually I realized that the stretching wasn’t working, and that I should just rest it up. I know Bikram will help with the rrecovery once it’s ready for more work, but currently, I have to sit Bikram out for a week or so, just to rest up my hamstring.

    I haven’t been to the doctor yet because I feel as if I know what the problem is. I’ve had this for about a month, but still in the first week of true rest. If things don’t ease up in the next week or so, I might end up going just to get his advice and access to a PT perhaps.

    Great idea about the seat cushion for the car and work. I’ll do that immediately. 🙂 The foam roller is a great idea too. Is there a youtube you can link to with the specific ham roller exercises you recommend or at least which worked for you?

    Thanks again and hope you’re still on the healing path. Namaste.

    • Mom2naynay says:

      Unfortunately, after a week of Bikram my hamstring flared up. It doesn’t hurt when sitting, but instead when I bend over. So frustrating! My PT said that the yoga, while good, should be done using a modified position during the standing leg series. Boo hoo!

      • AJ says:

        hi Mom2naynay: My Bikram instructors were very helpful with suggested modifications for the standing series and the stretching series before Spine Twist. Overall, though, my primary goals is to be better at listening to my body. I’m still trying to rest (it’s soooooo hard to sit still after years of workouts), but, like Golden Trails, I’m in it for the long haul. It helps that my spouse gets irritated when I work out and then complain about it hurting. 🙂 I’m off to roll my hamstrings and spread some cushions around, so I can sit in a variety of chairs around the house (and in my car). I agree–pillows and cushions really help alleviate the sitting pain at least.

  55. lorna says:

    My story…..
    I have had this same problem. 3 years ago I had an ultrasound that showed that I had a tear to the hamstring attachment right at the sits bone. It had been following a “normal” run in Russia, and then I had a very long overseas flight home that day. I arrived home and really couldn’t sit any longer. I was sure at this point I had done something to pull my hamstring, and laid off running. Then a few weeks later I had to return overseas, and another long flight pretty much put it over the edge. Following this I couldn’t run at all, walk, or even really use my hamstring to pull my shoes off. After the tear was diagnosed I virtually didn’t run for 12 months. In fact I couldn’t even sit down for more than 5 minutes without pain for over 6 months. Cycling wasn’t an option as I couldn’t sit, so I really rested for 3 months, and then started some light swimming (pull) only. Finally I was able to walk and swim with some kick (probably about 7 months), and then I pursued seeing a specialist in ART (active release therapy). This really did help – would definitely recommend it – and probably about 3 months after starting this as well as some core strengthening, that I was able to return to some running. Also – I made a foam cushion for my road bike to help reduce sitting on my right sits bone and any pressure there, and I also made a “travel” cushion out of foam, in which I cut 2 holes in the bottom so that my sits bones wouldn’t make as direct contact with the seat. I am now running regularly, and cycling and swimming, however, I really can’t handle too much running mileage, definitely no speed training, and occasionally if I sit for extended time periods it gets irritated again, and I have to lay off and return to ART. Based on anything that I have read this is a very tricky problem to completely resolve……

  56. candace says:

    This is amazing! I am glad I am not going crazy (which is what everyone thought). My doctor was beginning to believe that I am a hypochondriac. It started in my left hamstring, but it wasnt high up at first. Only recently did I start to feel the pain near the insertion, and now my glute is involved. Strangely enough, about 3 weeks ago I started to feel in coming on in my right side too.I am a personal trainer so I use my body a lot. I am not an ultra runner, but I did compete in 3 half marathons last year (2 of them were obstacle courses) with little preparation. To train for those I did my normal weight training routines, plyometrics, core work, stretching and I was running 4-5 miles 2-3 days a week. I felt great during my races and my hamstring really didnt bother me while running, but the pain has slowly gotten worse over the last 10 months. It is frustrating not to be able to sprint anymore. It used to be a part of my routine and now I can’t even walk fast because when I lengthen my stride it starts to ache. Inclines are the worst. I am glad to see other people with similar symptoms. The hardest part for me is going to be the rest. I am constantly battling about 15 lbs, and the only way to keep them off is moving! I will have to be very strict about my diet if I am going to rest. One question: I already practice yoga. Do you think I should stop that too or should I continue to practice and just cut out everything else?

  57. Kevyla says:

    There is a really good, informative article here called “High Hamstring Tendinopathy Injuries – Signs, Symptoms and Research-Backed Treatment Solutions for a Literal Pain in the Butt”

  58. Harrison Taylor says:

    this just happened to me today and im kinda up set im pretty flexible i can place may head to my knees and hold it there. but my injury is from a lot of lunges and running a lot of hills (I’m a athlete, football player, and run track) and squatting heavy but i just want to thank you for your advice and im going to use it

  59. Mark says:

    Add me to the (long) list of those who share your injury and frustration. I play soccer and run, and have been dealing with the same HHT for years now. It seems that I can take time off everything and things seem to be better, only to recur once I start moving again. I find Naproxen helps the most, but I know it’s not a solution. I was convinced there was a connection between the statins I’m taking and HHT but it’s difficult to make that connection. Taking CoQ10 seems to help, but I can’t tell yet if it’s just a placebo effect.

  60. Ryan E says:


    First off, everything you explained is me. 100%. I have spent 4 months with this injury – is subsiding from when it first happened which, was the most intense pain of my life.

    Here’s my story. I spent 10 months working out, running, training, swimming etc. I was physically in the best shape of my entire life at 26 years old. Phenominal shape, felt great, a lot of energy and overall happiness of where I was in my life. Boom, November. I start feeling a tightness in my ‘glute’ or so I thought. It went from ‘little nagging pain to HOLY $@#$ #@#@$@!$@.’ Sitting, standing, driving. However, I can walk fine, stretch pretty well too – quite stiff but the pain is still there. It does ‘irritate’ it a little after stretching.

    Fast forward to last wednesday. I’m laying watching a movie, sad, that I have basically lost the body I worked so hard for because of 1. the depression/anxiety this causes 2. pure pain of trying to exercise. I’m digging around with my fingers up where the high hamstring is and the inside part, Jackpot. What feels to be the biggest knot in history or build up of scar tissues or whatever, releases. I laugh and grunt as the level of relief and pain is at a euphoric hell like level, booya, good for me, I deserved that shit.
    Move over to the outside… feeling around, boom Mega Millions. I’m running finger down the outside of my hammy, but closer to the inside of the hammy? if that makes sense. What seems every inch theres a knot. Awesome. I explore the high hamstring region, wow hip flexors are so sore, and I have a knot on the hamstring too.

    Next Day: I’m venturing in Meijers to find a tennis ball. (They’re in the sports section, not toys fyi)
    Take it to work, sit on my desk, put the ball between my desk and hamstring and I can literally feel every single knot/scar tissue build up just rolling all over this tennis ball (you may need a harder one.) I’m just like WTF? Is this real life? How did this happen? and is it really happening right now?

    Forward today almost a week later. I can sit almost all day without pain but the outside of my hammy needs work still and my hip flexors. I think ATR may help me in my case because I can ‘feel the knots’ on the ball and get relief from applying pressure.

    Will be getting a foam roller to work on my IT bands/glutes/hammy.

    Going for ATR tomorrow. Will let you all know how it goes!

  61. Anonymous says:

    Thank u! I have been in constant pain since marathon in jan…I typically recover from long distance runs very quick. I had no trouble at all in training. i was actually in this crazy utopia pain free state for months! Not an ache or pain even after a 20 mile run. Drove my partners crazy! I usually run a 3:40 marathon. 3 weeks b4 this one the pain started but I decided just lay off rest legs do just short runs till race day. I started in pain with first step…kept thinking I would run through it…3 weeks b4 I would have bet money I could do under 3:30 I was so strong. I never stopped I ran it in 4 flat which ofcourse was a horrible time but actually amazing for the level of pain I was in…I changed my gait up when I could to get some relief….I looked like a freak but I needed my 4 hours to keep my priority status…after that day I fell of the map I went from being a person who would run all day if I could…to asking my kids to bring me things so I didn’t have to walk 5 yards in my house. Driving is horribly painful but with four kids its what i do all day everyday! I will continue to rest and then get back into my regular yoga and stretching routines…that’s exactly how I learned to beat it the first time I just didn’t really know what I had! I experimented and pretty much came up with most the same solutions u have…foam roller rest yoga planks, etc. Thanks so much for the validation…. No one knows what the heck I’m talking about! Glad to find some one who does!

    • Anonymous says:

      Golden trails…I too changed my running gait several years ago. I was a major heal striker and after my last child was born. I just all over…it changed my life…I was ready to give up running. So out of desperation I bought a pair of vibrams and newtons and just started all over…I run barefoot style now and it worked! I was also in done having babies obssessive want my body back mode so I was working out hard core as well as running and doing yoga. That was 3 yrs ago and my injury is back as of Houston marathon in jan….3 weeks b4 the race I quit my trainer to rest up a bit b4 marathon.during those 3 weeks my injury slowly returned…I was wearing the same newtons I trained in but not doing my weight lifting and daily core exercises! My conclusion…I need my new running style and regular workouts and yoga…if I let any one of those 3 things slide. This pain in the ass will come right back!!! So now I’m am starting all over again….only yoga and stretching first then add workouts and core exercises then when the pain is gone….start running again. This worked the first time for me but its alot to fit into daily life!

  62. Alan says:

    Always hamstring problems, but this is a first with the high hamstring. Yes sitting in the car is the worst. Haven’t run in 2 weeks since the NYC half was on pace 7:20 and hurt myself at mile 9 finished the last 4 in over 11 min pace.

    Will the pain alleviate during run, I cant really pick up my feet properly.

  63. beccakahn says:

    A little over a year ago I was in a kettlebell workout class. The instructor told me I could go deeper and pushed me down into a squat. I heard a snap and was in a lot of pain. I thought I pulled a muscle and took a few days off. I am an avid ballroom dancer and love to workout at the gym and within a few days I went back to my routine. I stretched a lot, but just figured the pain would subside in a few weeks.
    Well.. several months later it was still hurting and starting to limit my activities, although I was confused as to why the WORST pain was when I’d sit. My doctor recommended PT and when that still didn’t work, I had an MRI which showed I had Femoral acetabular impingement (FAI) — it’s the congenital condition A-rod had surgery for as well. You can read more about it on my blog I also had fraying in the labrum and they believed this was due to my mishaped femur which had begun tearing the cartilege. However, the ONLY pain I had pre-op was at the hamstring attachment. To try and keep this brief… I had hip surgery Dec. 21, 2012 where my femur bone was reshaped and the frayed labrum debrided. It’s been 4 months and my recovery is on schedule. HOWEVER…. that same exact pain is there and it’s gotten worse.

    Needless to say, I’m concerned that I had unnecessary surgery. Most people with FAI are asymptomatic and I am so scared that it was just a coincidence that they found out I had FAI when what really should have been treated was the hamstring injury!

    The MRI at the very bottom did say I had mild proximal hamstring tendinitus. But the surgeon totally ignored that part as did I. I just assumed the pain was from the labral fraying.

    What I’m wondering is could this now be an avulsion at worst, or at best, now a chronic condition that I”ll have to live with forever? PT is doing ultrasound and massage, but will this be fixed without surgery? What are my options after having done this over a year ago?

    Feeback is greatly appreciated.

  64. k says:

    Thank you for this wonderful post! I’ve had high hamstring tendinitis going on probably two years now. I started having pain when the amount of time of spent driving for school/work increased. Over the time the lingering pain I had while driving slowly seeped over into my running and sitting in general. I took a break from running starting this past January and have been trying to ‘self-rehab’ over the past 4 months with some success.

    I am actually a current PT student. Unfortunately high hamstring tendinitis is relatively ‘rare’ and doesn’t have much research to support any specific interventions, so its not a injury that’s covered (at all) when we learn about musculoskeletal conditions. Each person’s body is different so this may not work for everyone, but doing the following has helped me:
    -To start, rest!
    -Postural realignment: excessive lordosis, knee hyperextension were my normal so I spent time relearning how to stand and sit correctly
    -Core stability exercises: especially the transverse abdominis; first just activating the right muscles and slowly carrying things over to more functional exercises
    -Strengthening of hip/knee stabilizers: quads, gluts, glut med to decrease overuse of the hamstring during walking, running
    -Stretching: personally I had very tight quads and hip adductors, as the pain went down in my hamstring I began to stretch that as well
    -Running form: I reached back into my high school days and starting doing all the drills and warm up exercises that I threw to way side during college track and after graduation…(ex. butt kicks, A,B, & C skip, build ups, etc while focusing on good posture and core engagement for lumbopelvic stability); easing back into short runs using mid/forefoot strike instead of a heel strike to prevent overstriding…

    Currently having a flare up from prolonged driving/sitting, but I will go on to doing some eccentric hamstring strengthening once the pain subsides (will see if using a pillow while sitting will help with minimizing flare ups)… Personally I do Pilates and Vinyasa Yoga (with positional modifications to start) as part of my ‘self-rehab’ routine. Again, I am a student and by no means intend this to be a one size fits all program, but I hope it may help some others.

  65. Tammy Marie says:

    OMG…. I’m into this for 6 months now. Started hurting in Sept. But due to insurance issues, I didn’t/couldn’t do anything medically about it until Jan. After 2 seemingly incompitent doctors, finally found one that believed me and did an MRI. Torn hamstring tendon… just to the point of needing surgery. I’m thinking now I should have gone for a long run or sat thru another 3 3hr movies then went – the surgery seems like it might be a shorter recovery period!! I can not sit! Unless it’s on my frozen peas. 🙂 I was doing better thanks to a great therapist, but then did something stupid and now I feel I’m back to square one. Does anyone else have pain along the Ischial Tuberosity and running medially?? It’s the bone pain that scares me… and the thought that at 6 months, I still have what seems like forever to go…. all i want to do is RUN!!!! or cry… and sit on frozen peas…

    Thanks for the post. I don’t feel so alone anymore.

    • beccakahn says:

      Thanks! Just today I went for a contisone injection into the Ischial Tuberosity. I’m hoping that relieves the pain, but then what? I guess just continuing with the exercises, massage, etc. Maybe I’ll try acupuncture. I’ve read that myofascial release technique can be helpful too. 2 years is a lot, K. I’m sorry for everyone’s suffering. It really reduces the quality of life for active people like us. All I want to do is get back to ballroom dancing and I’m afraid that won’t happen.

  66. Danielle says:

    I also just had a cortisone injection into the Ischial Tuberosity after being diagnosed with tendonitis. The right side of my body is stronger than my left. I think this imbalance helped cause my overuse issue on my right side. I’m still feel a little pain, but hoping it gets better. It’s been 10 days since my injections.They used ultrasound to help guide the needle to the exact location of tendon attachment. They “needled” the area. They believe bleeding helps promote healing. I’m also on a month long course of anti-inflammatory medication. I do weight lifting and light running. I too haven’t worked out since November. I did do a few restorative yoga classes with an emphasis on stretching. That helped the pain. Before I saw the sports med. orthopedic doctor, I went to see a chiropractor. She said one leg was higher than the other, That adjustment made some of the pain go away. The worst pain for me is also while driving. I’m going to try your pillow trick. I may try bikram yoga once I’m feeling better. Starting PT in May. Good luck to everyone!

  67. Jen says:

    Has anyone here tried a nitroglycerin patch? My doctor has me doing this now. I wear it for 12 hours and it helps promote blood flow to the inflamed bursa. (I wear it at night while sleeping.) During the day I wear a lidoderm patch for pain so that I can strengthen my hamstring and other supporting muscles. She hasn’t done the cortisone shot yet. Just wondering if anyone else is doing this therapy.

  68. Just found this blog! I have just been diagosed with hamstring tendinosois and acute chronic avulsive stress. Although, I don’t really understand what that means, it is a pain in the butt! I had the same pain in my right leg/butt for 5 years. Doctors told me it was due to my legs being different lengths, then the way my car seat sloped back. I ran and raced with the pain for 5 years and cried everytime I sat in a car. My commute to work is 3 hours roundtrip. Finally, after my first marathon in 2011, I decided to cut back on running and let it rest. Finally after a year, it feels pain free to sit. Now, I am running higher distances again and have the same pain in my left leg/butt/hamstring. Got another MRI and above is my diagnosis. I’ve read most of the posts before this and seems lots of different treatments. Wondering if its due to the way I run or are there other issues (spinal) that are causing this on both sides of my body. Waiting til Monday to talk to a dr. about the next steps, but very unhappy.

  69. WisBadgerFan says:

    Another person who is glad they found this blog! I am also a long-time runner who has been dealing with hamstring tendinopathy for at least 1.5 years. I just had a 3rd MRI done which shows it is still there and this one referenced a partial tear. I think my sports medicine doc isn’t sure what to try next. We have done multiple prolotherapy injections, a plasma injection, chiropractic treatment, ART, acupuncture, etc. I probably really have not had a true PT program laid out which is obviously a big missing piece here as I suspect I am continuing to re-injure/re-aggratvate the problem. I am going to see a PT next week to see if I can get some additional guidance as I think I really need to go back to square 1 here.

    One question I have is when you first discovered the injury and said you did not walk much, do you truly mean not even casual walking? I’m thinking our yellow lab will be the least understanding member of my family when he doesn’t get a daily 2-3 mile walk! But, I probably have not really stopped doing anything for an extended period and am thinking I need to do that so am curious what people mean when they said not doing anything. Thanks for any thoughts or suggestions anyone has!

    • Anonymous says:

      i am now using a nitro patch… and knock on wood – it seems to be working. (trying not to say that too loudly or often!) My doc said patch and aggressive strengthening, esp eccentric work. Look up Russian Hamstring curls – been doing lots of them, and regular curls with my foot interiorly rotated. and stretching – again with my leg internally rotated to get both involved hamstring tendons. the other exercise he told me to do was leg extensions with my knee flexed. He says this injury is due to tight and weak hamstrings. (His bedside manner was not so nice tho.) So I’ve been doing p90X, running and the exercises he recommended. Lots of heat, stretching and ice. So far so good… fingers corssed! Good luck!!!

      • WisBadgerFan says:

        I have read about the nitroglycerin patches and am curious about those. Can you get those without a prescription? What kind of dosage are you using? Thanks!

      • Anonymous says:

        No, you need a script for the patch. it is a 0.2 mg patch that gets cut into quarters and changed every 24 hours. I’m on my 12th quarter and have noticed some improvements. The entire treatment is to last 3 months to get the full effect of the patch, and will have a good idea by 6 weeks if its going to work. It was covered by my insurance, where the PRP shots are not. (big bonus!!)

      • Tammy Marie says:

        sorry – this is me, didn’t realize it didn’t sign me in.

    • beccakahn says:

      I have the same question! It seems that if I work out a little bit (no running, but doing the elliptical and dancing) I’m sometimes better off than when I do nothing for a few weeks. So, it’s hard to know what I should be doing. If doing nothing other than a bit of walking actually seemed to work, I’d be more likely to stick with it. But since sometimes I’m in just as much pain as when I don’t rest it, I figure why not at least get in some exercise? Anyone else share that?

      • Brandon says:

        HHT has been my diagnosis but just recently i read my own MRI reports and they never supported that diagnosis. They’ve never found anything actually, but its been 16 months and i still have little pains/pulling sensations in the high hamstring/butt area. I started ‘training’ again yesterday, going to try to get back into marathoning shape and see if the pain will stay lowgrade or just not be there. The past 5 months ive done nothing, i quit PT, cross training, and core strengthening just due to time issue and although at first it seemed like things got worse… the High Hamstring pain and ive developed a bilateral hip issue during that time from something. But recently the rear pain seems to have finally subsided. I’m going to start slow and make sure i keep core strength as a key part of it and hopefully i can get back to form.

        I’ve posted several times above, but I’ve had a hip MRI, MRI with dye contrast, steroid injection at the ischial tuberocity, an oral steroid, and 3 months of deep tissue massage focused PT therapy and none of it has really made any noticeable progress toward definitive diagnosis or correction. If its reinjured/still there when i get going good then I suppose ill look into PRP or some of the other suggestions.

        GL to all!

  70. Anonymous says:

    Wow, so many different suggestions. I’ve stopped running and now been told to stop walking for exercise. I do have a new complication- I slid across a floor and ended up in a split position, with my injured leg stretched in front. Immediate pain and a popping feeling. Just had a second MRI and the tech said it doesn’t look good. Waiting for the report. Started therapy and was told to do no exercise at all using legs. He started with working with my core and retraining my brain to use correct muscles (glutes) instead of hamstring and piriformis. Only gone 2 times, but hurts. I will ask what I can do (yoga, pilates) that will not do more damage.

    • Tammy Marie says:

      sometimes I think a complete tear would be better – surgery, reattachement, therapy, done. none of this playing around with what works and what doesn’t. Good Luck!!

    • WisBadgerFan says:

      That doesn’t sound good! I have heard similar things about needing to get the glutes to fire more and have bee given various exercises in the past for that. As it relates to being told not to walk, did they give you much guidance on every day activities and things to avoid? I’m wondering if that’s even where I’m making mistakes doing too much…..

  71. beccakahn says:

    In the past week, I’ve developed a new problem which is freaking me out. I’ve been seeing a chiropractor to deal with my hamstring injury (it’s been over a year) and it seems to be helping! Even after just 3 sessions I now just feel really tight, but very little pain. HOWEVER, about 2 days before I started seeing him (just so you know it’s not his fault!) I started having lower back pain right above my butt. I figured I just slept weird, but it won’t go away. It seems to come and go. I’ll have a flare up for about 2 days and then a few days with no pain. Then it comes back and I’m in major pain again. Could the hamstring tendonosis have progressed to this or just caused it? From what I’ve read it sounds like I’ve suddenly developed sciatica! This endless cycle of pain is so depressing.

    • Chas says:

      Given what I’m experiencing, it sounds like sacrotuberous inflammation or SI inflammation. I’m working to effectively loosen both sides of my pelvis/SI now because I think I got my left SI joint inflamed and left sacrotuberous inflamed because of working so hard to stretch the left- and the ischial tuberosity attaches to the sacrum through the sacrotuberous ligaments. (If you’re having new numbness or weakness of your extremities, ignore what I wrote above and see a doctor.)

      • beccakahn says:

        That is exactly how the chiroprator explained it to me today and what he’s treating me for. I was just in such a fog that I couldn’t recall all the terminology. Thanks so much! And no, there is no numbness so he told me that’s a really good thing. At least that was some good news! Thanks for your help in clarifying.

  72. Chas says:

    I am now on month 10 after a tiny pop at the 200 mark of a 400 race then a second pop 4 days later during the last 200 of repeat 200s. Burning in butt and spasm of piriformis. Early on, I had no high hamstring pain, so I thought it was piriformis syndrome. Some sciatic involvement on a flight 1 month in to the injury. First MRI 3 months in showed partial tear and tendinosis or proximal left hamstring. I did PT with dry needling. All quieted down abit. Ran some, got worse. I did more PT with dry needling. Ran some, got worse. Did PRP in December, took 6 weeks off. Did PT for 6 weeks with ultrasound on the tendon then eccentrics. Ran a little, got worse. Did 4 weeks of ART on the piriformis, glut med and Graston on the high hamstring and extensive core work. Repeat MRI 2 weeks ago was normal. I had PRP last week and some trigger point injections at the left SI joint. I have suffered, since the initial injury with piriformis, gluteus medius spasm, sacrotuberous and SI pain on the same L side. Varying degrees of improvement with ART and dry needling. I am currently just a little inflamed. I was wearing minimalist shoes for last couple of days when not at work and no shoes when at home and I’ve noticed some pronounced tightness/ache in the proximal tendon with walking around. Today I am switching to my old running shoes with orthotics with the idea that I am shortening the hamstring so it does not have as much eccentric loading when I walk.

    My sit tolerance is actually improving. (When I’m really inflamed, long drives were putting the spasm from hamstring/piriformis/gluts in overdrive.)

    I sit on the side of chairs and I have been trying to consistently do that for 6 months now. Every time I start something faster than a walk, I get inflamed again. At 38, last summer, I was running mid 53s in the 400 at the beginning of my summer ‘season.’ Now I’d just like to run a mile. I have started working to release the RIGHT IT band and the RIGHT piriformis to help release my SI joint. I am stretching the hip flexors on both legs now to help release the loading on the hamstring. I am stretching more of the glut area, the low back but minimal hamstring stretching.

    Next step is to go back to chiropractor for graston of mid and distal hamstring and ART again of the Gluts/piriformis. Then I have to decide of the dry needling with the PT is warranted before starting some core work with bridging then some slow jogging in the pool- assuming my inflammation is minimal in 2-3 weeks.

    I am not a patient patient. Waiting to get to pain free is not a wait that I was made for… let alone a SLOW frustrating recovery.

    • WisBadgerFan says:

      When you said your second MRI was normal, did they say your tear was healed? I’ve heard different things now from a PT and doc on that. Most recently, one of the PT’s said it was likely the tear in my tendon wouldn’t heal so that a lot of the therapy was to strengthen the muscles around it so that the tear didn’t become any worse. Given the number of prolo injections and the one PRP injection I’ve had there, I’m starting to think it’s not going to heal!

  73. Chas says:

    I had the MRI read by a friend who is a Sports medicine trained radiologist and the person who was reading MRIs that day and they both said the tear was healed. My PT also thought we would be strengthening around the tear, so I was surprised the tear was no longer visible. This 2nd MRI is 4 months after the first PRP injection and multiple months of PT. Sadly, again, this hasn’t really decreased my symptoms.

    • Brandon says:

      My thoughts on my own injury, and when i hear something like yours, is that the continued symptoms might be due to scar tissue buildup at the site of injury. Im not expert though, and I havent looked at how to deal with that if it is the case.

  74. Anonymous says:

    has anyone ever tried laser therapy? I’ve been having issues for over a year now (see post above) and while sitting, is not painful anymore, but as soon as i do anything somewhat strenuous, both my hams and IT bands scream for a day or two.

  75. Chas says:

    I have used graston technique at the ischial tuberosity/proximal tendon and laser with my chiropractor. I felt like it was helping. Hopefully she broke up the scar tissue even though I recently proceeded to a new flare up. My orthopaedist, who I saw shortly after the 4 weeks of graston/ART and lasering when I was in a new flare up thought that I had never allowed the inflammation to quiet enough. She gave me a steroid injection at the area which did very little, 3 weeks ago. That is why I decided to try PRP again 1.5 weeks ago.

  76. Fred says:

    A few questions good sirs/ma’ams:
    Is this the same as “High Hamstring Tendinitis”?
    I have been having a pain that I think is in the high hamstrings but not sure – it is just lateral of my center in between, well, you know. It is a deep, piercing pain. I also have a much more dull, aching pain in the same leg (left) when I stretch with leg extended touching the toes on the extreme lateral side of my upper leg – in what feels like a tendon that runs in between the quads and hamstrings on the exterior (vastus lateralis?) Thirdly, I get a deep, dull, (but not as achy) in my lower hamstrings of that leg.
    I got the injury from overstretching while doing Taekwondo. I am very active, walk a lot, do martial arts, run 3 miles every other week or so, and am a 21 year-old male. Is this likely to be tendinitis?

  77. Rick Bonura says:

    I haven’t fully read your piece here but what I have so far has been the most uplifting advice/life story yet. I have book marked this. I’m suffering from the exact same symtoms you have described here. I have been dealing w/ this for probably abit over a month now but when the symptoms first started I was able to slow down my lower body activity and almost completey eliminate the pain. Then I would do something stupid like haul a 200 pound boat and trailer down and up a long steep hill to a local pond and the symptoms would start all over. It was as recent as the end of last week that I was waking up in the morning and able to get out of bed with no issue. And then I did the aforementioned act of ignorance and I am back to all your symptoms. I, too, have been a distance runner all my life and I’m currently 55. I’m used to the ankle, knee, and shin splint aches but this is nothing that can be taken lightly. I may have brought this on by a 65 mile bike ride I did in April since it had been 6 months since I had even gotten on a bike (I’m primarily a runner).
    Once again, thank you for your piece!


  78. Jennifer Forkenbrock says:

    I have every single one of the symptoms you listed. I have tried massage, I roll on the foam roller and I stretch. I want to run a 3;05 at Philly in November – already registered. I can’t stop running. I’ve never not run for more than 2 days in a row. I have an appointment with my PCP tomorrow to get a script for PT, sadly though, I already do all the exercises they will prescribe for me. UGH!

    • dflorczak says:

      You may want to consider seeing an orthopedic doctor who specializes in sports medicine. I’ve been seeing one and he has helped me a lot. He has sent me to PT. I have been told by him that women are more likely to get this injury due to having wider hips than men. I have an issue where my hips are rotated so it’s pulling on one hamstring more than other other side. The orthopedic doctor did needling to the injured area which helps bring blood area to promote healing. I’ve had it done twice. I was told by the orthopedic dr. not to roll the injured hamstring area. I can roll everywhere on that leg, but not directly on the spot that’s painful. I was also told by PT that the stretching is a temporary fix, it doesn’t fix the underlying cause of the problem. It just feels better after, but won’t take away the cause. Hope this info helps.

      • Jenn Forkenbrock says:

        Thanks. . . PT cut me loose yesterday after my evaluation stating my problem was “not
        biomechanical” and there was nothing they could do for me that I wasn’t already doing, i.e. core exercises. I see ortho June 27th. Did you do massage, A-Stym, or ART at all?

      • dflorczak says:

        They do graston on the area, and on my entire hamstring every time I goto PT (which is once a week). Ortho told me sometimes the body gets to a point where it doesn’t heal itself. It tries heal when the injury first occurs then it hits a plateau so to speak. That’s where the needling comes in. It brings blood to the area to help the body to heal itself. From what I’m told not every Ortho dr. does this procedure b/c it’s controversial if it actually works or not. It helped me tremendously. It isn’t cheap. They use ultrasound to guide the needle to the correct area, after numbing it first. Just to warn you it was about $5000, but my insurance covered most and I only paid $600 a procedure. Still not cheap. But with the results I got well worth it. They did not fore warn me about the cost (it’s considered a surgery). A bit of a surprised when the bill came!!

  79. Pingback: Dealing with Upper Hamstring Tear | Tim Harris

  80. Melissa says:

    I am not a runner. However, I garden and do a lot of bending over. Recently, I started suffering pain right where the hamstring goes into the buttocks area. My doctor said it could be a high hamstring pull. I am also having aching in my whole bottom area. He said there are a lot of muscles that come together there and that if one is inflamed it may cause the others to hurt as well. Just wondering if anyone else has had the same sort of pain. Thanks.

  81. Kate n says:

    I’m not a runner having a couple of assets that would give me black eyes. I fell and landed heavily on my left hip in July 2012. I am only now beginning to walk a couple of miles three or four times a week but by the end of the walk my leg feels like a dead weight and kind of numb. Tripped over my feet a couple of times recently. Is this happening to other people too as I also have a thyroid issue that affects the muscles that could be to blame. I just can’t get anyone medical to take me seriously on this. I live in a rural part of Scotland so the classes you mention are out of the question.


  82. Anonymous says:

    I’m 54 and reasonably fast for my age – spent 18 mths recovering from an achilles problem, and seemed to suffer a very mild hamstring strain (on same leg as achilles injury) after having a 4k track race. It really is very mild & I hardly notice it much day to day – but as soon as I try and run I experience soreness & tenderness that affects my gait. After 18 mths of achilles/calf stretching etc & physio I have decided just to rest this new injury til its better. Do U think that is enough, given its mild – I’m continuing with achilles stretches and weight training (upper body only) and maybe some cycling.

  83. Keri says:

    I’m a 17 year old female runner. I injured what I thought was my hip last summer. I think it was an overtraining injury as well because I was running about 45 miles a week and had recently started sometimes running twice a day. I’d had some knee problems in the spring but hadn’t had any problems besides that. Then one day (July 14, 2012 to be exact :D) my left hip started to hurt. It was a bit difficult to walk, so I took about a week off, but then I had to go back to running because XC practices started up. I kept training through it with a lot of pain throughout XC and my times suffered a lot. The pain eventually localized to the area surrounding my “sit bone” like you described. I got an MRI at the end of April, and all that the MRI reader guy saw was inflamation in the tendon. I took the month of May off hoping to heal, but it didn’t work. Now the pain is still there, but I have to keep training for XC. I’ve done the bridges, gone to PT and done those exercises, gone to a Chiropractor, gotten acupuncture and tried supplements, anti-inflamatories, and ice. Any suggestions of what else I can do?? I really want to have a good XC season this year!!
    Thanks so much!
    Keri Celeste 🙂

    • Keri says:

      This is Keri again. I’m back 3 years later and want to let anyone who stumbles upon this know that I did heal! Recovery from high hamstring tendinopathy is possible! During XC season my senior year of high school (2013, about a year and 2 months after the injury), the pain finally began to go away, and it would only hurt sometimes after very hard work outs. I was able to get back to my times from my sophomore year (pre injury). So anyone out there struggling with this injury, especially to high school runners like I was, don’t give up hope! And if you need advice about recovery, feel free to email me!

  84. beccakahn says:

    Hi Keri,
    Has your chiropractor done any psoas release on you? It seemed to work wonders for me, and now I do it myself by laying on a soft ball once a day. I’ve been suffering with hamstring tendonosis for a year and a half and this is the only thing that’s worked for me.

  85. Shanna says:

    I am so grateful I found this article. I have this injury on both legs! For me, both were acute injuries (left leg during a surf lesson & right leg while riding my bike).

    I have had acupuncture done on both sides which helps but is not a miracle cure. I stretch every day & will start foam rolling my legs very soon.

    My question is: at what point do I start using the foam roller? My left side feels much better than the right. The injury on my right-side occurred 2 days ago & is still very tender. I’m guessing I need to wait until the pain & inflammation subside somewhat before I start foam rolling the area?

    Any advice will be greatly appreciated!
    Thanks 🙂

  86. Trey says:

    I too have been suffering from this debilitating injury. It took me down at a point where I was in prime physical shape. But, some of you are mentioning symptoms I experienced that were actually from other sources. If this injury causes pain down your entire leg and lumbar spine has been ruled out, consider being evaluated for a stress fracture and/or labral tear. I had both. Treatment for the stress fracture (crutches) got me walking again without pain. The doc following up on the stress fracture ordered a MR Arthrogram which showed a labral tear. The key to healing is finding a PT that can work with a multifaceted series of injuries like this. Unfortunately labral tears don’t heal since they are non vascular, but you can definitely get the pain under control (i get an occassional pinching feeling in the groin). As of today I am rehabbing HHT again and am seeing much better results since we know I have more than one injury. Fortunately I have been cleared to use cardio machines with no incline (avoid aggressive engaging of the hamstring) and I can lift weights for upper body. They key is knowledge, time and patience.

    • Trey says:

      One more thing to mention, looking back the worst pain was from a femoral neck stress fracture. It was practically disabling. Healing was confirmed via CT scan. As for HHT, healing is slow but I am getting there. HHT is a type of injury where you won’t see daily improvement and you will have flare ups. But, you will have moments where you look back and realize you are feeling much better than a few weeks ago.

  87. Anonymous says:

    Does anyone have any input what kind of pt has helped with this?

    I have been getting ART for a few months and see no improvement or even feel the pt is accessing the problematic areas. The other day I got transverse friction massage that felt like it really massaged all the soreness, but I was in pain afterwards, which went away after icing. So I don’t know if that pain was good in a way because it finally accessed my problem areas or if the ART was better because I didn’t feel anything?

    I will say the TFM immediately gave me a bit of increased mobility in the affected hamstring.

  88. annoymus says:

    thx for the info but i am 12 and my pain is reallly bad it will hurt when i do anything because it has been hurting for 4 months now and i tried everything and nothing is working are u sure this will work for me becuase i want it to go away by the end of the summer in time for me to go back to my ballet that i do 5 days a week including sunday

    • Julian says:

      FINALLY! Someone around my age who has this. I am 14 and I have had this for 4 months, too! I am a track athlete and everything seemed to be going so well: good body, running good times… i was in pretty decent shape. And then BOOM. IT all went down hill. After doing extensive research i can give you some tips. Remember, this is a degenerative tendon issue. If you want to be back by the end of the summer then resting is not enough. You need to rehabilitate the tendon. Follow this article it is great.

      At the moment i am stuck, though. After a week of strengthening i feel great and go out for a run and then it feels so much worse afterwards :S This is a long, persistent injury. We’ll get through it eventually… i think…. . I’m just hoping not to pull out of GCSE PE 😦

      • Anonymous says:

        A week of strengthening won’t do it. . . it will be months of strengthening and rest. I’m 8 weeks in right now and my pain has finally gone from a 2-3 all the time to a 1 — when I do any kind of activity it is a 4. good luck.

  89. katoptric says:

    Did you experience any ower back tightness on your runs or in the morning?

    It’s so frustrating knowing that it will feel better if I run…but that it will only come back later, and worse. I’d love to know the answer to that quandary if you ever find it!

      • Anonymous says:

        I always have lower back pain and sometimes tightness too… I didn’t think they were related but my PT says it is all a cause of weak trunk and hip muscles. She has me doing a lot of planks and clamshells. It is not helping my hamstring but she says it will correct the weaknesses to stop further possible injuries. It is only after stoping running for 7 months that I am getting better, that plus transverse friction massage on my hamstring.

  90. Anonymous says:

    This is a great piece of information! Thank you all for posting! I tore my hamstring in early Dec last year (so over 6 months ago) playing soccer. It was a painful experience and I heard a massive crack making me believe it was a bone that got dislodged and not a muscle tear. But, it turned out to be a large tear up where the tendons attaches to the sit bone (right were you have indicated you had pain). The first week I could barely walk. It gradually got better once the initial swelling reduced and after 3 month I started having massages done by a sports masseur. This helped greatly. It got blood back into the area and i got a lot more mobile compared to when the injury was fresh.

    I felt this was a good sign and I was feeling stronger so after 3-4 months I started getting back into soccer (which was not a smart move) and noticed that the hamstring still got irritated after a game and the injury did not improve. Since there was no sign of recovery from this point and the muscle was still inflamed. I decided to have an MRI done to rule out any other issues. The MRI showed I had a big tear in the tendons, just where they attach to the sit bone. Luckily the tear was healed but the muscles were sill significantly inflamed.

    So about 1-2 months ago I stopped all work out that could impact the hamstring and I went back to basics. Currently, I am only doing basic strengthening exercises at the gym. I still can’t jog and walking starts hurting after only 1 km. I use heat and cold packs and I have recently started taking anti-inflammatory pills for the still inflamed tendons.

    It is such a long and tedious process that I do not wish on anyone. What I can recommend from my own experience and long recovery process is to;

    1) Go and see a doctor straight away (I didn’t since it sounded like bone dislodgement to me).

    2) Start rehab asap – I can highly recommend a sports masseur with experience in the area.

    3) Don’t get back into sports even if it feels alright. If you are still in pain or if the muscles get irritated after a workout session the work out was too intensive and did no good for your injury.

    4) Don’t spend all your money on going to a physio – I think the masseur is a better option and more value for the money (I went to 2 different physios. No one could help me but one at least sent me to have my MRI done).

    If anyone have or has had a similar problem to me where after 6-7 month you feel far from healed (can’t even jog and walking hurts), please share your experiences to what you did to get passed that phase. I am going to take up swimming to get some cardio going.

  91. Julian says:

    I’ve been strengthening for a while now and ive started to experience pulsing/tightening in the glute/ hamstring area. Is this a sign of healing or could it be getting worse?

    • beccakahn says:

      I hope someone can answer this as the same exact thing is happening to me. I’ve been dealing with hamstring tendonosis for a year and a half and my new PT is having me do one-legged bridges to strenghten my hamstring. Sometimes I feel that it just causes tightness and aggravates it, but how else can you strengthen it?

      • Anonymous says:

        i have been doing PT for 5 weeks and my therapist still won’t let me do double leg bridges! i have been limited to clams, reverse clams, resistance band hip strengthening, torso twists, glute squeezes, marching, inch worms, bottoms up, etc. my pain is considerably less after 5 weeks of no running but isn’t gone.

      • Julian says:

        Strengthen with eccentric hamstring curls – the key to recovery. I am 14 and have had this for 4 months… it feels great while resting ad doing light exercise but i can definitely not do a one-legged bridge without aggravating it 😦 😦

    • Kate Noble says:

      I have the same. Sort of like cramp but without any pain. My pt has discharged me now. I’m no sports person but just walking can be challenging without my leg feeling it isn’t really attached to me any more. Having said that, just four weeks ago a 2 mile walk involved painkillers and a rest day. I can do that without trouble, and faster, now.

      • Anna says:

        I have had the same issue for 3 months. Both hammies. 3 months ago I couldn’t do a double leg bridge, I can now do single leg bridges holding for 30 seconds x 10. I lost a lot of muscle mass on the badly affected hammy on the right side and things only started slowly improving once I did isometric exercises routinely, stopped stretching and getting ART etc (for me I felt like it was only very temporary relief). Read the article by Cook and Purdam on the treatment of hamstring tendinopathy for the competing athlete. Progress is slow but I couldnt walk 3 months ago and im definitely feeling stronger with less pain day to day.

  92. Vicki says:

    I feel for you all. My story is one of 17 months so far but have a lot of experience to bring to this. First or all I’m a runner with what was a full-time desk job. Not a good combo. I was diagnosed with higher hamstring tendonopathy. This became chronic and is now termed higher hamstring tendinosis. Tendonopathy is an inflammation and tendinosis is not both require different treatments.

    Higher hamstring tendinosis (not inflamed) occurs when the tendon (ischial tuberosity) that attaches to the sit bone (pelvis) is repeatedly stressed to the point of breaking down. White blood cells cannot repair the tendon fast enough compared to the repeated stressing. This could be running or sitting on it.

    So far I’ve had 14 months of physiotherapy with 5 physio’s. 4 Private and 1 NHS. The first 4 missed an egg size lump of scar tissue from a grade 3 tear in the fascia of the left hamstring and loaded me with an hour and a half of remedial exercises at home every day. Due to scar tissue blockage lower down these remedial exercises tugged away at my higher hamstring tendon. This along with my desk job resulted in HH tedonopathy which became chronic as didn’t feel right going off work on sick leave and subsequently became chronic and tendinosis. I.e the tendon is breaking down – rotting.

    Bear with me, there’s going to be a happy ending to this story and if I can help just one person not go through what I have it’ll be worth it.

    I’m going to post this so far as I’ve tried to post on a different site wrote lots and the link broke!

    • bob says:

      I’d be real interested in hearing you the rest of your story. I’m about a year into my injury and about 6 months into PT. (June 28, 2012 at 11:46 pm was my post on this blog.)
      The PT is helping but every time I try and push any type of exercise both my hams flair up. Very high up near the ischial tuberosity.
      In PT im receiving LASER therapy, which seems to be helping. I’m just worried my hams will never heal…

      again interested in your whole story…


    • beccakahn says:

      Hope to hear from you soon as well! I’ve been dealing with hamstring tendonosis for a year and 7 months. My PT massages it twice a week and it helps but only temporarily. I’m considering PRP injections but have to save up a ton of money first.

  93. Vicki says:

    More…. Finally found the best sports physiotherapist. Very important point here. The first four I had weren’t sports and missed the problem and had limited knowledge. One was a leg stroker! Stared out the window looking a bit gormless stroking my leg. The sports physio found the lump of scar tissue within two mins of first visit and over time manually broke it down with hands and elbows at one point. Agony, nearly off the table several times and a bit of shouting out on my part but luckily her neighbour was hard of hearing! Such luck!

    Also found I had a leg length discrepancy of 3mm but didn’t think this much of a problem. Hypermobile joints, right sided hip tight and stiff, the worst hamstrings she’d ever seen (her words) knotted all the way up and IT bands so tight it was an injury waiting to happen.

    This lady worked on Chris Hoy at the Olympics so when she told me off about another cardinal sin I took notice…. Trainers!!! I thought I was saving money as small feet and bought junior Asics to save on the VAT. It’s funny now. Junior trainers aren’t built the same for adults weight etc. So obvious when you are told.

    When physio (using various techniques incl ART, massage and a bit of dry needling) could no longer improve the tendon (due to continued sitting at work) I saw a sports med consultant who gave me a ultrasound guided steroid injection. I was totally against this idea but whole business was getting me down by then.

    Very important, please don’t have a steroid injection unless it is guided. If it goes into the tendon and not around it in inflamed tissue, it can rupture!

    Reduced the pain by half but soon returned at week 5 when steroid wore off.

    Had a second steroid injection which did nothing.

    During this I also had an MRI which found nothing, NSAIDS for a month from GP which did nothing, an ultrasound scan that found fluid around the ischial tuberosity (tendon).

    Had an ultrasound treatment which made it worse as stired it up when I was trying to settle it.

    The drive to work was very painful which continued all day and home again so bought a storage box and put my monitor and keyboard on it and stood up all day. This made no difference as it was too late and the tendon was breaking down. You need to keep some movement going to keep the blood flowing to injury to carry the white blood cells to it and toxins away. It’s a fine art.

    I’m now signed off sick (should have done it sooner) and unable to sit. Am either standing up, walking some or lying down, given up driving so social life non existent but good friends visit me at home or we walk in the local park having a coffee and a natter!

    I’ve done loads of research which was when the penny dropped re my problem being rotting not inflammation. I’m not clinical so don’t want to make sweeping statements but from studies I’ve read by universities and my own experiences, the above treatments may not work if you have HH tendinosis (breaking down/rotting). This will come up if you google hamstring tendon rot. The issue is getting the right diagnosis to establish what you have.

    I’ve decided not to have any more expensive interventions. I’m ashamed and gutted to say this lot has cost me…. well a small fortune. I’m resting as described until the body heals itself. All clinicians I’ve asked have said if left alone the body will heal the tendon itself. This will take between 4 and 10 months of rest as chronic. Not ideal in anyway particularly with regards to work.

    Please, please if you are early on with this rest before it becomes chronic and if you are not rest!!

    I’ve been off for 7 weeks now and down from an 8 on pain scale to a 2 or 3.

  94. Vicki says:

    Oh there’s something else that has been remarkable. A friend found me a sports nutrition supplement in tablet form on Amazon. Now I’m against this sort of thing off the internet so researched all the ingredients and then took it to my doctor to look at. He said it won’t do you any harm. I don’t think I can say what it is on here but it contains the following:

    Glucosamine Sulphate
    Chondroitin Sulphate
    Hydrolysed Collagen
    Vitamin C

    Hope you can find it and if you do please check with your doctor first before you take it. My pain was reduced within in a day and a half of taking it.

  95. Vicki says:

    Lol! Rhymes with: Heck! What you do when you go walking cross country. Mental……..

  96. Vicki says:

    Beccakahn the only thing left I would have if I don’t Improve is PRP. Sounds logical re white blood cells.

  97. Vicki says:

    Swimming helped hugely.

  98. Adrian says:

    Thanks for sharing your problems, I THINK I may have same problem, well I have a few of the symptoms u mentioned, I also am I keen runner and have had to stop running for 10 months now, I’ve seen 4 sports massures and also had acti puntcher( can’t spell the word but its where u have needles put in) still no good, I’ve been told by everyone I’ve seen its not a tear but a pull but everything I tried has not wrk and its got to the point where I can no longer afford to keep going to physios every week.
    I know I shouldn’t of but I’ve just been for a run has I’m getting so frustrated not running and I can now feel it again..
    Can u answer some questions for me please?
    Did u feel more a few hours after a run then u did actually running?

    Did a physio know what the problem was right away as all the ones I’m seeing haven’t got a clue and just tell me I got tight hamstrings?

    It seems to hurt more the day after I’m stretching it. Did u have this problem?

    I’m now book in for a scan at the hospital to see if they can find out the actual problem.

    Thanks for any help you can give

  99. Vicki says:

    Adrian, where is your pain? Is it in the hamstring area or is it tucked under your bum where the hamstring connects to the sit bone (pelvis)?

    Do you sit a lot?

    I saw 4 physio’s before the 5th one a sports physio found the problem. Persevere….

  100. Marko says:

    I’m dealing with this since April ’13. Stopped running in May. Resting for last three months. Working out (hamstrings, quads, core strenght, abs…). doing light hamstring stretchings recently. Visited Chiro to adjust my pelvis on couple of occasions. Recently having soft tissue mobilization (ART) on injured leg and hips.

    QUESTION: do you think that sitting down on hard surfaces (such as while driving car) is prolonging and making this injury more severe or its just producing pain (without additional negative implications).
    If its just producing pain, I can deal with it – but if its making it worst I need to change my livign / working habbits asap.

    Greetings from Croatia.

  101. Vicki says:

    Marko, if your HHT is reasonably bad it is likely you are re-injuring or aggravating your existing injury by sitting. I’ve had to give up driving (haven’t sat down for approx. two months). I either stand up or lie down. If I do sit for longer than five minutes I’m back up to an 8 on the pain scale. Don’t want to concern you too much. Mine’s severe yours may not be. As Golden says try using a pillow in the car first before you give up driving. If this doesn’t work then yes it’s something to seriously consider.

  102. D says:

    Bikram Yoga is extremely injurious. There are many scientific reasons NOT to do Bikram. First of all, I did it. For 60 days in a row. It did help to catapult me further into my yogic advancement. But I’m glad I left. After completing my first yoga teaching certificate, my feelings about Bikram were solidified: it’s not healthy. For starters, you NEVER NEVER NEVER lock your knee. I don’t care (and neither do doctors, PTs, sports rehabilitators) what Bikram or his master guru said. Don’t. Lock. Your. Knee. Ever. Never. It cuts of the synovial fluid to your knee. What’s synovial fluid? It’s the fluid that lubricates, and hence, makes work, the joints in yoru body. Why cut off synovial fluid? If you want to hurt your joints, keep locking your knees. Second, Bikram is WAAAY too hot. It doesn’t have anything to do with being touch or thinking you’re some elite athlete or that you can handle most extreme conditions that most people. Again, its scientific. Everything is neurological. If you raise the temperature of your muscles to an extreme temperature (relative to the muscle’s normal temperature) you actually cut off full communication that the muscle has with the brain. The heat has a direct dampening effect on the mechanisms in the muscle which are responsible for relaying information to the brain. The result? Oops, I accidentally just tore a muscle/tendon and had no idea I was about to tear it. Because I could not feel it. Just a brief intro from not even that advanced of a yoga teacher as to why Bikram is not a good form of Yoga. Ask more advanced Yoga teachers what they have to say about Bikram, They will have much more to say than I. Ask a Bikram Teacher what they think about Bikram Yoga, they can’t point to a single objective scientific fact or observation. They just talk about only the good results they see, the injured students are hidden and not spoken about. They talk only about how they feel about Bikram. Start educating yourself on yogic therapy. You will see many things after studying which Bikram is heavily mistaken about.

  103. Kat says:

    Quick question: what about a foam roller? I tried using that over the weekend and the sensation I was feeling all the way down to my knee was extreme. But the results were good. My leg started to feel much better that same day. Just curious if you think it’s a good idea to use a foam roller even though the sensation/pain is pretty extreme. Thank you.

  104. Sean says:

    I think the foam roller does wonders for almost all my ailments – a minor form of this HHT and my IT band. It gently rolls out and loosens the muscle, which in turn puts less stress on the tendons. Static stretching would only stress the tendons more. Hydration is also key. I’ve used the foam roller or ‘The stick’ before soccer, running, rowing, and my legs felt great and usually don’t feel the pain afterwards. I’ve still got a few events that I’m looking forward to (Half Marathon, 10 mile, rowing/running biathlon), so I can’t rest up just yet, but probably should take December off from running 😦

    • Julian says:

      if you have pain while… sitting, running, running at the onset of fast speed, doing a bent knee stretch… then stop NOW. The earlier you stop the earlier you recovery! Forget the races. Otherwise the injury could stick around for years. As soon as you can do a standing hamstring catch pain free get straight on to a Nordic Curl machine. Eccentric hamstring curls kick start the healing process

  105. Hi Vicki, I have been suffering with a hamstring tendinopathy for about 3 years, not the rotting tendon injury though. When you refer to the clinicians saying the tendon will heal itself in 4-10 months, is that just the rotting tendon injury or also the tendinopathy? Thanks.

    • Vicki says:

      Hi Kevin, third attempt to reply. Tut! System has a problem. HH tendonopathy seems to be the pre stage to HH tendinosis. From what I’ve read tendonopathy becomes tendinosis after a period of time. i.e. when you’ve had it so long it becomes chronic. Also, it appears that this happens when tendonopathy hasn’t been rested enough, is reinjured and the tendon is stressed beyond the bodies capabilities of repair.

      Logically then I would have thought that HH tendonopathy would heal quicker than tendinosis but healing this frustrating injury depends on many factors.

      How much resting have you been doing and do you have a desk job or drive a lot for work?

      I started reading as much as I could when I got nowhere with the medical profession. Must add, there are some good clinicians out there too.

      • Julian says:

        I am really worried as you mentioned the tendinosis happens after re-injury. Well, i’ve had the injury for 5 months and i finally started participating in GCSE PE. We did a 20 minute continuous run and me (being really competitive) ran it like a race. That was 5 hours ago and it doesn’t seem to be worse now… I’m really worried though. How do i know if im ready to be running again, because many times during the injury i jumped the gun.

        Note: My injury was never ‘that severe’. The first few weeks it was pretty horid but i quickly started on rehab. It would be great if you could tell me how to know if im ready.. thanks…

      • Vicki says:

        Hi Julian,

        Returning to running is different for everybody depending on the severity of the injury and how rested it is. I know it’s not easy but try not to worry. Also try hard not to be impatient with it and go back to sport too early, even if you feel 100% fit, leave it for a month or so then try a short jog and see how you feel after and the day after. Build up gradually.

  106. Pingback: High Hamstring Tendinopathy: 3 Excellent Resources | Working In London. Running In Surrey.

  107. Marko says:

    I got better recently (after 3 month without running), worked on my strenght and flexibility. Unfortunately I started to stretch too early and now I’m back again with butt pain while sitting and driving 😦 be carefull when choosing the right moment to start stretch your hamstrings or when to begin to run again. Rather wait 30-40 days more.

    • beccakahn says:

      I’m still waiting for that right moment after a year and 9 months LOL. This is never going to go away on me, I fear. But, that’s because I pushed through it for 3 months with regular activity.

      • Nikki says:

        I don’t think mine will ever go away either, but I’ve learned to manage it. If it hurts after a run I ice and stretch, and take a couple days off running. I usually swim or bike on those days. I have yet to return to speedwork as I think that’s what landed me in this position in the first place. Good luck!

  108. I’m much the same Nikki. I’ve had this for about 3 years now and have accepted that I can run, but not race or do the speedwork that I used to. I can get away with 20 or so miles a week with ice and rest, but just not too fast. Also, I was always told NOT to stretch the hamstring concerned as it would irritate it, so I don’t stretch it anymore.

  109. Julian says:


  110. Anonymous says:

    I’ve been here before – here’s an update. after almost a year of dealing with this “Pain in the Butt”, and a second MRI, I have found that nothing I have done in the past year (PT, rest, all go-no stop, nitroglycerin patches) has not changed a thing in my radiologic report – it’s still a partial tear. Going for a cortisone injection next week. But no one seems to think that will help much, or for long, either. And no seems to think surgery will do much. I can not continue to live with this pain!!! This is horrible… and depressing. I guess I’ve come to grips with the fact that I won’t make my dream of running a marathon – but I at least thought the monthly 5k would be okay…. now I’m not sure I’ll be able to do anything but swim, eliptical and the occasional stand up bike ride – b/c I can’t sit on the darn seat!!! Oh, and the possible addiction to vicodin in my future b/c there’s not a 3 day stretch that goes by that the pain is that bearable…. This Sucks!

    • Tammy Marie says:

      helps if I would have logged in… sorry guys!!
      The above post was me…

      • Dawn says:

        Tammy, Like you, after almost 6 months I’m about ready to accept this as a lifelong handicap. I’m scheduled for an MRI next week but not very encouraged that there will be an end to the pain even after I have an official name to call it by. It does help a little just knowing there are others out there who understand what I’m going through. The doctors I’ve been to so far sure don’t! Best of luck to all of you who have been willing to share here.

  111. Anonymous says:

    Well I have dealt with this 10 months and finally ran 5k on a treadmill, 0 incline, and finger crossed, no problems!!! I don’t want to say I’m healed, but I think running with no incline on a softer surface is finally ok again. I do remember the last I ran outside with some small hills I had to stop and limp home, so I really think any incline isn’t good for this problem. Anyways I stopped running and ALL activity for 3 months, just let myself go, relaxed and forgot all about any form of working out, and now I finally am feeling pretty good. I’m so excited to be back! If you are still dealing with this just please stop all activity and rest, not just a few weeks, but maybe months. I kept trying to start up too early at the beginning of this and I see now it completely delayed my recovery.

  112. Tom says:

    I do a lot of driving and often have pain in the back of my thigh. For temporary relief, I slide up the back of the seat slightly so that my weight is off my butt. Most of the weight is then on my left foot (not the one on the gas-pedal !) and I’m pushing my back against the seat. It works.

  113. Kathy says:

    I also have been suffering with all the symptoms listed above (no diagnois) but as long as I am standing or walking I am fine. Sitting at all is impossible and extremely painfull bending to do any kind of gardening or just picking up something you drop IMPOSSIBLE, getting up from a sitting position I look and feel like I am 90 years old —so frustrating. I have been going
    to a Physicial therapist (sport medicine) he did ultrasound treatments and some stretching exercises I feel good when I leave but once I sit in the car I am dying again. He did tell me to get a pillow and roll a towel at my lower back so I am sitting straight— helps in the car . I have been driving long distance’s for the last 20 years he thinks that is the cause. I just need a solution for the extreme pain I cannot sit for any length of time. It was good to read all the stories with all the similiar symptoms helped a lot. The therapist is talking about the cortisone shots judging from all the posts I do not think I am going through with them.Do I but a foam rollar at any store . I will keep stopping by the site to see if anyone comes up with a solution. Thank you for all your information.

  114. Tyler says:

    Thank you so much for all of this information! All of my issues started back in May and I ignored them like a good runner does, ran a BQ, and am now paying the price. I’ve registered for Boston and my new goal for the fall is to be healthy to start training in November. Fingers crossed! Your suggestions have made me feel like I am going to get better…with some work of course!

  115. beccakahn says:

    Is anyone dealing with medial knee pain (just below the knee) as a consequence of their hamstring injury? My PT seems to think it’s connected since that where the hamstring attaches (my main source of pain is at the ischial tuberosity)

    • Julian says:

      I am just getting out of the hht injury and am now discovering pain on the midial knee of the opposite leg? Particularly with breast stroke

  116. B.D says:

    Thank you for this. I have been dealing with high hamstring tendinopathy for over a year. I am 29 and was running, training hard for military/tactical positions. I overdid it. I’ve been going to PT (grafton, release techniques, ultrasound, + routine of exercises to strengthen the area). I think I plateaued there after about 1.5 months. My PT cleaned up my hip with some re-aligning, but my ischial area stayed tweaked, limiting me from running, bumming me out.

    I went to dry needling today — pretty amazing feeling (release). My ischial area feels healthy again for the first time in a year….that’s my background…I see you talk about hot yoga — I am very interested in that, but I am wondering if I am ready for it? I think part of the damage I did came from over-stretching, and being too aggressive with stretching to ameliorate my hamstring pain. Can you advise me on how to proceed with hot yoga, please?

    • Vicki says:

      Thanks for the info re dry needling BD. Something else that may or may not help but thought it worth sharing, vitamin D deficiency. During my research to find the answer to solving this frustrating injury, vitamin D deficiency came up several times. As 75% of runners are deficient and I had rib and back pain plus clicking hips and knees (lol! talk about rinsed out), I had mine checked. I’m deficient and GP has started me on high strength tablets. 20,000 IU’s once a week for 6 weeks and then every two weeks until pack finished. Been taking for 2 weeks and will keep you posted. A non running friend of mine also an office/clinic worker had the same earlier this year and said it takes six weeks to feel any effect.

    • Julie Jameson Benay says:

      Be careful with hot yoga. I did Bikram for over 8 years and am a real proponent, but that is also how I got this damn tendinopathy. You can get great relief from the heat, but you have to be very careful with forward bends and all the intense holds and stretches

      • D says:

        She is right. Bikram bad for you. And Bikram Choundary is a greedy dude whos trying to patent yoga. Talk about bad energy…..

  117. Silly Fl. Mama says:

    Silly Fl. Mama. My hammy is much better. I have excepted the fact that my right ham string is not as stretchy as my left due to scar tissue. Original injury to right hammy cart wheels. My bike didn’t fit me. My hammy was tight. Cart Wheels didn’t help.
    1. If you get a TRI Bike ( have it sized correctly for you) if your bike does not fit you it will hurt you.
    2. Get new running shoes every 6months ( depends on mileage) Have a gait analysis done at running shoe store and buy the shoes they suggest. Yes good shoes cost but the Dr. will cost you more.
    3. If you get injured stop doing what injured you until the pain is gone. ( 4months off from running for me) No cartwheels ever again. Got a bike that fits.
    4. Do not under any circumstances stretch a ham string that is torn or pulled. Let it heal. Ice, elevate, compress. Roll only if you can walk. It hurts when its stretched because it is injured.
    I started stretching my injured hamstring too early. I believe if I had stopped stretching my hammy it would have healed sooner.
    5. Learn how to be nicer to yourself when you exercise. Learn to Swim
    6. Don’t lunge, squat or leg curl. Don’t do stair stepping over and over. Don’t stretch the bad hammy. Don’t run up hills. And don’t under any circumstances do speed work. If you do your pain in the ass will be with you for ever.
    7. Be patient. Your body wants to heal give it time. Feed it real non inflammatory over processed food.
    I learned over a period of 3yrs. how to be nicer to myself. I no longer have a pain in my ass. I can sit in the car. I can touch my toes. Shave my legs. I am training for my first half marathon wish me luck. You will heal faster then us because you are going to learn from our mistakes. Good Luck Silly Fl. Mama

    • IceE says:

      I wish I had read your “no cartwheels” post before I did a few (and a roundoff) and felt my hamstring go *POP.* It’s been injured before, and I had been pain-free for a while … drat. No more cartwheels — EVER!! 😦

  118. Adk Hiker says:

    LIke so many before me, I am grateful for the community of folks trying to figure out how to get through the high-hamstring injury ordeal. Unlike most of you, I am not a runner, but an avid hiker. I am 60 years old, on my third injury. The first came 15 years ago, when I dove to return a tennis ball (yeh, we’re all a little nuts with our sports). The bruise extended from my buttocks to below the back of my knee. I was never able to regain full strength or run at full speed, but I was able to bike, hike and play my favorite sport — ping pong. Four years ago, the day after a 20-mile hike with a large ascent, I foolishly carried an air conditioner into my basement. I didn’t feel anything pop, but it was the beginning of a three-year discomfort odyssey that included a year of doing nothing but walking slowly. I eventually got almost all the way back, but reinjury occurred just two weeks ago, hence my finding this website. I have some observations and questions I would like to share.

    1. Sometimes there is nothing to do but rest. Yes, you can live without running or whatever is your passion.
    2. What works for other people may not work for you. You only learn by trying.
    3. Pay attention to pain. My first two PTs did a lot with exercise and stimulation. It just made things worse. Rolling the muscle early in the injury, didn’t help me. It hurt. Same with massage.
    4. Stretching ain’t for everyone. My second go round with this injury took a dramatic step forward once I stopped trying to stretch my right hamstring. I had been to the Hospital for Special Surgeries in NYC and seen one of the best orthopedic surgeons in the world. He told me that my tendon was attenuated and scarred. He thought he could shorten it, but said that the surgery wasn’t trivial (he actually said this several times) and my recovery would be six months. He didn’t guarantee a full recovery, and I appreciated his candid opinion. In my experience, surgeons generally underestimate recovery time. I feel lucky that I was already two years into my issue when I saw him. I had regained enough strength to forgo the surgery. Perhaps if I had been younger I would have gone through with it. But I thought about his diagnosis. If my tendon needed to be shortened, why was I trying to stretch it? That’s when I stopped stretching it and recovered more fully. Unfortunately, moving another heavy object (when will I learn?) resulted in similar injury (insertion point strains/tears, pain sitting, and a lot of the other symptoms familiar to this blog). This brings me to my question.
    Laser therapy? Is it for real. I’ve seen some discussion of it here, but it seems questionable. Anyone out there think it is clearly helps?
    Peace and good health to all of my fellow sufferers. This too shall pass.

    • Vicki says:

      Thanks for sharing Adk but I have no experience with laser therapy. All the best for a speedy recovery.

      • Trazza says:

        I think I have this but my MRI said it is a partial tear so not sure if it’s the same. I’ve had it for a year now with no change. I felt the hamstring actually go during a sprinting session.

        I’m due to have shockwave therapy as a last resort, has anyone else had any success with this?

    • daniela says:

      I don’t feel laser helped. Nor does prolotherapy . Stretching made it worse. I too forgo the surgery, I am almost recovered its been 6 years. The foam roller helps me trememdously, however in reading all of these comments I see nowhere that anyone is doing anything to strengthen hamstrings and keep them healthy. Most importantly a good leg workout in fact a full resistance training workout is what is needed. Good nutrition and mild stretching. I used to and still do drive with a tennis under my hamstring. It relieves the tension in the muscle which in turn relieves the tension at the insertion of the hamstring muscle. It is a slow process but does work.

  119. marko says:

    If pain in the butt while sitting/driving is present – should I excercize or rest ?

  120. Brenda says:

    So where to start? How do you get through the depression? How long specifically, if ever (say that isn’t the case please!!) did it take to get back? Golden Trails- thank you for posting this blog, been reading it for a while, and glad you are back to running, hope that is still the situation? And thanks to all that have posted, it is good to not feel so alone.

    I know life could be worse, but this is all I have, and cry often. My identity is a runner, I love it, more than almost anything. Now I can’t do anything without pain, last run was Aug 29 2013- but this developed a few weeks before- and like a naïve person, I kept going- and I fear really did myself in. I am a 40 yr old female. My ortho said it is a strain, I think worse, no MRI yet, but am in PT, trying iontophresis, some home strengthening exercises.

    I try not to read much bc I almost don’t want the answer- but am compelled- to see how long, if ever to get back to running. How is this possible? I know tendonosis, the body stops healing itself, but please, can someone tell me, doesn’t it have to get better? Am I crazy to think I will never get back to running I mean, a football player can tear a muscle and be back in the game. But about how long were you all out of running? The PT says there is no reason why not, but I am not seeing any improvement at all, and it hurts to varying degrees all day, sit on ice, sit on pillow. Even if someone tells me it will be a year, even longer, I can take that, just to know I can get back again. I feel like I’m all done. PT is vague, non committal, and the stories I read are scary. Sorry so lengthy, just desperate in Boston.

    • Anonymous says:

      Mine lasted 8-9 months and only once I stopped running completely for about 4 months did it start to heal. Now I am back! And I feel I am a stronger runner now. My form has changed for the better I think, because I am guarding myself more from impact, more controlled, and more careful.
      I would suggest to think of it as a 6 month break and focus on strengthening excercises that your pt could suggest. It was very hard for me and I was depressed to, but finally came to this feeling like, just forget it, take it easy and relax! And I finally did for 4 months, and it pretty much healed. Just have faith it will heal with time and let it go of running for while. The longer you hold onto “running” as part of you and don’t want to let it go, the longer it will take to heal, because you will always be focused on it, testing if it’s better, focussing on any feelings of pain, trying a little running and probably reinjuring/ delaying healing…. Just truly let go of running for the next 6 months or so, and eventually it will heal and you will be back. Have faith!

      • Brenda says:

        Thank you for responding- sounds cliché, but your response- truly made a positive, real life difference in my life. I just needed to hear from people who have lived through this to run again. It seems impossible to comprehend I will get better- I’m still at the point where anything and everything hurts- since Aug- but to hear you were here and now you are back- gives me hope.

      • Anonymous says:

        Also have read something about it taking your body 100 days to form new collagen to repair tendons (sorry if all this terminology isn’t accurate, I’m not a medical type person). But when I read that it made sense to me why for the first 5 months I felt my life was over, I constantly had pain and if it died down and I went for a run to test things out, it would come back full force… Well I think I was constantly re-tearing it with a little run here and there, and each time I set myself back and the healing/collagen repair had to start from scratch. I don’t know if that is true, but it seemed that yes after I truly stopped all activity with that leg, 100+ days later it was much better. So again, not sure if this is accurate, but think I read something about your body needing a couple cycles of this collagen formation to finally build up/ repair the tendon. Someone please correct me if this is inaccurate. Anyways, point being that is why this injury takes so long to heal.

      • Brenda says:

        OH as much as I am sorry to read about your depression, feeling life is over after the constant pain for 5 mos, I must say, it still gives me hope in unbelievable ways to know you were here and you are better now. I am in that everything hurts, all day everyday stage- hope it is stage- but I can’t even approach running so I wonder if you were somewhat better off than I am. I like the idea of what you are saying with collagen- sounds very sensible, I heard of edema- and something like the higher up this problem, the longer to heal. I have PT tomorrow night. I’m going to ask about the 100+ days of collagen, Gastron and ART- active reflex something…it came up during desperate searches, along with cortisone and dry needling. This blog, your help, is my beacon of hope.

    • Anonymous says:

      Its very individual, you have to listen to your body.
      Forget about running for about 6 months, totaly!!!

      Focus on something else during those months. Work on your glutes, quads/hams, core streght and hip flexibility in the mean time.

      Sit on a egg-shell type of pillows (I use the neck pillow) in the office and while driving – to minimize compression on your sitting bone on your injured side.

      Then start to run again (if you’ll be feeling you’re able to – test it after 6 months). Be gentle and patient. You’re be able to google some of the ”come back” running (7-8 week) programs.

      My general advice:
      – dont rush
      – when you start feeling better, wait one more month – its so easy to mess up all the progress you’ve made with one stupid run a moment too soon

      take care

      • Brenda says:

        Really really thank you, I was so down about this injury, and to know others have been here and come back, well, thank you for all the advice and hope. You pretty much took me out of the depths of deep, harrowing depression to show me there is a light at the end of this tunnel. I can wait, just to know you went through this and can run again, that just helps me soo much. Thank you.

  121. Ewan says:

    Aged 47 I have been doing Insanity for over a year with occasional runs. I have previous Achilles’ tendon tears and found the circuit training of Insanity suited me fine which along with spells of Pilates have improved my flexibility, fitness and core dramatically. However I do a bit of refereeing (rugby) at a junior level. Disappointingly I have found myself suffering minor symptoms similar to those discussed on this excellent blog, no I haven’t been good at stretching pre refing despite all the discipline of Insanity………..what a fool! Thanks to all for sharing the info, experiences and advice!!!

  122. Tammy Marie says:

    I am scheduled to have surgery to fix my tendon next week. I’ve been dealing with this for a year now. Nothing has helped or changed the MRI (1st in Jan, 2nd in Sept), I’ve done PT with all modalities available, complete rest, all out strengthening, Nitro patches, cortizone shots – nothing has helped. The docs feel that the tendon probably has more damage on the inside than what is showing on the MRI and will reattach/repair it surgically. They say it is similar to the procedures done for tennis elbows, rotator cuffs and Achillies tendons and that they have had great results with it. Fingers crossed that 6 months from next week I will be running again!!!

    • Vicki says:

      Thanks Tammy Marie,
      This is very helpful. I’ve had the same for 20 months. Have tried everything you have mentioned apart from patches and my MRI showed nothing also. I’ve an appointment soon at one of the best London teaching hospital. If they suggest surgery it has to be better than this. Haven’t sat down at all for two months in an effort to fully rest. Usually get out the house once a week as can walk slowly for ten minutes before tendon aggravated. To start with I was upset that I couldn’t run but now I’d be happy with a normal life.

      Wishing you all the best with your op.

      Keep us posted!

      • beccakahn says:

        It’s been 20 months for me as well. I wish I had known not to push it for 4 months after my injury. This might have been just a few months’ time instead of a chronic conditon I fear will never get better.

      • Tammy Marie says:

        This is the last option. I have also had to give up running… along with almost every other activity known to happy people… depression doesn’t begin to describe it! If it was just the running, I could almost live with it… but who can go a life time without sitting?? or having to make sure you pack pain pills with you when you have to take the kids to hockey practice b/c the car ride is enough to kill you?!??
        I will be in a knee brace for 2-4 weeks and on crutches for 4-6 after surgery. I will keep you all posted… Good Luck!!!

      • Vicki says:

        I’m gathering information before my appointment so keep it coming. All clinicians I’ve seen so far have misdiagnosed, mistreated or I’ve had to help them out with info.
        Stay in touch.

  123. Vicki says:

    Just like to add I gave up running immediately so haven’t run for 20 months and no joy so certain it is tendinosis not tendonitis. Do wonder following on from Tammy Marie’s post if internal tendon surgical repair required. Something I hadn’t thought of so thanks again.

  124. Julian says:

    I think everyone needs to know that once your pain has subsided and you’ve strengthened your hammy’s and glutes you need to start working on your running form. I was recently under threat of re-injury because of the way i run. Considering this injury took me out of running for 7 months and i am only 15 i got to work. I know for many of you healing seems like it’s a long way away – but bear this in mind as it will save you. TRUST ME. You need to focus on your feet landing straight forward in a line while you run and perhaps change to the foorfoot strike. Just thought i’d like to help out as many of you helped me through injury and it was very tough 🙂

  125. I did wonder about this. So it is definitely better to land on the front of your foot and not on your heel? This will take pressure off your hamstring?

    • Anonymous says:

      I know in my situation it was landing on my heel that caused my injury – I usually wear asics and land on mid foot, but changed to a shoe with a big rise in the heel (Nike airs?) and the shoe made me land on my heel. With each step I could feel a force go up my leg and end in my butt, it didn’t feel bad, but after two runs all of a sudden I couldn’t step forward and land on my foot without excruciating pain in my butt. So I know it was a heel strike that caused my injury.

  126. Al. says:

    I am 58, and have been denying I have this problem for 2+ years (the result of taking part in a new sport when I should have known better). A recent MRI confrmed the problems, but your initial report nearly reduced me to tears as it descibed so exactly what I’m experiencing. Sitting at a desk is the killer. But, good old “health and safety” say adaptations to the work station are not allowed. I need thave a good think about this. Bikram is the only thing I haven’t tried (apart from proper rest) but there aren’t any classes near me.

    • Brenda says:

      I can offer some hope. I had an injury in Aug continued to run till end of Aug- 2nd PT group, now getting more aggressive (be sure the PT is more for athletic people, not rehab older knee replacement style) and very deep manual massage by PT. Lucky for me b/c the first PT didn’t notice my IT band was covered with scar tissue that pressed against the siatic nerve. PT is pushing- painfully- but it’s a good pain-the scar tissue away. I also was shocked (and saddened at first) by how every post matched my symptoms exactly- I also was in deep, deep depression- deep-crying, best is behind me etc. over the idea of possibly never being able to run again. This blog, kind people, truly helped me know I would get better. I have not run again, and do get sore, but it’s not the constant all day, sit, stand, move, lay down pain. I use a neck pillow to sit on during my 1 hr commute each way, then at my desk all day. I am still afraid but now hopeful because the acute all day, throbbing, aching, isolated pain has subsided.

  127. Vicki says:

    Tammy Marie, how did you get on? Really hope it went well and wishing you a speedy recovery.

    • Tammy Marie says:

      I am 9 days post op and still in some surgical pain. So it still hurts to sit! lol There is a 2 inch incision under my left arse cheek. 😀 The Doc used 4 anchors in the repair. I have my follow-up on the 18th. I will know more then, as he talked to my husband after surgery and my husband is about as medical as a humming bird. From what I understand of the procedure once inside the hamstring tendon was sliced down the center, opened up and then 3-5 anchors placed into the pelvic bone depending on the damage. Like I said, he used 4 on me. then he closed up the tendon, attached it to the anchors and closed me up. I am partial weight bearing, but mostly hop around on my crutches. I still sit on lots of ice!! But it is a different kind of pain, so that makes me feel a bit better.

      I have always been a mid foot runner, so my form was never the cause of my injury… mine i think is a wear and tear kind of thing. I’ve had 4 knee surgeries on that side from being a gymnast and falling during a tumblinlg move. My hamstring was always weaker on that side, add in a lovely bunion and mechanically I’m sure that leg got favored slightly.

      I will post again when I know something new. Thanks for the good wishes. I wish all of you the best in this pain in the butt situation!! ❤

      • Vicki says:

        Thanks for taking the time to reply while you are recovering. That’s a fascinating operation. Amazing what they can do. I’m sure this post has been helpful to everyone on here in a similar situation. Take care and best wishes for a speedy recovery.

  128. kristin says:

    this is one of the most annoying injuries i’ve ever had. i believe the most difficult part about it is the fact that it came on rather slowly so at first once the pain subsided i would continue on with running or playing soccer. it’s very difficult to go from a high level of training to all of a sudden do nothing – which is the best thing you can do with this sort of injury. because i had no idea what was going on i continued exercising longer than i should of and i’m sure that prolonged the issue.

    initially, my doctor sent me to PT for about a month. the exercises were great, but did nothing for my high hamstring. after a month the doc let me do the exercises on my own and sent me to get a MRI. after reviewing, he said he could see a slight tear in the tendon at the insertion point and a good deal of associated inflammation. however, the report from the radiologist said nothing and later another doc told me he couldn’t tell if there was a tear or not. this is a complicated injury that most doctors, even if sports-related, aren’t too familiar with.

    the worst pain i have now is when sitting and because i have a desk job this is largely unavoidable. i feel best on mondays when i haven’t been sitting at a desk all weekend and worse by the end of the week. i can now “run” about 2 miles at a slow pace with no pain, but the muscle tires once i go past that. however, the pain is still there when i sit at work.

    the ortho sent me to another doctor to have a guided cortisone shot in the area surrounding the ischial tuberosity – the area where the hamstring tendon attaches to the bone. this doctor wasn’t even sure i had a tear and said it could be bursitis. i received this yesterday and still have pain from the shot (and associated poking around of the needle) so I can’t tell if it’s starting to help or not.

    the big obvious on this injury is that there is no cohesive, acknowledged medical advice for treatment. i’ve gotten wide-ranging advice on what to do and my ortho is not worried about me jogging slowly at short distances now – just no soccer, sprinting, etc. however, the doctor who performed the injection pretty much said to do nothing and couldn’t believe that i didn’t “know” what activity caused the injury or when it happened. when i said it came on slowly and after a month or so got much worse he looked at me as though i wasn’t being forthcoming with information.

    to be honest, i think i’ve done better reading testimony from individuals who have had this injury and from a few medical articles i’ve found. i really have no idea when i’ll be able to really run again because i feel like sitting at work sets me back more than going for a short jog – although i can’t avoid the sitting. pillows don’t seem to help too much either. to say this is frustrating is a complete understatement. i was in amazing shape before this came on and was planning a half for october and a full for february. those are all tanked and i’ll consider myself lucky if i can make it to a slow, 5miler by february.

    my advice to anyone who develops this injury – find a hobby to fill the time you previously spent running or doing other forms of exercise or you will literally go insane. thanks for the information and to anyone who feels like they are developing this issue STOP what you are doing and go find a nice ice pack for a while.

    • Tammy Marie says:

      If I understood my surgeon correctly, my tear was actually worse on the inside of the tendon, and not seen on the MRIs. Kristin, I did everything you did. The cort shot did NOTHING!!! Frozen peas or an ice pack do wonders when you HAVE to sit. I’m hoping my surgery will fix me and I’ll be able to run again… but I’ll settle for being able to sit!! Good Luck!!!

    • Vicki says:

      Thanks for your experiences Kristin. I’ve had similar and have had to read about this injury as much as possible as so far all the clinicians (and there have been many) don’t really understand what’s going on with it and pass me onto another speciality. Some haven’t known the difference between tendinitis and tendonosis which is vital.

      Just been seen today by the Rheumatology Dept. of Excellence at one of the best London teaching hospitals. Took my rather large and ever growing file of medical reports with me and a typed time line of events, diagnostics and treatments so far. They couldn’t help and are referring me on to another dept. luckily at the same hospital.

      It was reassuring in some strange way to hear that some doctors couldn’t see a tear on your MRI. I’ve been told the same and you start to doubt the Radiologist.

      I resisted going off sick from work (a desk job also) for 8 months and this has definitely contributed to a delay in healing and making the problem worse. The pain was so bad it used to radiate across to the other tendon that wasn’t injured and down the backs of both legs to just behind the back of the knees. It felt like someone had grabbed both my tendons in their fist and were squeezing them as hard as they could all day and eve.

      Since being off this has subsided to just very localised pain in the injured tendon area at a level of 2 out of 10. Saying that to get to this point, I haven’t sat down for 6 months……at all! So no driving and eat standing etc. I can’t bend either so have to go onto my knees to pick things up off the floor.

      I sincerely wish you good luck with a speedy recovery.

  129. Kristin, your situation sounds pretty much identical to mine, except I’ve had mine for 3 years this month. I too have had an MRI without an exact diagnosis and have some discomfort when sitting.

    I tried doing loads of eccentric strengthening and lengthening exercises for months, but they had no real affect. The PT who treated me was the head guy in his dept and he actually gave up running due to this injury after about a year of trying to get better. He now cycles instead.

    I think one of the worst things I ever did, was to give up running for a period of time, because all of my other leg muscles weakened, leaving my hamstring tendon more vunerable.

    In fact, the only “treatment” I’ve found that works is to ice after every run, rest, use a foam roller (not 100% this does anything though), don’t run too fast and don’t hit the hills hard.

    I am currently trying to change my foot strike so I don’t land on my heel, but this is really hard to implement and I don’t know yet if it’s making any difference, apart from making my calf’s a bit sore!

    To give you some hope, I can now run relatively long distances up to 10 miles, without too much discomfort in the following days. I tend to run 3-4 miles on a Tuesday and Thursday and then up to 10 miles on a Sunday, but sometimes I have to miss one of the shorter runs.

    However, I have accepted my racing days are over, but it took me a long time to accept it.

    • Nikki says:

      I have the same issue and I am back to running. I can no longer run 6 days a week, but I can run long distances. I am going to be running a marathon in 2 weeks. I now ice and roll after every long run. Last weekend was 22 miles, and I didn’t have any residual pain the next day; I still have some pain while running long distances.

      I have switched to landing on my forefoot, but when I get tired old habits resume; that’s when I notice my leg beginning to hurt again. When the pain happens I tighten my core, and focus on taking tiny strides. It seems to help.

      For me it’s a chronic issue at this point. I did pt for a year, and the exercises and ultrasound got me to where I can run mostly pain free. My pt said as long as I don’t have pain the next day after a run it’s fine; if I have pain the next day I have to take a few days off and cross train.

      I have given up ever racing again as speedwork causes my leg to flare up. I cannot play soccer anymore. I have to ice, roll and stretch after long runs. And finally, I can run, at most, 5 days a week, and three of those days have to be 4 miles or less. I will be training for a 50 mile “race” beginning in January.

      Good luck. You can return to running, but you probably won’t ever be able to run at the level that got you this injury in the first place.

  130. Hi Nikki, When your PT said not to run if you had “pain”, did they mean any pain whatsoever, or if it was “bad” pain? I can pretty much always feel mine a bit when running and sometimes when walking fast, but it’s more of an “ache” than an actual pain..

    I try to keep my stride pattern short as well, as this means less pull on the hamstring area.

    I was always told not to stretch the hamstring as this would irritate it? Do you find it helps, or do you mean stretching other muscles/areas?

    Do you think the foam roller really helps?

    • Nikki says:

      My PT said if I have pain the next day I’m to take time off running. Specifically, one day for each time I feel the pain. Like I said, while running I can sometimes feel it, but if I tighten everything up (core and stride) it will stop. I was told not to roll over the tendon, but my nagging issue seems to be in the belly of my hamstring (more towards the outside of my thigh). That’s where I feel a tightness that then leads to tendon pain if I don’t roll it. I do stretch my hamstrings, but I try to avoid stretching the high hamstring; sports med doc told me I could cause more injury by stretching the tendon.

  131. Vicki says:

    Kevin you’re worrying me slightly, tell me to butt out (excuse the pun!) do you think you should be running with pain even if low level. When you read through this thread the main theme is rest for full recovery then return to running gradually once pain free.

    I appreciate it’s hard to give up sport totally but it’s like wiping the balance sheet clean then starting again at a better position.

    Oh almost forgot, I used the foam roller (Trigger Point is the best make by far) on my very tight T.I .bands. It’s agony at first due to tightness of bands but after two weeks this starts to subside so definitely recommend using one. My PT advised every day for five mins on each TI band. Can use it on all parts of body though. Only thing is question mark over using on injured hamstring tendons as may well aggravate, a bit like sitting on them.

    PT said using on TI Bands will help loosen them and as every part of our mechanics effects the next connecting part it would help the strain elsewhere….makes sense I guess.

  132. kristin says:

    the whole injury is very strange to me. i’ve had minimal pain ever doing any of the physical therapy exercises and can do lunges, rubber band exercises, even most weighted leg exercises without pain – including 1-legged deadlifts with a 10lb kettlebell. what i can’t do is SIT! after taking about a month off running i eased back into walk/jogging and after a month or so of that i can do 2 mi slow without any issue. i even did a 5K last weekend (husband’s company thing – not at a race-speed… about 2.5 min off of what i would normally do) and didn’t have pain at the tendon area just some fatigue and soreness in the entire muscle, but the next day there was no additional pain. took a day off of work the next day to get some stuff done and was fine…. then after sitting tuesday, wed, and thursday the ass-pain returned!

    previously, i didn’t have as much pain when sitting, but certainly could NOT go jog even a few blocks. i also had pain down my entire leg and pain in my lower back. the sitting issue seems to have flip flopped. now i’m sore from the cortisone shot and associated needle-digging so i guess that will take a few days to figure out if that helped. of course, it’s also the weekend so that means i won’t be sitting all the time so that somewhat confounds this little cortisone experiment for now.

    has anyone had lower back pain associated with this? my injury is on the left side and my left lower back previously hurt significantly, but now not so much.

  133. Hi Vicki, All of the various therapists I’ve seen have said it’s OK to run as long as it’s not too painful. Like I said before, it’s not even a pain as such, more an annoying ache. I ran 3 miles at 9 min/mile pace last night and I could probably do it again tonight – if I had time!

    I work in an office 5 days a week and I’ve never not been able to sit down, it just gets a bit sore sometimes.

    My injury is always there when I run and the next day, but it’s not so painful it’s debilitating.

    Unfortunately for you, I think your symptoms are much worse than mine, like not being able to sit down for months – luckily I’ve never had that problem.

    Kristin – I have some lower back pain on the other side. I’ve seen a chiropractor and he suggested that it’s because my pelvis is slightly higher on one side, so I get hamstring tendon problems on one side and lower back/sciatica on the other.

  134. Marko says:

    I would be thankful if you could help understand two points, thanks …

    1) if there is a pain while sitting/driving (as only discomfort), is it smart to run in your opinion?
    2) can anybody share experience with shockwave therapy (working or not)

  135. kristin says:

    I have a question for those who have recovered, or at least relatively recovered…

    Do you run with compression shorts or a compression sleeve on the affected side? If so, has this been helpful? And if it’s contraindicated for some reason please let me know. Wearing tights has always seemed to make other ailments feel better, but i live in a relatively warm climate where i may wear tights for running a good 1-2 times per year (if even). Before I spend money on some compression shorts/sleeve I’d like to hear your feedback. Thanks everyone.

    • Brandon says:

      I have a sleeve and compression shorts and i use them anytime i run now (usually both together). I cant give you any scientific results to fall back on, but I buy into the belief that they will help support the hamstring and therefore limit its stress during the workout.

  136. Willy says:

    I’m 66 and play softball in a senior league several times a week, all year. As an outfielder, It’s a 3 hour workout of random 40 yard dashes and pivots. I have my share of shin splints, tendonitis, calf knots and groin pulls, but never have had this upper hamstring injury before. It’s as everyone has described, more painful sitting than standing and just won’t heal. It’s depressing not to run and lose the cardio conditioning that takes months to build up.

    Not wanting to try dry needles but thinking that the problem in healing is getting enough blood flow into the injured area. I pulled out the large heating pad and began sitting on it hours on end at high heat. I place it from my butt to the knee, using the recliner to keep some weight off the pelvis. It’s my smoked butt therapy.

    After a week or so of this the pain starts to subside and I can walk a bit faster without too much pain. After month I’m back on the treadmill doing a 1 mile fast walk/slow jog. The hamstring is still sore, but better. It’s getting close to normal muscle ache after a good workout.

    Something to try.

  137. andrew says:

    OUCH! I am feeling your pain 😦 i have had this infliction for the past three weeks and has nearly thrown me into depression. Stacking the kilos on because im not going to the gym and drinking instead lol oh well thanks for your experience and i hope it clears for me sooner than 5 months.

  138. sarah says:

    my name is Sarah. I’ve known Johnson for years, When we finally got together things were kind of weird so we broke up which was in February of 2011 In June of 2012 he and I recently got back together and we were together until march of 2013 which he told me he was not interested in relationship again During that time I changed completely, I wasn’t eating,I was sleeping a lot, I wasn’t talking to anybody, I cried a lot,I’m so depressed and stressed out that I’m scared I’m going to end up in the hospital because of all the stress and depression until one day i search online on getting love tips because I Love & care about him deeply and I just want us to be together as a couple again and I want us to last forever Google recommend me that he will solve my relationship problem then prophetkalito told me he will come back to me between 48hrs after he cast spell on him never believe it until my fiance called me on the phone and told me he want us to come back and live happy together forever , Am so happy now that prophetkalito, help me bring Johnson back to me. Thanks so much(prophetkalito) his

  139. Olivier says:

    Unique blog looking into this not so uncommon injury in runners/soccer player. It seems that most of us have very precise symptoms. Pain is such a subjective measure, I am really wondering about when is it okay to start doing some of the stretching/yoga. My PT recommended stretching the hammy everyday and do other exercise. By far, for me the worst is when I have to sit for a few hours. Driving to and from work is really annoying. my commute is only 35 minutes but it is enough to trigger the pain.

    Is a slight discomfort normal after YOGA and stretching? I would not call it painful but certainly there is an annoying sensation around the ischial tuberosity.

    • Brandon says:

      after 2 years i have a slight discomfort/sensation doing day to day activities and motions… and it doesnt bother me at all running, at least so far. I ran 3.5 miles around 8min/mile pace last week and had no new pain as a result. Good Luck Olivier.

      • beccakahn says:

        It’s taken my injury almost 2 years to heal as well. I’d say about 95 percent better. There’s hope!

    • Brenda says:

      You might want to double check with the PT- only because my PT said do NOT stretch hammy- can cause further injury on any healing that occurred (initially at least)- and I read similar. I am not cleared to stretch it at home, in PT since Oct- 3x a week including deep massage- right ON the ischial tuberosity- good stuff. I sit on a neck pillow (a travel pillow) in the car (1 hr commute ea way) and at my desk job. I haven’t run again yet- Aug 2013 injury- but I’m on the elliptical and bike, so progress!

  140. Olivier says:

    My discomfort clearly comes from sitting. I wonder about those kneeling chair… Has anyone tried that? I would like to stop any pressure on the area? I tried a cushion at work and it the car but no success yet.

    • Vicki says:

      I’ve bought a kneeling chair but not using yet as not sitting at all. It’s for when I am better as I’m planning on not sitting unless I have to i.e. for driving.

      • Brenda says:

        I wish I thought of the kneeling chair! I was getting better, and overdid by use and stretching, now I have- in addition to my HHT- 2 pulled calf muscles, grade 1, I think, no kidding!! I am very down and in slight denial. Lesson- do not be me! Take it very slow and easy when coming back to activity!!

      • Tammy Marie says:

        I have a kneeling chair…. it still hurts. sorry to burst bubbles… but it may not hurt for you.

      • Vicki says:

        Hi Tammy Marie,

        How are you getting on…..any improvement?

  141. Tammy Marie says:

    I am almost 2 months post op… I still have a lot of pain with sitting, but the doc tells me it’s normal and will go away completely within 4 months of surgery. My hamstring is very weak and rehab is still limited to strengthening only – inlcudeing hamstring curls, squats, 4-way straight leg raises, quad curls (which hurt sometimes bc of sitting), step ups, hip stabilization exercises (stepping onto upsidedown bosu ball) and just started quadriped hip extension today. There is no stretching or dynamic exercises yet. I am allowed to start swimming soon! I do hamstring rolls and qlut rolls on the foam roller – I’m getting some pretty strong muscle cramps in my glut! I am limited in walking, having some pain during swing phase and heel strike, and cannot walk up hills. Most of the pain and subsequent issues are still from surgery – it was pretty agressive! I still have high hopes for complete recovery, but it will take the full 6 months. But I have an end date, a light at the end of the tunnel, and hope!!! Thanks for asking!!

  142. Olivier says:

    I sounds kind of silly but I have been keeping with me pacs of ice for when I am driving. I feel this is really helping to reduce inflammation. I have been doing this for whenever I need to sit and it helps. I feel I am definitely improving but slowly, I am on a 6 month recovery plan. 1 month of light stretching and light warmup and I will move my way up slowly, definitely no running for 5 months.

  143. Fernando says:

    Hi everyone
    I used to be a keen runner till 18 months ago (2.27 marathon in April 2012)
    I jog slow and wit pain now
    It all started with a hamstring injury. It never really healed. I was told I need to change the way I run because I did not run straight (cross the legs and move arms a lot). As a result of this I started using hamstrings and gluts more and they were not string enough. For several months I would go running with extreme tightness in the hamstrings, and not being able to run even 1 km at my usual marathon pace. I finally got the diagnosis this morning: hamstring tendinosis. Treatment: 6 weeks compete stop and then new scan to determine whether I go for the different type of injections or surgery…and I only have a 50% chance of recovery because apparently my tendon is absolute crap. So you now what I am really tempted of doing after stories of many of you saying that you have not seen any change after stopping and different treatments? I think I am just going to keep on running, at a lower pace and forget about coming back to running fast. I am already 35 and I have already spent a good decade running a lot of races. I just cannot stop running, it is my life. I am not the same person in the office, I am not the same husband, brother or son if I am not running

    Good luck to everyone

    • Julie Jameson Benay says:

      Fernando, lots of runners find a similar release from Bikram Yoga. I got on this train of emails because I got the same injury from overdoing Bikram! For you, if you saw a skilled Bikram teacher and started slowly, you might be able to heal ANDbe the sane man you want to be. You MUST also see a good physical therapist. If you try Bikram, avoid forward bending postures until you heal. Also everyone should check out Yamuna body rolling, better than foam rollers. I took 3 months off from Bikram, did an hour of PT and body rolling every blessed day, and now I’m almost healed, although I’ve also had to accept that moderation and modification are my life. People, I’ve had cancer. This is not cancer. Get some perspective, keep working to find some exercise that gives you release, and be grateful to be alive.

      • Vicki says:

        Thanks for your thoughts Julie and putting things in perspective. I couldn’t agree more even though I’ve just lost my job due to not being able to sit down. Staying positive and will get better. Well done!

      • beccakahn says:

        I needed to hear that, Julie, so thank you! I’m 95 percent better at this point but it took two years.

    • Brenda says:

      Fernando, I have been meaning to write since I read your post- your words are my words, your feelings, exactly as I feel. While I recognize things could be a lot worse, this is our worst right now. You pretty much said it all. What I can say to you is, time heals. I here pro and con about the injection, but personally I would have tried anything. I have been in PT for 4+ months now and started running in Jan- but back to having bad pain deep in the isheral tiberal (sp). Regarding tendonosis- what I have read is that you can strengthen the muscles or tendons around that tendon and/ or surgery. We have no choice but to listen to the Drs-and if they say complete stop for 6 mos, as horrific as it is, maybe it will help. At least you can say you tried that. Or If you can run at a lower pace, at least you are running- but…. even a lower pace is still using those tendons and muscles.

      • Fernando says:

        Thanks all for the comments. Julie, I cannot agree more with you. It is so important to put things in perspective and to have a “complete live”, not just focused in one or two things, because if they fail…we may find ourselves lost. Yago Lamela, an 8m56cm long jumper, twice second in Wold Champs, died yesterday at 36 in Spain. He had injuries since he was 25 and he could not find something else in life and fell in depressions.
        None of us here is a professional runner, but many have made of running a way of life, a philosophy. When I say I am a runner, I do not describe what I like doing 1 hr every day. I am describing myself as a person. I am a runner when I am sleeping, I am a runner when I am at work and I am a runner when I go to a restaurant. It is so important to realise there are other things in life, and yet so difficult not to be sad.
        On the positive side in the last 4 months there are signs of recovery. I run 5-6 days a week, I cannot do it fast because the tendon is tight. I feel like a runner again and hence I recognise myself. I am not certain I will run fast again but I will always dream of it. At the same time, as Julie says before, I am making efforts to find pleasure in other things.
        Brenda, I hope you are doing better now and best of luck
        If any of you lives in London, happy to meet for a run, but slowly 🙂

      • beccakahn says:

        Fernando, beautifully said. I have to just replace the word “runner ” with “dancer” and it is exactly what I need to keep in mind.

      • Brenda says:

        Fernando- If I remember you were in similar depression over this injury as me- using statements that you are not the man you could be- and I remember talking with Dawn about cortisone and so many others–we all want to hear from people ‘on the other side’ of this injury. I feel such kinship to you all because your statements could be my statements- this blog has been a lifesaver.

        Running is my life- and the fact that I could not (note past tense) run, truly affected my every breath. Running is really the one thing that gives me unfiltered pure joy, satisfaction, accomplishment…no kids (yay!) so my focus has been on stats. I always read, warm up, cool down, stretch…but never thought it applied to me…I was just running 5 miles on a treadmill afterall…and my cooldown, well that was a speedwalk on an incline. Days off, naw, that would hinder my progress…..alas, here I am…7 mos not running, $1000s in therapy, MRI and doctors- heck I even bought a TENS machine…so lesson learned- warm up, don’t run everyday, and strength train.

        But I am I guess writing offering some hope?? I was in pain all the time, at times I described the pain as mind numbing, in back of ham and buttock, and I was scheduled for a cortisone shot- which I never had- because the acute pain passed and I was afraid of the idea of steroids. So for about a month now, I still get very sore, but I’ve been able to run up to 3 + miles, about 3 or so times a week. I can add to it with elliptical and bike- but PT says run only every other day. Anyways, I wanted to write to share that I was pretty bad off, and now at least on the bridge to the other side- and wish the same for all.

  144. Lisa says:

    Hi there! My question is my issue sounds very similar but I feel pain deep within the inner side of my sit bone, insertion into the glute. I too have run for over 20 yrs and am quite tight in my posterior aspect and have trouble touching my toes when cold but can after I am warmed up takes about a good half hour. I too have a strong core can hold planks for over 4 mins. However I only feel the pain when im on a bike not running. I think it might semimembranousus that im feeling specific pain in. Can this still be the same issue or perhaps siatica? However I dont experience the other symptoms of siatica such as a pain shooting down the leg. Ive been doing periformis stretches for along time and my trunk flexion is good. My achellies feel and look like a bone instead of a tendon and occasionally I get pain in the area where the hip and sacrum meet. Any feed back would be most helpful, even if its a push in the right direction to the right health professional.

  145. allisona says:

    This is my problem! Doc put me on anti-inflammatories after x-ray and said I had tendonitis. I am an avid yogi and think I pulled something during a hot class 2 years ago – overstretched and heard a snap – when I run or play tennis it all starts over again. I decided after a week to get off anti-inflammatories due to taking all those chemicals and plus would like to have a glass of wine every now and then. How LONG ARE YOU using your foam roller???? I just started taking CuraMed…natural anti-inflammatory.

    • Sean says:

      Definitely think natural inflammatories are the way to go (I’m certainly not giving up beer!). I’ll put Turmeric on everything I eat, so that has to help over time. Foam roller and stick rolling help loosen the muscle without the tearing that comes from stretching. And I’ve started wearing compression shorts, which seem to make a huge difference. I’ve started training for a half marathon, but have only got up to 4 mile runs so far – I’m taking it easier on the runs this year than in the past, where I’d probably have already got up to 7-8 miles. More core and hip exercises at home, and less mileage.

      • allisona says:

        How long are you rolling. I have a black foam roller and get so sick of it. My gluts hurt right where the bone and tendon meet as well as the high side of my hips on either side of hip bones. they kill when i drive for over 15 minutes. Tennis is the problem. If I avoid tennis i am fine but don’t want to do that.

      • Sean says:

        I usually get a good 20 rolls on my hamstring, glute, and lower back. I also have one of those stick rollers, which hurt a bit less, and I get my wife to roll the back of my legs while I’m lying face down. I can imagine the tennis hurting more with the quick turns and stops and hard surface. I find the glute stretch, where you cross your lower leg in front of you and lean forward, does wonders for the areas on the side of your hips.

    • daniela says:

      I take turmeric for anti inflammatory. Long term effect, however when something is torn or over stretched wont really take away pain. Ice Ice Ice. and the foam roller everyday no matter what, it has been my life saver!

  146. JT Teacher says:

    Wow! Great article! I’m feeling better, but not 100% and I’m so tempted to run – even though I know I shouldn’t. You say ” I committed early on to not patch up my injury and come back quickly but to take as much time as necessary to heal. My main goal is to run into my 70s and 80s and not to run as soon as possible with a high likelihood of re-injury.”
    That is going to be my mantra – to remember that I want to remain active late into my life, not to worry about the 1/2 Marathon I want to run in 4 months. I’m going to wait until my DPT says I can run before I do.
    Thanks so much for sharing!

  147. Mona says:

    My problem is weak hamstrings. It started a year ago. Two years ago I terminated my gym membership and started my weight lifting at home. I ran 3 times a week in the mountains. I went to a running specialist and he said that I have weak hamstrings compared to the strength of my quads. He advised me to do the bridge like exercises everyday as much as possible. Well, that really didn’t help especially that I did about 1000 a day bridge like movements where I life my buttocks up and bring it down 100 times for 10 times. I did dead lifts but now my back is hurting. I am limited really at home with equipments. I only have a cardio machine and some weights. Please help and thank you so much for your article. It was great.

  148. Anonymous says:

    Been 3 years and counting. My first half marathon at 31 most probably did it. Found the best osteopath, been to chiros and physios as well. Spent over 15,000 dollars on my leg and its still there. Read more about it than I could care to discuss. Amazing diet, amazing fitness, supplements etc all in place. Rest, recovery, stretches. Im so sick of it. Its still there. So Ive just said to hell with my injury – just signed up for my first marathon. But good to know there are other frustrated people out there who deal with and share my pain….

  149. K says:

    Thank you so much for this! My symptoms sound exactly like yours with the numbness/tingling as well. I was able to do 3 hour runs despite all of this, but recently, things have drastically gotten worse to the point of not being able to run at all (not discomfort, but decreased stability). In your experience, were you able to do things like biking/elliptical or would you not do those?

  150. Anonymous says:

    Wow! If there’s any comfort in knowing you’re not alone in your misery, your post has provided some relief. Seems like most, as yourself, are runners at the time of injury. And then there are many comments about the value of yoga. So I have to add a comment that I am not a runner, though I use to walk a lot, and I believe it was yoga that initiated my high hamstring tendonopathy about 3.5 months ago. It was after the second or third yoga class that this pain formed in my left side. It got severe enough that I went to a doctor and of course he proscribed drugs, which I took out of desperation but the relief was minimal and short-lived. My next step after reading your post is to find a sports therapy practitioner. Thanks for sharing!

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  152. Tammy Marie says:

    UPDATE: tomorrow is 15 weeks from surgery. I am doing better!! I survived a 1 hr car ride 6 times this weekend!!! With little discomfort and slight sorness on Monday, but No pain pills b/c of the pain. I am now stretching and strengthening. Still no running or walking any distances or hills. Next week I will be able to hit the treadmill and a bike (I have been able to do a recumbant bike with no problems for a while now). I have also been doing the eliptical machine without any discomfort. Hard chairs still pose a problem, but the added pillow fixes that nicely (which wasn’t even an option before).
    I am very pleased that I had this procedure done and am happy with the results – altho it’s a bit frustrating that it’s such a long slow process… but it will be worth it (and has been) to be able to sit and run again pain free.
    One thing my therapist is really good at, as I add my strengthening activites back in and the stretching is making sure I am doing the exercises correctly and with proper body mechanics…its amazing how ‘lazy’ you can get with being so active! Minor tweeks to which toe my knee goes over during a squat, which angle my foot comes up to my butt during a hamstring curl, stretching my hamstring with both a straight and bent knee… little things. Plus lots of hip strengthening too. All those things you know as a runner you’re supposed to do – but go run an extra mile instead! It’s a whole body approach!! 🙂
    Don’t get me wrong, I still sit on my ice pack and stand more than not – but it is so much better than before!! If the docs tell you the surgery in an option, I highly recommmend you seriously think about it!

    • Daniela mcnally says:

      I wish I had done the surgery! Read my story below. I have all kinds of problems now because I did not do it. Back in 08 there were not many women who had had the surgery. Where was your tear? I’m trying to figure out where to go from here.

      • Tammy Marie says:

        I still cannot do yoga. My hamstring is not strong or flexible enough to hold the positions. Even before my surgery, yoga was a no-go for me.
        I highly recommend the surgery, but it is a long recovery!! And frustrating…. but there is a light at the end of the tunnel!! Where before there was not. I’m sure this is an injury that will still plague me later, but not to the extent of not being able to sit at all!!! And yes, I can see why and how it will cause other problems with your body, trying to keep itself balanced.
        A more precise description of my surgery is somewhere above, but if you can’t find it or have questions, I can answer them.
        I wish you the best of luck!!! It’s a horrible injury (they all are really….) to deal with.

    • Tammy Marie says:

      I made it thru a movie!!! My first in more than a year and a half!! In a theater. With my kids!! It was awesome!!! I did take Advil, and moved around a lot to keep comfortable – but I didn’t leave in tears, early and taking pain pills!! BIG IMPROVEMENT!!!!!!!!

  153. Pingback: Surprising Cause of Injury for Runners & Triathletes – #STRONG2014

  154. Daniela mcnally says:

    I had a partial tear in the spring of 08, doc wanted to surgically repair, i did not want to do that, did not rest and worked around my injury which caused many imbalances in my body. Then I ruptured posterior tibialis on the opposite foot as a result of hobbling around that was in 2009, then had reconstructive surgery on foot, hobbled around for almost a year in a boot and on crutches which caused trochanteric bursitis back on the hamstring side in 2010 – 2014. After 10 cortisone s shots I had bursitis surgery at end of 2012. I have done countless hours of PT, and I now am back to that hamstring that is so week now, will not fire and I now have tendinosis, it’s 2014 now it’s been years, I hate the foam roller, but will start with it again, I used to run, do plyometrics , lift weights, strengthened everything I could strengthen….. Still it’s hard to get out of bed , stand up after sitting, I know yoga helps but it’s painful. Riding my bike helps a lot, but cannot do in winter, stationary bike does not work, aggravates it, so I guess my question is bikram yoga., do u love it? I have not tried that yet. Thanks for your story, I can totally relate!!!!

    • Julie Jameson Benay says:

      Bikram yoga is amazing and wonderful, but you need to listen carefully to the dialogue and to your body. Don’t be at all competitive with others in the room and just listen to your body.

  155. Brenda says:

    Remind me again- this gets better?! I was injured last Aug, in PT since Oct, started running again Jan- 10 miles a week…then PT had me ‘open my stride’, and I did that for 2 days, since then, same pain, on ice, kneeling at the computer at work. PT states it was because I overdid it and did not stretch- (3x cardio a day incl run, elipt and bike). I don’t do anything anymore (like others, even the bike is painful), and now think my MCL is out of place- is that even possible, knee locks in pain. I’m supposed to write something positive here, like life could be worse, which I recognize as true, but its hard to believe.

  156. Nikki says:

    Open your stride? As in, lengthen? My PT told me I needed to not stride out so far; that by doing so I’m putting stress on the tendon. I can always tell when I’m striding out too far as my ass starts to hurt. If I bring my stride back in the pain goes away.

    • Brenda says:

      Right I’ve always read, keep your feet under hips. But PT was meaning swing arms, engage core, said I was running stiff- I’m just so afraid of re-injury, and here I am. I guess we (the injured) don’t want to blame PT, but believe in them, but just seems like a strange coincidence- I was doing so well, then a change, and then the pain. So I think I did go out too far gait-wise, which really wasn’t that far, but that is how sensitive this injury can be, I guess. Though maybe it was as PT thinks, my lack of warm up, cool down, consistent stretching and too much cardio (but really only 25 min max probably of actual running, and spread out throughout the day- thinking it’s better to keep all limbs relatively loose). Thanks for reading and responding.

      • Nikki says:

        I hear you! I’m terrified of reinjuring myself, but I think I caught mine early; at least that’s what the PT said. I took 8 weeks off and then came back slowly. I changed how I run (I now strike on my forefoot), and I went to a 4 mm drop shoe. I can’t do speed work anymore. I found that I can’t sprint with a compact stride. I ran a marathon in December, and next weekend I’ll be doing a 50k. I’m currently training for a 50 mile run that’s in April. I’ve managed to keep the injury at bay. Some days it flares up, and I take a couple days off running, and go to spin class or cycle outdoors. I think this is just one of those injuries that will always be with me. I’ve learned to listen to my body. I’ll probably never run another sub4 marathon, but that’s okay as long as I can run. Good luck, and don’t get discouraged.

  157. Cooper says:

    Thank you all for sharing your symptoms and treatment tips. I won’t go on about my symptoms and I know us runners share a common bond of frustration. Rest has been the most difficult part of what I hope will be a road to recovery. I was wondering if anyone has tried Prolotherapy treatments? It is a series of injections of dextrose combined with fatty acids that claim to accelerate the healing process. Also, those of you who are looking to alter your running style to avoid injury, I recommend looking into the book (or Audio book) Chi Running by Danny Dreyer. Thanks again.

  158. I drop a leave a response when I like a article on a website or if I have something to add
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  159. James O'Connor says:

    I have seen every body about this hamstring tendinitis no one has helped me .I have had this for about four years I have doing karate for forty years and only have it in my left leg. The pain has change my life there are days I don’t want to talk to anyone or do anything . I will try what you have recommend thank you .

    • Cooper says:

      I understand your frustration all too well. At first I thought it was a strain. Treated with ice,heat and electro therapy. 2 months later, no progress. Read more about the high hamstring tendinopathy. I definitely had the symptoms. The only thing I had not done was refrain from running and boot camp. I thought I would try to rest.

      I too saw a sports med doctor who prescribed physical therapy. I am only 4 months into the injury when I saw the web site below. I am forgoing the PT and opting to try Prolotherapy treatments. My first treatment is next week. We’ll see how it goes. Like everyone on this blog, I am extremely frustrated. Enjoy the link below, it is an interesting read.

  160. Vjb321 says:

    I have had this pain for about a month, and have been doing elliptical and bike and lower body machines and stuff, but still hurts to run. Anyone have any experience with this? I feel like it should be healed by now. I am only 20 years old, and had to transfer my bib for the Pitt Marathon in May and just want to be healthy again for XC in August, and I have been running for at least 5 years. but never an injury for this long.
    I have been diagnosed with high hamstring strain, but no tear, so a Grade 1 strain. Any experiences with this? Should I just stop doing any cross training at all and let it heal? I hate not being able to run. 😦

  161. Anonymous says:

    Thank you for this article, and to all others who posted. It’s the sneakiest injury because you think you are fine when it goes away, so you keep going without knowing it’s getting worse. I am resting, applying ice, doing core exercises, ibuprofin, and i ordered a foam roller. Thanks again for the advice, and good luck to everyone who has it!

    • Brenda says:

      I know I (we) need to remain positive, and life could be worse- especially on today’s marathon anniversary, But I truly, truly, miss running with every cell of my body since last Summer – and being totally honest, hard to fathom life being worse- there I said it, this is horrible-awful of me to say (but if we can’t be honest here, then where?), but I’d almost rather be sick, then I would not even have the tease of watching people run by, while I sit on ice driving, leg straight out to alleviate the constant pain. Every month, I watch the one thing that gives me pure joy drift away. I had an MRI last night, and onto a hip specialist, but PT thinks the hammy healed (I could run in Jan, but reinjured by Feb) and it’s now a L5 S1- say what?! I grab onto each posting, hoping to hear from people who had this and got better, can run. But more often than not, it’s people in the same boat- so while I’m glad to know I’m not alone, oh boy would I like to hear ‘I had that for 1.5 yrs and can run 30 miles a week now no problem”. Good luck to us and the Red Sox.

      • Fernando says:

        Are you getting better….I think I am seeing the end of the tunnel but still the exit from it is several months away! almost 2 years. I run today at 3.45 km for 10 ks!!!!! still tendon is tight but feel like I am getting my natural stride back. Vamos!

    • Vicki says:

      Please stop using ibuprofen. Ibuprofen inhibits collagen repair which is crucial to recovery. Please google ibuprofen and collagen repair, it’s all there. I’ve gone onto paracetamol instead but only when I have to. It’s also much easier on the stomach.

      Also, the main thing to find out is if you have tendonitis or tendinosis. Most doctors won’t know the difference I’ve discovered. Tendonitis is inflammation, tendinosis is where tendon has gone beyond inflammation due to constant reinjury and the cells have died. Tendinosis can occur if you do not rest when you have inflammation ie. tendonitis.

      I have tendinosis i.e. my tendon cells have died. If you have tendonitis you are much better off and can rest it out.

      It’s crucial to establish which you have as the treatment methods are different. If you have tendinosis there is absolutely no point in taking anti inflammatories such as NSAIDS or having steroid injections as both treat inflammation and therefore won’t work.

      I’ve been telling doctors this but get no where until now. Researched the best hospital dept. to go to in the country (UK) and G.P. agreed the funding – thankfully. He probably took pity as I haven’t sat down since August 2013 at all and have lost my job due to this injury. Had a desk job. So have no income. On top of that something much worse than this (yes hard to believe) has happened.

      Please stay as positive as possible and believe you will get better as positive mental attitude is connected to repair and recovery, although I appreciate this is hard to believe. Also, do as much research as possible and get to know your injury. The doctors you see will need help with understanding this injury!! Very little is known about it in the medical profession. If you have any questions, please get in touch, more than glad to help. Have studied this as much as I can.

      • Anonymous says:

        I had this problem for almost a year and it somewhat healed and I can run again. Not with the same speed and agility as before, but who cares, I can put in a run now and this injury doesn’t seem to flare up and stop me anymore.
        I am wondering if the supplement Glucosamine Chondroitin could help with this condition, as it is supposed to aid collagen repair. I took this for a problem I began having with my knee, and I really did notice a difference quite quickly. So now I wonder if would also help with repairing the hamstring tendon as well?

      • beccakahn says:

        Hi Vicki, That’s exactly what I’ve been reading up on for the past year. I’ve had my injury for more than 2 years and I’m sure it’s tendonosis not tendonitis as I pushed through it for several months. I’m going to see a doc for a consultation for Platelet Rich Plasma therapy injections (PRP) and the whole thing behind that is to cause inflammation so your body once again recognizes it as an injury and can heal it. I’m hopeful that this will help because 2 years of this is debilitating (plus I had hip surgery for FAI but that’s another story entirel and the hamstring injury is what got me into that mess!) Thanks for your input!

  162. beccakahn says:

    I was misdiagnosed and consequently had unnecessary sugery. The doctor failed to diagnose me with high hamstring tendonopathy and now I”m stuck with the consequences of hip surgery PLUS the hamstring issue. I’ve blogged about it here for those who are interested:

    • Cooper says:

      Hi Becca. Sounds all too familiar. I think you are on the right track with Prolotherapy. Make sure they are Hackett and Hemwall technique certified. I’ve read stories of those who have had Prolotherapy treatments from those who do not use this technique and had little success. Vickie is correct about ibuprofen. Also, prolotherapists do not recommend ice either. They say both will slow down the healing process. They are proponents of heat and increasing blood flow to the injury.

      I was ordered to do physical therapy however, I have not read anything that offered positive results for this injury. I’ve had my first Prolotherapy treatment of the recommended four. I don’t know if I am making progress yet. They won’t allow running or strenuous exercise during the treatment period. I’ve been able to do elliptical and biking for supplemental cardio. I’ve been subjected to only upper body work outs.

      Good luck and I hope you have positive results.

      • Vicki says:

        Hi Everyone, an accurate read on tendinosis is What is written fits with my experiences so far. There is information on PRP and other treatments. As always steroid injections and NSAIDS aren’t recommended for tendinosis.

        Eccentric hamstring exercises are advised but only at a later stage of the healing process with a gradual build up of very gentle exercises prescribed by a good PT that understands tendinosis. Even gentle stretching doesn’t come into it until later on due to the fragility of the tendon/s as this may well cause re-injury.

        I’m lucky, finally, after two years of no doctor knowing what I’m talking about, I saw my medical teams consultant pop up on TV at the London Marathon having been invited to advise on injury. It raised a smile anyway.

        PT and hydro pool work has just started. Homework: only allowed to do calf raisers 3 times in one week and that’s it! Next appt for both, this week. Hopefully things will start to gather pace. Stay positive!!

      • beccakahn says:

        Thanks for the info, Cooper, and please send an update on your progress!

      • Brenda says:

        I don’t know how to do a new posting, sorry….but please- has anyone had experience with Ischial Tuberosity Bursitis and/ or ultrasound guided cortisone shot in the area? I had an MRI, and Dr said hamstrings structurally in tact (which should be good news but I’m in horrific pain), but bursitis in different areas. He saw tendonopathy equal in both sides, so the explanation for extreme hamstring pain on left only is bursitis- but probably a strain-gotta be something wrong, and recommends a cortisone injection. The pain in the ham is much worse than deep in the Ischial area, but from what I read, the inflammation of the bursa can cause tight hamstrings (??). The pain when sitting but especially hamstring is so extreme, and watching the runners today is too sad because I am jealous. Honestly, your posts help- so even if no response to this plea, it helps to just hear anything from others in similar situations.

      • Dawn says:

        Hi Brenda. I’m relieved that you brought up Ischial Bursitis because I think that’s at least a factor, if not the main issue I’m dealing with but no one else here seems to have mentioned it. Unfortunately the prognosis for relief doesn’t seem very positive from what I’ve studied, which worries me. I’m scheduled for an MRI this Friday and I’ve been told it will be able to detect if the issue is with the bursa. I’ve had symptoms for almost six months and it’s really life altering! Best of luck to you. Would be glad to hear how your treatment works.

      • Brenda says:

        Hi Dawn- Definitely please let me know the results of your MRI! Where is your pain- isolated around the Ish Tub or also along back of thigh ham (proximal?) I ask because I don’t get how a shot in the bursa near the Ish Tub will help my hamstring pain. I mean I have read about the friction between Hamstrings and Ish Tub- that is where my shot will be, and anesthia properties of the cortisone shot- but trouble understanding it’s not a bandaid and will help my back thigh pain. Sorry about your 6 mos, we are in the same boat, I’m on 8. I keep reading and re-reading your post about prognosis is not good- meaning tendinosis or bursitis? Probably both… I fully agree with you on life altering. This blog helps me mentally, so thanks to all.

      • Dawn says:

        Hi Brenda, When I suggested Bursitis as the possible cause of my pain and asked if cortisone shots would help, the doctor told me he would refer me to Physical Therapy. Of course I’ll wait for MRI report but I’m having a hard time understanding how PT could help. The pain in my hamstring (which isn’t constant) feels like a cramped muscle but there is also very specific pain around the Ish Tub. When will you be getting the shots?

      • Brenda says:

        Yes, so after the MRI you’ll at least have a scientific diagnosis (though I read a lot about mis-diag)- wish I did it months ago. Your pain sounds very much like what I experience. I’ve been in PT since Oct 2013, and it’s almost more mental therapy for me- for someone to pat me on the back and say you will get better- that’s why I love this blog- but still hoping to hear from people on the other side of the injury. Afraid we don’t hear from them because that is rare if ever? I did ask if I should continue PT after he read the MRI, answer was ‘it can only help’. I know ham is tight, and stretching is a must- but not to pain- but then there is no stretch- do you make time for warm-up stretching without cardio. Cortisone is May 12…Dr said I can run without injuring or making anything worse (ham is not torn)- but I don’t understand that b/c when I’ve tried, the pain in the ham is unbearable after- so maybe he means after the cortisone.

      • Dawn says:

        Hey Brenda, My MRI confirmed a tear in the tendon at the upper hamstring attachment. It didn’t confirm bursa inflammation but I’m convinced that’s going on as well. Doc said he could do a steroid injection or PRP but would prefer to try Physical Therapy for six weeks first. Sounds like PT didn’t do you much good and I’m doubting it will do anything for me. Please let me know if the cortisone injection gives you relief. Like you, I’d sure be glad to hear some testimonies from people who are on the other side of this ordeal. Hope you’re feeling better soon!

      • Brenda says:

        Hi Dawn- Been hoping to hear from you- so a tear in the upper hamstring attachment, sorry to hear that- but on the plus side, at least you have a scientific reason behind the pain and can take it from there. You are right, you may have some bursitis also, or even a back component. For example, the back L5 S1 goes into the back of the thigh. From what I gather, this is a rare and not well documented set of injuries.

        Plus, the body naturally wants to heal itself, right? I asked if someone has HHT but no PT, would the body heal, answer was a very hesitant yes but maybe not correctly. I read about HHT, and things such as PRP, Gastron, dry needling, as obsessively as I use to think about and document my runs. But overall, PT is the less invasive, and more relied upon route. Two Ortho and my primary recommended PT. But here I am months later, still in pain, still can’t run much, $1000s out, but I have learned a lot that I wish I knew Aug 2013. Such as, if your body is sore, take time off to let muscles recover.

        If you were vigilant, you could go the route of you-tube to find exercises, but PT guides you in not overdoing it, and doing things the right way. It also helped to learn about the body, healing, what affects what- like who knew about the hip flexor- but…the cardio/ actual exercise part could be more aggressive. From what I read about tears and tendinosis- if that is a tear- you need to strengthen the ‘things’ around the tear, to help support it. Did the Dr say how much of a tear- like more than 50%?

        Is surgery an option for you Dawn? I’ll report about the cortisone shot- learned for some it helps, some not at all, and some need more than 1 shot. Arg!

        Also thanks for Vicki and all postings- I read, re-read and digest all this information.

      • Dawn says:

        Good to hear from you Brenda! Here’s the thing; I did three years of training in The Alexander Technique; something few people in this country have heard of. It has to do with intelligent/conscious use of the body (whole self actually). And what I learned will sometimes go contrary to traditional physical therapy. So I can’t help but approach PT somewhat skeptically. Furthermore, yes, I do believe the body naturally heals itself and I don’t want to do anything that works against that process. I’m going to see the Physical Therapist next week. I will be open but I won’t negate the intelligence I believe I have about my body. Injections? Yikes! I truly hope it won’t come to that. But I’ll be anxious to hear of your experience. If it works, I won’t choose to suffer rather than try it. Blessings to you!

  163. Vicki says:

    PRP and prolotherapy are two different treatments. Cooper would you keep us up to date on how you progress please. Many thanks. Best wishes everyone!

    • Cooper says:

      Hi Vickie. I will keep you informed. My second treatment is in a week. They are performed 4-6 weeks apart. The down side is insurance (mine) won’t cover the treatments. They call it experimental. What’s sad is they would pay for drugs and surgeries that don’t work.

      The clinic that I researched used the term Prolotherapy for 3 types of treatments. The Fatty Acid/Sarapin, PRP and Stem Cell. I assume the term Prolotherapy is the treatment/technique? Feel free to visit their web site It is an interesting and informative read. Good luck and I’ll keep you posted.

  164. Ray Bartlett says:

    I have this problem you had!!!Do think a stationary bike is ok while rehabbing?

  165. kristin says:

    I’m interested to hear from someone on the other end of this injury. I first noticed a slight twinge at the end of July 2013. It didn’t stop me from playing soccer or running and would come and go. By late August it was very noticeable, but I’ve always just pushed through everything and magically things would disappear. Finally Sept I gave up my half-marathon training/plan for mid October, stopped playing soccer, went to the doc, and did PT for 1 month. PT was fine, but i’m disciplined and go to the gym regularly so the doc said I could just do exercises myself instead of coughing up a co-pay 2-3x per week. I was able to jog/walk by around late November and over the next month or 2 increased from around 1 mile to 3 miles with minimal discomfort. (compression shorts really helped at this phase). Then I was able to SLOWLY jog 4 miles fairly consistently as long as I gave myself 1-2 days rest in between. I haven’t touched a soccer ball since September and I’m pretty sure that will be the last thing to return (if ever). My ass still hurts here and there when I sit, but it’s more of a general discomfort than the searing pain I previously felt. Now I think I’m at a standstill. I saw gradual improvements before, but I can’t seem to progress any further. Every couple of weeks I have to take about a week off then start over again. Overall my strength has increased in my hams and glutes and have been slowly increasing reps/weight for deadlifts (normal & 1 legged), good mornings, squats, all sorts of rubber band shenanigans… but I’ve reached a point where I’m stuck. Not in the horrible pain from the beginning, but in limbo that waivers between being able to slow jog with no pain for a few weeks to general discomfort when sitting to uh-oh, need to take a few days off. This is a depressing injury, but at least I was seeing gradual, small gains before. Has anyone actually recovered for a significant period of time without relapse? how do you get over the limbo hump?

    • Nikki says:

      I think I’ve recovered. I’ll never be back where I was. I think a sub 4 hour marathon (which I did once and KNOW I could do better) is unattainable without a flare up, and it’s a risk I’m not willing to take. I went into physical therapy September 2012. I took 8 weeks off running, and then slowly began running again. It took me another three months to get back up to running 13 miles. I ran a marathon in Dec of 2013, a 50K March 2014 and a 50 miler April 2014. I’ve done all this without a single flare up.

      Here’s what I learned. My pace will never be what it once was for any distance over a 10K. I cannot do speedwork, and after long runs I need to take 2 days, minimum, off running. I ice and stretch after every run now too. I’ve learned to love cross training. I now swim, bike, and do various cardio machines at the gym. Finally, I learned to listen to my body. If it hurts, beyond normal running pains, DO NOT PUSH THROUGH THE PAIN!

      Now, having said all that, that 50 miler gave me a different issue in my other leg. My body pisses me off sometimes!

  166. Anonymous says:

    anyone have any experience with trying to maintain a base? is it worth it? I have had this hamstring strain lingering for over a month now, and it doesn’t hurt to bike and elliptical, but I do not know if this is prolonging the healing process?

    • Vicki says:

      Hi Everyone,

      Firstly, this is a long one – apologies.

      Brenda, I’ve had an MRI and get the results 8th May. I’ve had Ischial tuberosity pain both sides but left side worse for 2 years. I worked out I had at least got HH tendinosis. This is confirmed. However, will know more soon re bursitis etc. Now here’s the thing re steroid injections. I was against the idea but was persuaded by a top private doctor to have one (turns out later, for his own gain. Confessed after he injected me, he did so because he wanted to get in at my medical company I worked for!). Now I don’t want to put you off having this because we may have different problems but it gets worse. The pain was awful over next few days. I called him and he sounded panicked. Which alerted me to the possibility that he’d bowled a rickett! I did further research on internet after the jab to discover one should never inject steroid into a tendon, it should go into the inflamed tissue around the tendon so when I called him and he was panicked the pieces started to fall into place.

      His medical report arrived and he left out that he’d injected me with steroid and made stuff up about how he had consented me. This didn’t happen. After several phone calls and emails to him to get the report corrected, he sent an amended copy saying he’d used steroid but didn’t say where! Finally, I emailed him to say he had caused me anxiety and I was seeing my GP later that day because of it and wanted the correct version of what actually happened.

      This prompted him to send a third amended medical report with a place of where he injected me. This may or may not be true. I’m certain he’s stuck it in my tendon. I buried this mentally as there was nothing I could do. Spoke to a neighbour (radiologist) who said if he has, it’ll be in there at least a year because it’s got nowhere to go.

      In January this year, my tendon was physically examined by an ST5 who works at the dept that was built for the London Olympic athletes. He gave it a good going over to feel for scar tissue. The next day I felt like I’d been given another steroid injection! The symptoms went on for a month and I’m certain this pushed some of the steroid out into the blood stream. I’m hoping it pushed out the last of it but who knows.

      So that’s my experience but all that aside, it’s common knowledge that steroid is a short term fix for pain but in the long term it eats away at the tendon and sometimes bone. I’m sure you have already but if not, google steroid side effects. There’s more negative reading than positive.

      I’d like this to be a positive post for people, although it’s not at least it brings another person’s experience.

      I’m going to ask the ST5 if he would syphon off the tendon with a needle to see what comes up.

      I’ll keep you all posted and as always wish you the best of luck. Stay positive!

      • Dawn says:

        Hi Vicki, I really appreciate your post because I’ve felt like I would reject any suggestion of steroid shots and now you have helped to confirm my sense that this would be a waste of money and time with no hope of reduced pain. I’m having an MRI on Mon next week, yet even that may be a waste as I’ve yet to hear anyone say they were directed down a path to pain resolution even IF they got an accurate diagnosis. Not to mention that many seem to have been mis-diagnosed after an MRI! Like Brenda, I’m beginning to feel that the most comforting “treatment” is being able to share the burden of this mystery (misery?) with a supportive group of others. So thanks to Golden Trails for starting this blog!

  167. holly overman says:

    Thanks for this post. I myself have been dealing with this Injury for 11 weeks now. I have a complete rupture, I’ve been thru pt and just got a steroid injection into the tear. This is a very frustrating injury. I haven’t been able to walk free of pain yet. I’ve been resting it and now on bed rest to see if it can heal, as a last resort before surgery. Your article is very helpful, and reminds of the daily struggles I myself have and am dealing with. Its no fun on the sidelines.. I just want to be back to normal. The one thing I have learned through all this is patience, something I never had before.

  168. I haven’t run again now for 5 weeks due to a relapse following a 10 mile run. Something I’ve recently realised is that affects this injury for me is gardening, I’ve been doing a lot of digging and carrying of heavy bags of soil and I’ve noticed my hamstring tendon is extremely sore the day or 2 following this work.

    • Phil Dawson says:

      Hi Kevin, Had to smile at the gardening comment. While no laughing matter, I agree 100%, gardening doesn’t help. I have been suffering for 8 months with this HHT problem. Trouble is no matter how much you try to rest, life must go on and unless I get my wife to do everything (unlikely :-)) I’ve just had to try to minimise the things that aggravate it. I’m 62, and was running 200 miles a month when I got injured. and not knowing what I had initially, made all the mistakes of trying to return too soon and doing inappropriate excercise, or more accurately, doing some of the right exercises but too soon (strengthening not stretching). I am going to a physio for deep tissue massage but really don’t know how much good it’s doing yet. I have discovered that the only Gym equipment I can use without affecting the injury is the stair climber (bike, eliptical, rower are not painful, and I can go pretty hard at it, but I get symptoms later). I guess I’m lucky in that I’ve had 35 odd years of running however, I want more so I’m not giving up yet….in the meantime, where’s my goggles 🙂

      • Hi Phil, I’ve had this injury for 3 and a 1/2 years now and without wanting to sound defeatist, I’m fairly confident I’ll never fully get over it. I’ve tried all sorts without success and after reading lots of others posts on here, i don’t think I’ve read about a single person who is yet to completely beat HHT. What I’m no longer sure of, is whether it’s the running or the gardening that did it. However, I’m pretty sure it’s the gardening that’s really made it flare up this time and not the 10 mile run I thought it was. The great thing about that, is that before the flare up, I was back to running 10 miles at about 9 minute mile pace, so now I’m hopeful that once I’ve finished my current (rather large) project in the garden and I rest a bit, I may well get back to double figure running again. 🙂

  169. Sara says:

    I have been struggling with this since last June. I saw a PT for 3 months, but she was basically treating it as sciatica, and the symptoms have since morphed into ones consistent with tendinopathy. After some time dealing with it, I stopped running altogether with the exception of a mile here or there to “test” out how things were going, and each time I knew I wasn’t ready to get back into it. Instead, I have been doing the same amount of physical activity (about 1-1 1/2 hours of cardio each day) on the elliptical, bike, stairmaster, etc. While I don’t feel the pain nearly as much when I do these activities, I do feel it sometimes, especially if I’ve gone for over 45 minutes on the elliptical.

    About 2 months ago, I started doing some eccentric exercises to help strengthen my hamstrings (single and double-leg dead lifts, single leg sit-to-stand-to-sit with a particularly slow return to sitting) as well as bridges to strengthen my gluts. I am definitely noticing the muscles being strengthened, but I’m not yet noticing any decline in the mild aching at the top of my hamstring.

    Do you think I need to cut out all cardio activity for awhile? I perceived “rest” to be rest from running, which I have been diligent about, but I have not been all that great about truly resting from cardio. Is it possible that these other forms of cardio are preventing me from healing?

    Thanks for any input you might have!

    • beccakahn says:

      I”m so happy you asked that question. I keep wondering if by “just” doing the elliptical and not running whether I’m putting myself at further risk. I haven’t run in 2 years and it’s not better 😦 I just had an MRI yesterday on my hamstring and hip and can’t wait to hear the results.

      • Cooper says:

        Been injured for over 5 months and quit running 9 weeks ago to undergo Prolotherapy treatments. Both my sports doctor and prolotherapist suggest low impact cardio…elliptical, swimming etc…to minimize impact trauma to the proximal tendon. Running, squats, lunges or any high impact workouts involving the hamstring muscles are prohibited during the healing process. Aside from elliptical training to keep somewhat of a cardio base, I have been working upper body and calves. I am advised to make a concerted effort to avoid the putting undo stress on the hamstrings. Committing to time off from running is difficult but will hopefully pay off in the long run. The Prolotherapy treatments are designed to speed up the healing process by regenerating damaged tissue. I hope this answers your question. Good luck!

      • Vicki says:

        Cooper would you let us know how you get on with the prolotherapy.

        I had my MRI results Thursday and have HH tendinosis in both left and right side due to running and desk job. There is good news, no scarring, tears, bursitis or ruptures.

        Am having physiotherapy and hydro pool treatment but was told “I may never recover and this could be a permanent situation”. To be fair, I did say I like it straight. As I can’t sit down, work, drive etc. this won’t be a permanent.

        I’m not paying too much homage to it as attempting to stay positive due to strong evidence mind over matter is a contributory factor to the repair process and you can fully recover from tendinosis. Just hoping I’m one of them. Been over 2 years.

        Have decided If I get to January 2015 and no joy, I’m considering either prolotherapy or surgery to remove weak repair cells.

        Best wishes and good luck to you all.

      • Cooper says:

        Hi Vicki

        Glad to hear MRI pinpointed the damage. I have had my second Prolotherapy treatment. Since I cannot run, the only activity that I can gauge progress is sitting in car for long periods. The flare up in the glutes have seem to have subside. Have third treatment in a few weeks. I took the liberty of copying and pasting from the clinic’s web site regarding tendinosis. See below. This is why I chose to skip wasting time on PT and decided to try the Prolotherapy treatments.

        The typical tendinosis treatment, the degeneration of a tendon after an injury that was not allowed to heal properly, is to stop whatever activity involves the affected joint and rest. Since this condition often afflicts athletes, this means no more training and no more playing the sport. If a person does not feel better with rest, the person may be referred for physical therapy or be prescribed non-steroidal anti-inflammatory drugs (NSAIDs). Other modern medical treatment options include cryotherapy and massage. But, although they may provide temorary pain relief, they do not address the root of the problem – weakened and/or injured tendons and ligaments. Often a tendon issue becomes chronic and the person is finding it more and more difficult to perform daily tasks without feeling a nagging pain, let alone participate in sports to the level at which they were prior to the tendon injury.

        What does a degenerated tendon need? Regeneration! This is why Prolotherapy (“Prolo” for proliferative injection therapy) is the ideal treatment for tendon injuries, especially chronic cases. Prolotherapy injections at the site of the tendon attachments, as well as any tender or lax ligaments that also support our joints, offers excellent results. The Prolotherapy solutions trigger the body’s immune/healing components to concentrate on the area. This surge of blood flow to the area gives the tendon/ligaments a second chance at healing. In our office, we typically see that, three to six treatments are needed, in total. A better approach is to treat the degenerated tendon with . In addition, treating the ligaments in the affected joint with Prolotherapy can also be very effective. This is because tendons and ligaments reciprocally affect one another, with the injury of a tendon causing ligament stress and laxity, and ligament laxity causing further tendon stress. It’s a vicious cycle that Prolotherapy can end. This approach will encourage the damaged tissues to heal as quickly as possible, restoring the tendons and ligaments back to their pre-injury state over time.

    • Dawn says:

      I never was a runner, just lots of walking before I developed this pain after some yoga classes. And I haven’t done any cardio since it started last November. I’ve just started doing some very gentle stretching at the recommendation of a PT doctor. Too soon to tell if that’s going to help. But my point is, if NOT doing any cardio was going to help, then I should have improved by now.

    • marko says:

      Hi Sara, Im in same situation as you. Fighting it for a year now. After coupIe of unsuccesfull comeback to running I have completly cardio, stretching, rolling, core workouts … but recently, 1,5 month ago, went to gym. Im working on my glutes, hams, quads, hips and core … Roll the hams at the end … I can listen to my body now, so Im avoiding stuff which is making my pain worst.

      Only thing I dont do, as Im not ready, is streching it. Tried it few times, but it was realy bad after. Always brought me 2 steps back.

      My plan is to try to run again beg. of june, graduatly return following a 6 week program (walk, run, walk, run ….).

      Good luck. All the best,

      • marko says:

        “After coupIe of unsuccesfull comebacks to running I have completly CUT cardio, stretching, rolling, core workouts …” 🙂

    • Tiffany says:

      I’ve been dealing with this since March, but continued to run on it throughout the summer. Had an MRI that showed inflammation and an edema where the hamstring attaches to the ischial tuberosity. Have been doing PT for core, hips and glutes. I now haven’t run in almost 3 months except for 2 1-mile test runs (which I felt NO improvement). I was told cycling was fine – with little resistance. I think I set back my healing doing yoga (was told by the PT that the forward bends are too much), pushing the cycling in spin class and using the stair climber. I’m wondering if the cycling is causing issues too?? Your question is the same as mine – I’m having a hard time truly resting from all cardio and I’m wondering if it’s making things worse. I don’t see how I can just really do nothing. Have you had any improvement? Did you try ART?

  170. Vicki says:

    ** meant permanent not a permanent! Tut! Lol!

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  172. beccakahn says:

    Have any of you tried Ondamed for your high hamstring tendonosis? I’m starting treatment tomorrow. Fingers crossed this could help, although I’m pretty skeptical.

    • Vicki says:

      I hadn’t heard of Ondamed until you wrote about it. I’ve just read about it and sounds promising. I tried ultrasound but the guy whizzed up the machine too high to an 8 without discussing (he said after the event “to stir things up”). This sent my RSI off the scale. Good luck. Looking forward to hearing how you get on.

      Connor – How are you following prolotherapy?

      • Cooper says:

        I believe you meant Cooper? I’m a week away from my third treatment. Very difficult to gauge since I’ve been benched from running (10 weeks and counting). After the third treatment they might allow me to do run/walk intervals. As mentioned, my only test is enduring long trips in the car. Inflamation in the glute seems minimal. I’ll keep you posted.

        How is PT working for you? I hope you find some relief. Was the info I sent on tendinosis from a Prolotherapy perspective helpful?

        Becca, what is the philosophy of Ondamed??? Sounds interesting? Conventional methods do no seem to have any effect on this injury. Would like to hear more about the treatment.

      • Vicki says:

        Hi Cooper, very sorry about the name change, been off work for a while now and brain slowing down. Thanks for posting information regarding prolotherapy. To be honest I’ve just read it . I’ve been on here several times but missed it amongst other posts.

        I’ve ear marked prolotherapy if rest and physio don’t do it. It’s giving me hope knowing there is a back-up plan.

      • Brandon says:

        I went and read up some on ondemed yesterday… sounds like its something similar to ultrasound therapy… shooting of sound waves into tissues to loosen/stimulate activity/repair… for ondemed they describe it at electromagnetic energy. Well, sound waves are part of the electromagnetic spectrum so its a type of electromagnetic energy (as is your microwave and the energy from the sun), so I can only guess that this is a different wavelength than traditional methods. The goal of the process seems to be stimulating your body to send proteins and other repair machinery to the site of injury… they also describe one of the most important facets as the feedback mechanism.

        As someone thats been dealing with HHT for 2+ years (albeit at a lower grade pain than many here) its a tempting treatment option since no one I’ve talked to seems to have a good answer to how to proceed… but im unlucky enough to be in a state that has no doctors using it… only a dentist… not sure i want a dentist trying to treat my hamstring. =]

      • beccakahn says:

        Thanks for explaining this so well. I’ve had HHT for 2+years as well and like you, nothing has helped. So, I have nothing to lose but money (it’s 50 bucks a pop and she told me I probably need 7-10 treatment to see if it worked or not) That’s hilarious about a dentist trying it. She has my body choose the programs it needs, so to speak. Basically she takes my pulse and that’s how she finds the correct frequencies to use. She programmed it for scar tissue, tissue regeneration and one other thing (I forget already).

      • Brandon says:

        Do keep us up to date on your progress. I may consider calling up the dentist if you have good results =]

      • beccakahn says:

        Will do! Anything to help.

      • Cooper says:

        No worries. Glad to hear you’re hanging in there. Much luck with the PT.

        Brandon, thanks for the synopsis on Ondamed. Sounds interesting. Same concept / different approach as Prolotherapy. The philosophy is triggering the body’s healing response to the injury site and allow the tendon and surrounding ligaments to regenerate.
        Good decision on the dentist.

        Becca, please keep us posted on your progress. FYI – 50 bucks a pop sounds reasonable
        If it works.

  173. Kate Noble says:

    Help. I tore my hamstring following a fall, ironically as I was pulling my overweight and extremely unfit body round a circuits class nearly 3 years ago in an attempt to change. I went straight into a&e who simply checked that I had not broken a hip, gave me painkillers and sent me home. The thing I do remember from the examination though was being unable to do a leg lift whilst lying prone. I am still unable to do this and get cramp in the hamstring when I lift my foot backwards whilst keeping knees together. I feel like I am never without pain in my hamstring although I can walk substantial distances. Running is out of the question. Any suggestions on a) what it could be and b) how can I treat it whilst living in rural scotland and therefore without access to most excersice classes.


    • Anonymous says:

      Hi Kate, see your gp for an mri referral. Before any treatment you need to know what your treating. Not sure exercise classes will sort out pain in your hamstring.

  174. Brenda says:

    Denial- that is the only way I can explain why I am still running- that and I’m not convinced rest does anything for this. Has anyone experienced where you can run ok for 3 weeks (meaning every other day, just a few miles)- and then the familiar soreness and aches come back- on the upper hamstring, especially where the sit bone is- making sitting on ice the only option. After injury (?) Aug 2013, finally in Jan 2014, I could run again, then terrible pain came back…took 3 mos off, and now I’m in the same situation-after only running for 2-3 weeks in May. Other cardio does the same- even bike makes me sore.

    MRI showed bursitis, and I was going to have a cortisone, but cancelled because I felt better…now I wonder if I had the shot would I be in this pain now. Strange to understand how a shot in the bursa near the sit bone will help the hamstring long term. Life has not been the same since this started. Scary to hear from people who have had this for years. Need some hope please.

    • kfrisc2 says:

      Hey Brenda
      In NO WAY am i recovered, but i have experienced similar issues. I was able to run 4ish miles (slow) about 3 times a week a few months ago with minimal pain, but still had soreness after sitting. I thought I was improving and would eventually get back to real mileage, but suddenly everything started hurting from my hamstring, upper ham area, butt, hip, and even lower back for no apparent reason. It was absolutely depressing. Then I started feeling better my opposite glute hurt, but in a different way. I basically “gave up” and stopped running for about 3 weeks and started walking once I could tolerate it. I missed the feeling of working out so I signed up for swim lessons to learn how to swim laps for exercise (I know how to “swim”, but never tried it for exercise). The thought of jumping in a cold pool always seemed horrible to me so I never gave it much thought, but i NEED to have the feeling of exercise in my life. It has revealed a few things to me 1) I’m totally out of shape 2) it does not hurt my hamstring and 3) even though I’m just starting out I feel much better about my situation because i have an outlet to exhaust myself and it makes me feel like i’m doing something. Currently, I am not running any more than about 2 miles 2-3xs per week and do not plan to up the distance for a long time. It’s been hard because previously i would run 25+ miles per week along with 2-3 soccer games and a calendar full of distance races. The swimming, however, has given me another activity to “learn” and an outlet to get some fitness in without straining the hamstring injury. July will make 1 year since I first had a “twinge” and last September is when i stopped running to go see the doctor. I think strength training has helped in my recovery, but it’s very easy to overdo it without knowing until the next day. I had a cortisone shot in November – I don’t think it actually did anything. I feel better this week than I have through the course of this injury and have learned not to jump into anything. Previously, I was trying to up my mileage slowly to build back up to my old self and “maybe” be able to run certain races in the future. For now, i have given up, (if you will) run only tiny bits, and will be increasing the swimming. I in no way love swimming, but i do like that old feeling of being exhausted from exercise (which isn’t hard because i’m new to it and… totally out of shape).

    • Dawn says:

      I guess I have to add to the repeated pattern expressed here of what does NOT seem to help. Physical Therapy, no. Steroid injection, no. At this point I’m hoping time and attention to nutrition will bring healing. I’ve definitely lost hope in any quick fix.

    • Cooper says:

      Below are a few paragraphs from an article I read on high hamstring Tendinopathy. I hope this sheds a little light on some of your concerns regarding traditional methods of treatment. Link is below:

      “Occasionally the damage to the tendon in chronic cases can be severe enough to cause irritation of the nearby sciatic nerve, thus producing symptoms of referred pain down the entire back of the leg which are more typically associated with herniated lumbar disks. The pain is typically worse when the patient is seated on a hard surface, and after running, especially at faster speeds.”

      “There are several other conditions that can produce a similar symptom complex. Herniated lumbar disks and sacroiliac ligament strain both refer pain into the deep buttock area.”

      “We also never inject steroids, which is another favorite of orthodox physicians despite the fact that long term outcome is clearly not improved by this approach, and there are possible cadverse complications. Since steroids can weaken tendons, care should be taken to avoid injecting them directly into the tendon.”

      • beccakahn says:

        I’m scheduled to have a PRP injection on June 25. Just wondering if anyone knows whether prolotherapy is more/less successful.

      • Cooper says:

        Hi Becca. They claim to have a 90% success rate. Jury is still out for me. I’ve had my third treatment in 11 weeks. Still been advised not to run to enable the tendon to strengthen and regenerate. I’ve invested 11 weeks taking treatments and avoiding high impact exercise. I do notice improvement when sitting in the car for long periods. I have less inflammation in the glute area than before I started treatments. That is a positive sign. The true test will be when they allow me to resume running. The Prolotherapy solution I am receiving is a blend of dextrose, fatty acids and Sarapin. It is a little less expensive than the PRP or Stem Cell Prolotherapy treatments but they are supposed to have a faster recovery time. As I mentioned in a previous post, make sure your therapist uses the Hackett-Hemwell Prolotherapy. PRP given alone is typically one shot in the in the injury whereas Hackett-Hemwall Prolotherapy is around 30 injections. Below is some info from an article I read on Prolotherapy….

        “Prolotherapy injections are definitely the fastest route to recovery from high hamstring tendinopathy. The only possible danger from prolo for this disorder is the proximity of the hamstring tendons to the sciatic nerve, but proper experience and technique will always avert any problems in this regard. Return to full athletic activity is speeded up by “prolo,” and it is the only treatment of all available that actually stimulates the body to heal the damaged and painful area, for permanent relief, via the deposition of additional tissue strengthening collagen which becomes an intrinsic part of the tendons treated, restoring strength, elasticity, and functionality.”

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  179. Chas says:

    I had two PRP injections over the course of my 15 months from injury to recovery to running and I am confident that without PRP I might never have returned to running. That brings me to my current situation: I started running in October after recovering from my first hamstring tendon tear, built until I was doing indoor 200s in January, and I tore it again. Too much too soon! I struggled with PT and chiropractic from this February until May figuring that I had learned so much the last time that low and slow and strengthening would get me back again. No help. I had PRP 5 weeks ago and I am already at the bridging strengthening phase and yesterday I did some isolated hamstring eccentric curls- probably too much- so I’ll back down to bridges again with a little more weight loaded on the bad side. Progress, but slow. PRP is expensive, but I clearly have reached a healing/strengthening phase that 4 months of rest, dry needling, laser/ultrasound and gentle strengthening could not reach.

    • beccakahn says:

      I just had my first PRP injection last Wednesday. I start PT a week from this Wednesday (so 2 weeks after the injection). It’s been 5 days and I’m still rather sore. I still have to sit on pillows and ice several times a day. Do you remember how long the initial soreness lasted? And is 2 weeks without PT too long of a rest period? After suffering from HHT for 2.5 years, I want to make sure I get this right!

      • Cooper says:

        Having had 4 Prolotherapy treatments so far (similar to PRP) , the soreness lasts 1-2 weeks. They intentionally inflame the injury to provoke the body’s natural healing response. They recommend no lower body work for 4 days after the treatment. The first couple days, it is normal to feel tender in the glute area. How many PRP injections did they give you?

        I am surprised your therapist is allowing ice after treatment. See below:

        Why RICE prevents healing
        All of the components of RICE – rest, ice, compression and elevation – are designed to decrease swelling, and pain, by decreasing the circulation to the area, which is exactly what ligaments need to heal faster. Rest, compression and elevation, that is, immobilization, is extremely detrimental to joints and ligaments. It lowers the metabolic rate in the area. Ligaments heal slowly by nature, and they take twice as long to heal if immobilized. The fibro-osseous junction, the principal site of Prolotherapy treatments, heals even more slowly. Ice has a similar effect. And while lowering the temperature of an area is critical for certain surgeries and limb-salvage operations, where a lowered metabolism can mean the difference between success and failure, this is not so for injured ligaments. Ice leads to lower temperatures, which leads to lower metabolism, which leads to slower healing! And to make matters worse, injured athletes often continue their activities after getting “relief” from RICE, making themselves susceptible to further injury. Here’s why. The colder a ligament, the less force is needed to deform it, which is one of the reasons many athletic injuries occur in cold weather. In summary, anything that decreases the metabolic rate or blood supply to ligaments, such as rest, immobilization and ice, will further promote the decline of the ligaments, and profoundly delay their healing.

        Hang in there. I think the PRP is your best chance for recovery. I have not read any success stories about PT. Personally I saw it as a waste of time and money. It is a slow process, but if you do it right, you might be running in no time. 2.5 years and still no results should tell you that traditional methods do not work for this injury.

        This is the first week after 4 treatments that they are allowing me to run/walk. It has been about 4 months since I stopped running. We’ll see how it goes.

      • beccakahn says:

        Thanks, Cooper. Yeah, I kind of wondered why he said I could ice. I’ve stopped it now. I only had one PRP injection and I dont’ see improvement after 6 weeks they’ll do another one. They only do one at a time as opposed to Prolo where they inject in several spots.

      • Cooper says:

        Interesting! I hope you have a rapid recovery! The clinic I go to refers to PRP treatment as done just like any other Prolotherapy treatment, except the solution used for injection is plasma enriched with growth factors from your own blood. It is my understanding that the Hackett Hemwell technique is the reason for multiple shots of solution in and around the injury. They refer to Dextrose, PRP and Stem cell treatments as a form of Prolotherapy.

        Below is the protocol my clinic uses in lieu of RICE. I agree, Ice does feel good when your sore and it took awhile for me to get used to sitting on a pillow with a heating pad. I guess getting blood flow to the injury is key. I hope you find the info below helpful. I’ve learned quite a bit from this blog and I hope to pay it forward.

        The MEAT protocol, and why it promotes healing
        The more conservative, and effective, treatment for acute injuries to ligaments and tendons is the MEAT protocol. As mentioned earlier, MEAT stands for movement, exercise, analgesics and treatment. While immobility is detrimental to soft tissue healing, movement is beneficial because it improves blood flow to the injured area, removing debris. One of the effects of movement is the generation of heat, which increases blood flow. This is why the application of heat is also recommended for ligament and tendon injuries. Gentle range-of-motion exercises also help improve blood flow to the injured area. Natural analgesics, or painkillers, such as proteolytic enzymes, which break down proteins, aid soft tissue healing by reducing the viscosity, or stickiness, of the extracellular fluid. Examples include bromelain (from pineapple), trypsin, chymotrypsin and papain (from papaya). Reduced viscosity of the extracellular fluid in turn increases nutrient and waste transport from the injured site, reducing swelling, or edema. In other words, natural analgesics decrease the painful swelling of soft-tissue injuries but do not stop the natural inflammatory reactions that lead to healing, unlike anti-inflammatories, which can actually hinder healing.

      • Cooper says:

        Becca. Hope all is well. I wanted to check on your progress. Did you find any relief after the first PRP treatment?

      • beccakahn says:

        Hi Cooper, Tanks for asking about me! It’s been 6 weeks and it’s been interesting! I still have the same pain sometimes but it’s been mainly replaced by a different kind of soreness. Instead of the deep ache, I now have a more surface soreness almost like I worked out too hard. I’m wondering if that’s part of the progression of this and a good sign or not. My surgeon said to give it a few more weeks and then give him a call. At that time he’l assess whether I need another one. I feel like I will, especially since this has been a 2.5 year injury. Any thoughts? I know it takes months to heal if it works but how much improvement should I be seeing at this point? Thanks!

      • Cooper says:

        Hi Becca. I am no expert and can only share my own healing experience. I believe if you are experiencing a different kind of soreness, that is a good sign. Hopefully the tendon is regenerating. PRP is supposed to work quicker that the dextrose/ fatty acid treatments I’ve been receiving. You might need 2-3 treatments. My therapist who is also an avid runner had an ankle injury that required 3 PRP treatments.

        My therapist advised me not to run for the first 4 treatments. Up to that point, I could only gauge progress by how I felt sitting in the car for long periods. Each month gradually got better. It was sore but not as inflamed as when I was first injured. Two weeks after the 4th treatment I was allowed the start run/walking at 2 minute intervals. It was still sore but in a different way. I also added lower body strength training with very light weights. For 6 months I had avoided any hamstring exercises so I am sure the muscles had weakened over time. I had a 5th treatment a few weeks ago and will resume the run/walk regime. I hope to graduate into longer runs (no walk) as the hammy allows.

        Be patient and avoid the temptation to jump right back into running. I have not been injured as long as you, but I hope with the Prolotherapy treatments along with a little patience, I will accelerate what seems to be a very long healing process. All I have been doing since the first treatment is upper body strength training along with elliptical training and sitting on a heating pad In the morning and evening. It gets frustrating, however, it would be worse to have wasted all this time and money to come back too soon and re-injure the tendon once again.

        I think you’re on the mend if you feel any noticeable change since the injury. You can read more about PRP on this sports rehab web site:

        Thanks for the follow up and I am anxious to hear how you progress.

  180. Anonymous says:

    This confirms what I’ve experienced. Started P.T. reluctantly (persuaded shall we say by my treating doctor) two months ago. Very gentle exercises, no stretching. I said to both the doctor and physio if they give me anything to do that I know will aggravate the H.H. tendons, I’m not doing it. Been there too many times before. The exercises were ok to start with but I noticed previously, when I opted for no intervention at all and self care at home, after 5 months of rest and what Cooper describes above (MEAT but didn’t know it was called this) I was almost pain free, a 1 on the pain scale. Was eating pineapple everyday too. Only gentle exercise I was getting was walking and not very far or fast. Was just starting to tentatively sit.

    This was when a long awaited appointed was given to me at a top hospital. I really felt I shouldn’t go but was talked into attending “as it was a good opportunity that I shouldn’t waste” .

    At my first appointment, the doctor examined the tendons and was so harsh with it that night I was back up the pain scale to a 6/7. After a minute and a half of squeezing them, I asked him to stop but I knew the damage had been done.

    I’d lost 5 months of restrictive rest and my job, income, driving and social life. This was a low point. While I waited for the physio appointment to arrive (with same hospital/team), I continued to rest and was back down to a 3 after a couple of months. Started the physio and two months in they increased the load/exercises and am now back up to a 6/7.

    Then the doctor told me he’d discussed my case with the physio and they’d both agreed I was never going to get better, the cells had changed permanently and it was irreversible. When I saw the physio next I mentioned I was feeling low since being given the bad news and he draw a blank saying why what’s happened? I recalled my conversation with the doctor and the physio flatly denied he’d ever said it. I asked him if MRI scan’s show cells (wondering how the doctor could possibly know that my cells had changed irreversibly) he laughed saying if you could develop a machine that did that you’d be very rich! I really like this guy.

    During my appointment with the doctor he said I needed to go onto Amitriptaline (a pain killer which it turns out is an antidepressant too) and eventually have anaesthetic injections (I assume for life i.e. top up when they wear off) and do home physio for life.

    I’ve discharged myself from their care, explaining the best success has been when the tendons were left alone.

    Personally, through experience, leave it alone if you can. I know many have to continue sitting for their work so PRP is the only option. I now haven’t sat down since last August and will continue with this. If eventually I don’t get better, I’ll try PRP.

    It’s an overuse injury that requires the opposite to heal – under use.

    I apologise, I sound frustrated. Cooper you seem to be taking it much better than me. I’m also on 2.5 years with this.

    • Cooper says:

      Thanks for sharing and I feel your pain (literally). Sounds like you started out with the right approach. It is so damn confusing when you listen to all of the different approaches to this injury.

      Medical professionals are almost predictable with a menu of cortisone shots, physical therapy and surgery. This is often misdiagnosed! I have not heard of anyone making a recovery with these methods. We do it anyway because our “doctor said” and he would never steer us wrong??? Cortisone does more harm in the long run in terms of breaking down soft tissue. You feel great until it wears off. The pain is gone so therefore you continue to exercise all the while you are causing more damage to the injury!

      After doing much research and listening to our fellow athletes on this blog, one could conclude that modern medicine does not work on this chronic injury. I injured myself 7 months ago. I treated the injury like any pull or strain that I’ve had in the past. No progress in 3 of those 7 months. I realized the pain was higher than most hamstring injuries. I read that the proximal tendon can get worn out where the 3 hamstring muscles come together. Especially common in runners. There were some great articles about HHT. I went to a sports doctor who confirmed HHT and prescribed PT. I couldn’t understand how PT would help for this injury. I believe that PT is necessary for many injuries and surgery recovery but not HHT. I skipped PT and went right to Prolotherapy. The philosophy of triggering the body’s response heal itself made much more sense. (You did the same thing with pineapple) The concept of Prolotherapy, PRP or Stem cell treatments seemed like the logical answer. The link below is to a very informative web sight regarding all 3 types of treatments.

      I too am very frustrated being limited light exercise. Been a runner all my life and being patient is not my strong suite. However, as you experienced, too many misdiagnosis along the way can lead to a longer recovery period. Time and money wasted for no results. I hope by doing Prolotherapy (and skipping traditional methods that don’t work) I might expedite the healing process. It is still a long haul to recovery but my hope is if I do it right, I will heal in months and not years. Thanks again for sharing your story and good luck. Hope you find the link helpful.

  181. Vicki says:

    Guys, this is a really helpful read by Paul Ingraham, science writer. He’s spot on re. H.H.T.

    • beccakahn says:

      This is amazing!! Thanks, Vicki. This is something I’ll be reading many more times.

    • Cooper says:

      Good stuff Vicki! Scary but true! Thanks for the link. Hope all is well.

      • Anonymous says:

        Thanks for your replies and link Cooper. The concern over the steroid injection going into my tendon has resurrected itself today along with the pain. Just glad I refused the third one even though it annoyed them. I’m confident the second one (by a different doctor) went in the inflamed tissue on the outside so not worried about this one.

        I know it’s done now and some might say what’s the point in worrying which is true but when the pain is bad, the same thought kicks in.

        I’ve tried to find information on how long it takes the body to clear a cortisone injection from inside a tendon but so far haven’t found anything.

        I’ve asked several medical professionals and the answers have ranged from 1 day (sceptical about this answer) to “up to a year but I’m not sure.” I had the steroid that went into my H.H. tendon a year ago.

        I don’t know if the steroid loses it’s “necrosis powers” for want of a better phrase, after a certain period of time, even if it’s still in the tendon or whether it carries on damaging the tissue until it’s finally removed. Thus could be damaging it continually.

        Anyway, if anyone comes across evidence of time frames for this would they let me know.

        Many thanks.

  182. Anonymous says:

    I am by no means an elite runner. I have run between 15-25 miles per week for the past three years. However, I am experiencing some of the pain and discomfort associated with HHT. Do you think this is possible with an amateur runner? Or is it most likely a mere strain? I am hesitant to ‘make a big deal’ about it by seeking professional help at this point, but I also don’t want to risk further injury if I am one of the rare cases. Thanks for the advice!

    • Cooper says:

      Absolutely. Running is running. This injury is not exclusive to the elite (15-25 is a good regime). There have been young runners dealing with the same problem. Mine happened on the treadmill in the winter running an easy 6 (nothing intense, just happened). This is a freak injury.

      As far as your injury, hard to say. When I had a pull or a stain it was lower / mid hamstring. Usually happened while doing up tempo/sprint workouts. The proximal tendon is located where the 3 hamstring muscles come together at the base of the right or left glute. The pain was accute when running or sitting. Only you can identify with the location of the pain. The author of this blog shows a diagram at the very top with an arrow displaying the location of his Tendinopathy. Below is one of the many articles I read when I was trying to pinpoint my symptoms. I hope this helps, it helped me.

    • Anonymous says:

      Definitely get professional help as soon as on a just in case basis before it does become a big deal. Good luck!

  183. Vicki says:

    Think it’s probably obvious but a couple of my recent posts have stated they’re from anonymous as I didn’t log in. See if it works this time.

  184. Anonymous says:

    My story began a year ago in May. It’s a long story that began with shingles on my left side and has had many pains and issues since, mostly on the left side. I was in the best shape of my life a year ago competing for my team at Crossfit regionals. Four months ago the pain in my left leg, especially getting up after driving and driving/sitting became unbearable seemingly out of the blue. Once I got moving it seemed ok but after a while it was just awful and sleeping and getting up was excruciating. I was told by multiple doctors and after two Er visits it was herniated disks. I tried to explain I’ve had those since college in 1998 and never experienced pain like this. Now a neuromuscular therapist seems to think I have a high hamstring pull. She has done miracles after just 4 visits. After reading up some on this topic it does seem quite possible this is my problem, whether it was from the beginning or not I don’t know. But, I have been skeptical of the doctors all along since I was misdiagnosed when shingles came on and have been told everything wrong since is not connected and now it’s herniated disks. But, I have been good and doing nothing but swimming, walking, which now I think May be bad, and exercises the Pt has given, for my back, but many crossover for the hamstring I’m finding. How long could this take? I am usually running and biking by now getting ready for sprint triathlons and now I’m wondering if I have been getting more hurt by what pt is doing and telling me to do. Advice or suggestions?

    • Cooper says:

      What I have been reading, it has been months to years for some on this blog. My sports doctor said “don’t expect to recover right away”. If you do have HHT, it could be a long haul. I skipped PT and started Prolotherapy as soon as I could.

      Without sounding redundant go to the web site below and read about HHT or ischial tuberosity. They also said there could be a relationship with this injury to lower back problems. I am treating both. This doctor claims intense chiro adjustments have been known to cause this injury. I stopped high velocity adjustments during the treatment period for now.

      Your exercise regime sounds appropriate. They said during the treatment period I could do elliptical, swim or bike. Biking hurt due to sitting so I stuck with the elliptical. There is valuable insight on this web site as well as a comparative analysis between traditional medicine and alternative solutions proven to have a high percentage for recovery. Regardless of which direction you choose, this is a good read. I hope this helps.

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  186. Hello! I realize this is sort of off-topic but I
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  187. oatgirl12 says:

    Has anyone here also been told they may have piriformis syndrome? I bounce back between the diagnoses of trace disc bulge, piriformis syndrome, & hamstring tendonopathy depending who is treating me. I was surprised not to see any mention of piriformis syndrome here. It is so frustrating not to have a concrete diagnosis. I keep telling them I want exploratory surgery to just clean everything out that is scarred.

    • Vicki says:

      HI Oatgirl12,

      I can’t help with piriformis syndrome as I have semimembranosus tendinosis (tendinosis of the HHT). Have you had an MRI and if so wouldn’t this confirm the diagnosis?

      Regarding surgery, I was told by my orthopaedic doctor this wasn’t an option as the risks were too high due to there being so many nerves in the area and I could end up much worse..

  188. Jolie says:

    Thank you so much for this information. I have been in constant pain and frustration with this issue and now I feel that I have some answers. Thank you so much!! Off to find Bikram Yoga class. Is it possible to practice it at home – in at least the heat outside? I live in a small town and I do not think we have a Bikram Yoga class. But I am going to look. Thank you again!

  189. LIsa says:

    I have had this problem for 3 years now. After multiple MRIs, xRays, oral steriods, corisone shots, an epidural, doctors, physical therapists, nerve testing, etc. I am totally frustrated. I run in pain every day. I sit at my desk in pain every day. I can’t get comfortable on the couch. I’m definitely a fair weather runner so here in Michigan that means I take basically from November thru March or April off and just walk on my treadmill instead. Walking isn’t 100% pain free during those month but pretty close. Then comes the nice weather again…and the daily pain. At least I’ve learned to run in the evening instead of before work as that used to make for one long painful day. I don’t know if these posts offer me hope or just make me more depressed about the whole thing. I’m an active person. If I can’t work out I will lose it mentally. That is my ‘me’ time and how I relieve stress. Thanks for listening.

    • Cooper says:

      Hi LIsa. I assure you when I say you are in good company in the frustration department. As you know, there are many atheletes on this site sharing their stories and looking for answers. Sounds like you got hung up on the traditional medicine path which doesn’t seem to have any long term value towards healing. The only thing missing on your list is surgery which some have claimed a waste of time and money. What was the diagnosis after the MRI’s? Was it diagnosed as HHT? Below is a description of IT from a sports rehab web site which I think you will appreciate….

      The symptoms of ischial tuberosity pain are, plain and simple, “a pain in the butt.” Pain on the bottom of the buttock, especially when sitting and running is typical. The area may also be quite tender and sensitive to touch. Ischial tuberosity pain is often misdiagnosed as ischial bursitis, especially with athletes. The treatment modality commonly prescribed in modern medicine usually involves the RICE protocol, which consists of rest, ice, compression and elevation. The problem with this approach is that it does nothing to repair the injured tissue in the area, in this case ususally the sacrotuberous ligaments and/or the hamstring tendon attachment, and, thus, does not alleviate the chronic pain that people with this condition experience. Rest and ice are particularly serious culprits when it comes to soft tissue damage because they decrease circulation to the area, which actually hinders rather than helps the healing process.

      Physical therapy is commonly ordered and has its place for the treatment of ischial tuberosity pain, but once again, does not address the issue of weak or injured ligaments or tendon attachments.

      Steroid injections and anti-inflammatory medications are another standard recommendation of modern medicine. These treatments may provide short term relief, however, in the long run do more damage than good.

      • LIsa says:

        The MRI done on my pelvic area, which was done back in December 2011, showed normal wear and tear of the hamstring. I received the corizone shots based on a diagnosis of ischial tuberosity but when they offered no relief the doctor started looking for something else. I had one of my lumbar spine that showed some minor disc bulging, for which I had an epidural for. I had never complained of pain in my back but since that was my third doctor I was open to anything. I saw another doctor about PRP but considering it isn’t a guaranteed fix, and not covered by insurance, there is no way I’m paying out of pocket for it. After having nerve testing done 2 weeks ago as almost a ‘last resort’, that doctor concluded, based on where I was showing him I had pain when I ran and sit and without a thorough exam he diagnosed it as HHT. Now I’m just waiting to hear what my doctor who ordered the testing and who I have seen since day 1 has to say. I’m training for a half marathon that is on 9/21. As I have run with pain for the last 3 years I just plan to continue to run in pain until I finish the race…then from there I’ll see if maybe this can be fixed…although considering I usually take November – March/April off anyways and am pretty much pain free, only to be in constant pain once I take up running again, I’m not hopeful that I’ll ever run pain free again, which definitely saddens me. I try to be positive and tell myself at least I have the option to run, unlike the guy one cubicle row over at work who is confined to a wheechair, but it is sometimes hard to look on the bright side as I sit on constant pain trying to do my job.

        Thank you for taking the time to respond. Maybe just venting to people who can actually relate and understand will be the mental therapy I need.

      • Brenda says:

        Good morning Lisa and all…I share your frustration too- we all do- and I can tell you from experience that this blog sincerely helped me through the worst of my pain – like you said just having people to relate this pain and hear their stories, words of encouragement, knowing we are not alone. The scary part is all the misdiagnosis, and that underlining fear of will-today’s-workout be the one that brings back the acute pain. Do you cross train during the off season, that might be the best option, to interspace running even now with cross training?

      • Cooper says:

        You definitely found a sympathetic bunch on this blog. I am certainly no expert on the subject but the two things I’ve learned after reading this publication. First, you cannot work through this injury. Second, if you are healing and you come back too soon, you risk re-injuring the tendon. This is like no other injury we’ve had before. Being patient is the most difficult thing we are forced to do when faced with an injury. We’ve all had pulls and strains over the years and with ice, heat, ibuprofen and a little rest, we were usually running again in 3-4 weeks. As you know, this one hangs on for a long time.

        I injured myself in January 2014. Continued to run and workout for 3 months hoping with ice and ibuprofen, it would work itself out. I realized I was only making it worse. With a little research I learned that this is a degenerative injury and the tendon needs time to strengthen and regenerate.

        As mentioned in earlier posts, I skipped all the traditional methods, ignored my doctor and began Prolotherapy. This philosophy made the most sense to me. I understand about the out of pocket expense for PRP. Insurance companies treat Prolotherapy, PRP and stem cell treatments it like it is experimental even though they’ve had a 90% success rate. I’ve had 4 treatments with number 5 due at the end of this week. I won’t say I am 100% but I have been cleared to run/walk on the treadmill. Two minute run and two minute walk at slow speeds for 30 minutes. The nagging pain I used to experience is minimal. The inflammation after sitting in the car for long periods has subsided. I still feel some tightness but not nearly to the degree of pain I had 6 months ago. Prior to run/walk I was only allowed to do elliptical, bike or swim. The theory was to give the tendon an opportunity to regenerate then slowly work back into running and strengthening the hamstrings with light weight (no high velocity hammy exercises). The key is to be patient which is very difficult for us running junkies.

        Sorry for the long synopsis. I strongly feel that if we have a positive response toward beating this injury, we need to share it with others. I am not completely out of the woods, but I am much further along since the beginning of my 6 month sabbatical from running. Good luck.

      • LIsa says:

        Just for shits and giggles I went to a free injury clinic at a local running store last night. I showed them the memo from the nerve doctor diagnosing me with HHT. The doctor I saw said it was treatable and that I should feel better shortly if stretch my glute and streghthen my hamstrings. If that was the case, it seems like all the time spent at PT would have already fixed this. I couldn’t remember the last time I was aligned and he did do that for me but aside from that I left there feeling defeated. He said ‘maybe you’ll just have to start doing something else other than running, like biking or swimming.’ Easy fix if I had access to a pool, and liked to swim, or if I had time to devote to biking that would make me feel like I was getting the same type of workout that I do running, or even had somewhere to bike that wasn’t busy roads. A gym membership would help with the biking, but then again I hate sitting on a stationary bike for any period of time…and considering it hurts to sit on my chair at work, I can’t imagine sitting on the bike will feel ok.

        So I guess I’ll try the exercises he showed me today and will also hope that the aligning offers some relief…not holding my breath though 😦 Thanks for your continued support.

      • Cooper says:

        Funny stuff, thanks for the laugh. I couldn’t bike for that very reason. The only cardio I could do that didn’t aggravate the tendon was the elliptical. Tried biking but sitting on a bike seat was painful.

        When I injured myself, hamstring strength wasn’t the problem. At that time, I was doing 3 boot camps per week which included a lot of hammy work. “Over use” is one of the causes for this injury. The tendon just gets worn out. I was told to avoid high velocity chiro adjustments and high impact hammy exercises. The PT might have done more harm than good if the adjustments were high velocity. The article I read indicated “It is an injury we see in mid to long distance runners, yoga practitioners, and occasionally non-athletic individuals who have been injured by improper chiropractic adjustments or physical therapy.”

        Makes you wonder if the medical practitioners are giving us the best advice. Good luck with the exercises!

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  192. Ashley says:

    Thank you for this blog post! Although my injury does not seem as intense as yours I found this post so helpful and found comfort knowing ways in which to relieve the pain.

    I was hiking back in late June and the next day my hamstrings felt super tight, especially on my right leg. I couldn’t tell if it was tight (needing to be stretched) or pulled (needing rest). I gave it rest but a month later it was still sore, more so after driving or lots of walking. Now however it’s not my entire hamstring but just the upper, inner deep muscle right blow the glute. It has a pulsating pain, close to a sciatica kind of pain, but in the same small part of the muscle that worsens when stagnant or worked to hard. Was that what your injury felt like?

    Thanks you again for the information!

    • Brenda says:

      Ashley- I had/ have that deep pulsating pain literally right where the leg bends- learned it was where the hamstring meets the isheral tuberosity. The pain can extend down the ham- because there is a bursa sac at the end of that sit bone-that gets inflamed with overuse of the ham (I don’t get that, you see people doing ultras routinely, all I was doing was 5 or so a day!). I always described the pain as ‘deep up in there’- and when PT massaged with the elbow, it loosened some fluid and it felt better for that night. I foam roll and now started with a chiropractor. As I write this now, I know there is something still wrong, but I am compelled to run and cope with the pain.

      • Cooper says:


        Thought you might appreciate this description as posted on a sports rehab web site.

        Treatment of Ischial Tuberosity Pain

        The ischial tuberosity is a swollen part or broadening of the bone in the frontal portion of the ischium, the lowest of the three major bones that make up each half of the pelvis. As the point of fusion of the ischium and the pubis, it is attached to various muscles and supports the weight of the body when one is sitting. Ischial tuberosity pain may be experienced by a wide range of athletes, including soccer players, cyclists, baseball players, figure skaters, cheerleaders and any type of jumpers or runners. It is often misdiagnosed as ischial bursitis, an extremely painful condition.

        Ischial tuberosity pain can be very debilitating and severe, especially when sitting, standing, or running. It can be aggravated by prolonged sitting, since we sit on the ischial tuberosities.

        How does an ischial tuberosity injury develop?

        The ischial tuberosity is the point of origin of the adductor and hamstring muscles of the thigh, as well as the sacrotuberus ligaments. The forceful pull of these muscles, such as can happen during a variety of sports, as a result of a trauma such as a fall or other type of injury, or through the overuse of the hamstrings, as is common among runners and soccer players, results in a separation or detachment, also called an avulsion, of an open ischial apophysis.

        What are the symptoms of ischial tuberosity pain?

        The symptoms of ischial tuberosity pain are, plain and simple, “a pain in the butt.” Pain on the bottom of the buttock, especially when sitting and running is typical. The area may also be quite tender and sensitive to touch.

        The tyipcal pain management route

        Ischial tuberosity pain is often misdiagnosed as ischial bursitis, especially with athletes. The treatment modality commonly prescribed in modern medicine usually involves the RICE protocol, which consists of rest, ice, compression and elevation. The problem with this approach is that it does nothing to repair the injured tissue in the area, in this case ususally the sacrotuberous ligaments and/or the hamstring tendon attachment, and, thus, does not alleviate the chronic pain that people with this condition experience. Rest and ice are particularly serious culprits when it comes to soft tissue damage because they decrease circulation to the area, which actually hinders rather than helps the healing process.

        Physical therapy is commonly ordered and has its place for the treatment of ischial tuberosity pain, but once again, does not address the issue of weak or injured ligaments or tendon attachments.

        Steroid injections and anti-inflammatory medications are another standard recommendation of modern medicine. These treatments may provide short term relief, however, in the long run do more damage than good.

  193. Allen says:

    You over exhaust your body. I guess however fit we are fatigue really comes anytime. Maybe take it slowly next time and don’t rush to running instantly. You’re right, maybe you lack stretching that time. What you lack could help you now I guess. 😀

  194. Click here says:

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  195. mark says:

    i have the exact same thing…haven’t been able to run for 4-5 months.. can barely walk a golf course.. I only can swim at this point..i’m starting to lose hope that it will ever heal…I drive with a tennis ball under my hamy, so there is constant pressure.. I hate bikram yoga.. what else can I do?



    • oatgirl12 says:

      Has anyone tried biking or is that too bothersome with this condition?

      • Cooper says:

        Hi Oatgirl12. Personally, I found it was aggravating the hell out of my tendon. The bike seat wasn’t very pleasant. I found the elliptical trainer less painful. On the professional machines, you can set the ramp in a position so the hammys aren’t targeted, just the glutes and quads. You still get decent cardio without stressing the tendon. You want to avoid Swimming is another option if you have a pool at your discretion. Good luck

      • Cooper says:

        Sorry, in the last post I forgot to delete the “you want to avoid”… It looks like I’m advising you to avoid swimming. I began to suggest avoiding any stress to the tendon. Swimming is good cardio with this injury. My apologies for the confusion.

  196. Anonymous says:

    Hi everyone, thought this may be a useful link. Something to consider. Intra Muscular Stimulation – a form of dry needling/acupuncture.

    • Cooper says:

      Is that you Vicki Coming up anonymous? If so how is the physio going? Any progress?

      • Vicki says:

        Hi Cooper, yes it is. Had my IT man out yesterday to sort several problems for me. Been unable to post on here for a couple of weeks. Anonymous is as good as it gets at the mo.

        I stopped physio months ago when I realised it was making injuries worse. Physio was impeding healing. My personal opinion is until the injuries are healed or nearly healed, don’t have physio.

        I start with IMS today. Slightly apprehensive as despite researching this modality and two discussions with the practitioner, I’m not keen on anything that will increase the pain with only an approx. success rate of 50% ish. Apparently success depends on the patient not the severity of the injuries. Having studied different personalities and injury repair (I’ve a lot of time on my hands!) this may suit me.

        The acupuncture route (meridian lines, energy and practitioner saying spiritual words while performing and lack of scientific evidence) was perhaps not top of my list but on it. Although I know people who have had it and swear by it.

        I feel there is no choice though, as I could stay like this for years otherwise and that isn’t an option.

        As it’s a form of dry needling, at least there’s no substance being injected in with side effects.

        I’ll post if there is any improvement and thanks very much for asking.

      • Vicki says:

        I meant to ask Cooper, how are you getting on with PRP treatment?

        Also, in my previous post, I mentioned “injecting substances in and side effects”. I was referring to my regret of having two steroid injections not PRP.

  197. Vicki says:

    Oh and of course now my name is showing! Lol! Great success!

    • Cooper says:

      Good to hear from you! Though I’m sorry we’re all in this mess together, I enjoy your posts. I had my 6th Prolotherapy treatment this week. Therapist is treating the low back along with the hammy. I’ve been allowed to run/walk at 2 minute intervals. I also started very light lower body weights. I doesn’t take long for the muscles to weaken. Even the light weights were taxing. I’m not completely healed. When I run it is still tight back there but nothing like when I first injured the hammy. I would say I am about 80%. Thanks for asking.

      When you refer to IMS, is that the dry needling treatment? I am not familiar with the treatment. As we’ve shared, I skipped the physio myself and quit chiro treatments during the prolo treatments. I could not understand how physio would help regenerate a tendon. The prolotherapist claimed that high velocity adjustment could make the injury worse actually could have caused the injury. I wish you the best a by all means keep us posted on your progress and I will do the same. I am not going to endorse prolo until I am 100%.
      Great to hear from you and best of luck.

      • beccakahn says:

        Thanks for the update, Cooper! I’m now 8 weeks post my PRP treatment and I’m starting to see improvement. The past 4 days I’ve hardly had any pain at all while sitting (although I still keep my tennis ball at my desk and sit on it for pressure a lto of the time). I’ve also gotten stronger in PT with the hamstring exercises. I, too, had stopped doing any of them because I felt they were making things worse. Now I think they’re actually helping. For the first time in 2.5 years I had “normal” hamstring muscle soreness from working out! It was the good kind of pain that I knew would go away in a few days.

      • Vicki says:

        Really pleased you and Becca are making progress. Yes IMS is dry needling. Intra-muscular Stimulation. An acupuncture needle is put in a hollow stainless steel holder/device placed onto skin over the tendon, the needle is pushed in (with the plunger) and then moved about inside the tendon to create trauma and induce natural repair.

        That’s how I see it anyway. My physio would probably be horrified at that explanation!

        Something unexpected (on my part) has happened since the first session on Thursday. I’ve developed early mild symptoms of plantar fasciaitis – the night of my first session!

        This is called pain migration…..I looked it up. Apparently this is good, although it doesn’t feel like it. I haven’t contacted my physio for advice as I’m well aware these days of how to treat it and will talk it through next session on Thursday. Using RICE until tonight which will be the 72 hours then will continue rest as much as poss and probably get calf massaged to loosen which most say tight calves is partly contributory.

        This is the knock on effect of standing since last August, actually longer as I was standing at work for 6 months before I went off sick. One wonders about the effects of the move towards stand up desks here in the UK.

        Here’s the thing, apparently migrating pain is good as it shows IMS is working. Physio has said one of the effects of IMS is like sticking a pin in a balloon. HHT tendons are tight with injury pulling off pelvic bone. When pin is stuck in, the tightness is relieved and I’m guessing but think this has relaxed all muscles in left leg down to the foot and shown up the beggings of plantar fasciaitis.

        I’m unable to do the plantar fasciaitis exercises on the internet as they affect the H.H.T.’s making them painful and possibly undoing the repair of the I.M.S. and so we go on in a circle…….lovely.

        So I can’t sit and I’m determined not to stand too much as I know how bad tendons can get if not caught early.

        Will go now as need to get off my feet!

        Be in tough soon with up-date.

      • Cooper says:

        Hi Vicki. Sorry for the delay, been out of town. Sounds like IMS has the same theory as prolo, PRP etc…trigger the body to respond to the injury site by increasing blood flow to regenerate new tissue. Bummer about the fasciitis! If transference is a normal reaction, you may be making progress. I’m sure if it means beating the tendinosis, you’re willing to tolerate a little fasciitis. I wish you well. Please keep us posted.

      • Vicki says:

        Thanks Cooper, I’ll post if there is news.

      • Anonymous says:

        Ok I’m going through this too I’ve been misdiagnosed for a year being treating for SI joint and had SI joint injections with no luck after a year of treatments I decided to go to Mayo after a MRI it showed glut tendonopathy I’m schedule in about a week of injections of isch tuberosity but after reading your post I just emailed caring medical for a consult — so bottom line— it’s been several months for you to determine if the prolotherapy worked . So are you now pain free ??? Wondering if this is the direction I need to go instead of steroid injection but have to dish out so much money out if pocket was it worth it .

      • Tonya says:

        Ok I’m going through this too I’ve been misdiagnosed for a year being treating for SI joint and had SI joint injections with no luck after a year of treatments I decided to go to Mayo after a MRI it showed glut tendonopathy I’m schedule in about a week of injections of isch tuberosity but after reading your post I just emailed caring medical for a consult — so bottom line— it’s been several months for you to determine if the prolotherapy worked . So are you now pain free ??? Wondering if this is the direction I need to go instead of steroid injection but have to dish out so much money out if pocket was it worth it .

      • Cooper says:

        Hi Tonya

        I apologize, I did not see the post until this morning. After 6 Prolotherapy treatments I was able to ease back into running pain free for 6-8 weeks. I had regressed after sitting in the car for 8 hours and going for a short run thereafter. I immediately refrained from running since I felt the tendon getting aggravated toward the end of the run. I will resume again after giving the tendon a little break. I strongly advise perusing the consult. Dr Hauser is one of the best in his field. If I had it to do over, I would choose to do PRP. It is more expensive but I believe I probably would have needed less treatments. There is a price list is on the web site. If you’re lucky, insurance might give you some financial relief. Mine did not, they conveniently called it experimental. This is a great a alternative to surgery. I have not heard positive results regarding surgery (especially misdiagnosed injuries). Prolo and PRP are a natural way to speed up the body’s natural response to healing. Again, I apologize for the delay.

      • Cooper says:

        Hi Tonya

        One more piece of advice. Do not do steroid injections! It gives you temporary relief which in turn gives you a false sense of healing. Most who have had them, resume working out under the premise they are healed. In turn, they continue to do further damage to the injury. The steroid also breaks down soft tissue which only further prolongs the healing process. No ice and no anti-inflammatories! Natural supplements are acceptable. Low impact exercise such as elliptical and swimming are ok. Exercise not rest. Use heat to increase blood flow to the injury. I was treating this all wrong when I first experienced. Thought it was a pull or a strain. I followed Dr Hauser’s recommendations and it worked. Many have suffered with this a lot longer than I have and I have Caring Medical to thank for redirecting my efforts to a speedier recovery.

  198. Cooper says:

    Hey Becca, that is great news! I truly believe it is all about timing. When the injury is new, continuing to stress the tendon only furthers degeneration. You’ve allowed your PRP treatment time to rebuild and strengthen the tendon first. Once the tissue is strong enough, light strength training actually enhances blood flow to the tendon which aids in the healing process.

    I am so glad your getting positive results. The key is not to rush back into exercise too quickly. Be patient and ease into it gradually and hopefully you’ll be your old self again in no time!

  199. Kathy says:

    I’m suffering from this same glute/ hamstring issue, I’ve been training for my. 5th marathon, I haven’t ran in a month but I’ve been biking, it’s still so stiff and sore. It is better , I’ve been doing ice , the foam roller, stretching, everyday. Also the chiopractor and massage therapist every. 2 weeks . How long and staying active with the bike and elliptical, I know this will keep me strong but is it prolonging my recovery ? Thank you

    • Brenda says:

      Kathy- You might be prolonging the recovery with your cardio- at least that is what PT told me numerous times, but on the flip side,- it might be what is keeping you positive. I can’t express how depressed I was when I was deep in this injury, and months on end of not doing a thing was tearing out my heart. I know if I could do any activity without pain, I sure would, and did even with pain – I know I prolonged my recovery as a result, but I just felt myself gaining weight, loosing fitness and I have terrible OCD about exercise. I would recommend more strength training than cardio, but it’s easier said than done- much more fun to just run!!!!

  200. Hannah says:

    These are outstanding exercises for the hamstring! This can be a tough injury. Check out this article; it has a pretty good take on this:

  201. Vicki says:

    Thanks for the link Hannah. Brenda are you saying you have recovered from higher hamstring tendinosis?

    Having read through many websites on this injury, I found this to be one of the more accurate and informative sites.

    This includes information on Prolotherapy and PRP etc.

    I’ve just had my third dry needling session…..ouch!! What hasn’t been helping are the trigger point knots in the top of the hamstring muscle (at least 4) just before it becomes the tendon. Also, turns out I have several in the tendon itself too. Found out today. Much needling was done and gripping of the couch!

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  203. Vicki says:

    Hi All,

    I’ve found this very interesting and informative link regarding hormone imbalance and sporting injury – not just for the women!

    I see the link I’ve typed hasn’t turned blue so perhaps Google Sockdoc. It’s a site for natural injury prevention and treatment.


    Cooper and Bekha, how’s your recovery going? Well I hope……

  204. Vicki says:

    Oh! So now I’ve posted it, it turns blue. How my computer likes to make me look a fool! Lol!

    • Cooper says:

      Hi Vicki. How’s the dry needling treatment going? Any noticeable progress? Still experiencing pain migration to other areas in the body?

      I cancelled my 7th prolo treatment last week. Two weeks prior to my appointment, I had a few surprisingly pain free run/walk sessions. I started out 2 minute run and 2 minute walk intervals. I graduated to 3 minute run and 1 minute walk for 30 minutes. As much as I want to run non stop, I am easing back into my routine slowly. The nagging feeling has subsided.

      I started back to 1 boot camp per week. I told the trainer I was going to avoid any high velocity hammy work. I’m doing light weights to gradually build up the quads, hammy and calves. I do not want to take this for granted and come back too hard and fast. I don’t have flare ups while in the car for long periods like I used to when I first experienced this injury.

      I still use the heating pad twice daily to increase blood flow to the tendon. I use electro stim once daily. I don’t want to assume I’m out go the woods but I feel better than I have in the past 9 months. I’m still taking it slow. This blog has taught me the biggest mistake people with this injury make on the is coming back too fast only to damage the tendon again. This injury definitely taught me a new meaning for patience but I believe the Prolotherapy reduced what could have been years of healing into months.

      Thanks for asking. Please let me know how you’re progressing with the IMS. Take care and it was good to hear from you.

      • beccakahn says:

        Hi Vicki and Cooper! I’m doing MUCH better as well. I’d say at this point the injury is 80 percent better. They say PRP can take a full 6 months to work and I’m now only at the half way point, so I’m very excited with the progress. Being able to sit at work without having to constantly sit on a ball is the best part. Driving has become virtually pain free as well. Let us know how you’re progressing, Vicki!

      • Vicki says:

        Thanks for your positive replies. Well something somewhere has decided I’m going to suffer. I’m icing my feet on a frozen water bottle as I type. This is to help the plantar fasciaitis I’ve developed through standing.

        I think my H.H.T. must be more severe. As you know, on 2.5 years now and had to stop sitting to get any form of relief over a year ago.

        Out of interest, did you guys have pain all the time even when standing? And (bad grammar but not concerned! Think in America you can start a sentence with And unlike here!! lol!) did you have pain that travelled down the back of both legs to just above the knees at any point? I think this must have been referred pain.

        I’m asking to help me judge a way forward.

        The dry needling continues. Haven’t started on the right H.H.T. or the tendon that runs over the right hip yet. Developed a sore patch there in January.

        The dry needling physio has said I should have PRP as the gold standard way forward. However, the Hospital Consultant thinks I should take painkillers everyday and start eccentric exercises which I’ve commenced while I continue with the needling.

        So for the time being, until I make a decision about PRP, that’s the treatment plan. I’m seeing my GP this week to ask for hormone blood testing to see if out of balance and vitamin D plus calcium testing as all this can be contributory. Oh and zinc, magnesium and iron. Already had the B vitamins and folate done which were ok.

        Am having sunbeds (not keen) once a week for a few mins to top up vitamin D as we don’t get enough sun here and I’m low on it.

        The Consultant said something I felt was odd, “tendons don’t have blood running through them”. Everything I’ve read has said they have a poor blood supply. Call me slow on the uptake but if something has a poor blood supply surely there is blood!

        Have you been told the same at any point? If there is no blood, how does the tendon live and supply the bone it is attached to?

        Am very pleased for you both.

  205. Vicki says:

    And also why would they have injected dye into my arm to highlight hamstring tendon damage when I had an MRI if there is no blood supply? These are the things I ponder in my spare time.

    • Cooper says:

      Hi Vicki. The thing I learned early is that there are so many approaches to healing HHT and few are successful. It gets confusing and we would try anything to get back into our exercise regime. Three months after my injury, I realized I had more than a pull or a strain. I tried to work through it and only made it worse.

      It sounds like you’ve tried everything that showed promise. Personally I think your physio is correct in saying PRP is the gold standard. I had 3 choices to from the clinic I was attending, Prolo, PRP or Stem Cell. Since my insurance was not going to assist financially for these treatments I opted to go with Prolo. All are proven to be affective therapies for this injury. Prolo was the more cost effective of the treatments. It took a bit longer for me to experience results whereas PRP might cost more but taken less time to work.

      I understand your frustration after 2.5 years of patiently tring all means and methods possible. After much research I chose to bypass all conventional treatments recommended through western medicine (ie: PT, Ice, antiinflammatories etc….) I didn’t want to waste the time and money chasing bad advice.

      If I could make a suggestion, stop everything your doing, save the time and money (and aggravation) begin PRP treatments and only PRP treatments. If you follow your therapists instructions, I truly believe you’ll get past this. PRP makes the most sense. They can even treat your faciitis. Your insurance may not want to help, but some companies do pay something towards this type of treatment. Mine conveniently called it experimental. Due to the severity of your injury, you may require more than one treatment. It has a 90% success rate. I like those odds!!!

      • Vicki says:

        Thanks for the advice Cooper. I don’t have insurance. Most people here don’t as we have the (free) NHS so don’t think to get it and then something goes wrong. That’s when you discover the lack of services available outside of dated tried and tested methods.

        The problem with this also is most NHS dr’s won’t be up to speed on the detail of newer more modern approaches. When I’ve spoken to them about PRP etc. they’ve all put me off the idea saying not enough is known about it and we don’t know what it’ll cause later. Once the seed of doubt is sown, what can you do.

        Think I’ll sort insurance today. Already found a company that will cover existing injuries.

        At the moment, I’m going to continue with dry needling and eccentric exercise. Saw the physio Tuesday, discussed this with him and he was equally as enthusiastic about this approach. I’ve still got lumps of knots in my tendons that need getting rid of.

        If I’ve struggled through enough eccentric at the right pace for tendons to cope and not getting anywhere then I’m going up the PRP/prolotherapy route.

      • Cooper says:

        I understand. All of my treatments were out of pocket. Give your practioners this web site Dr Hauser is a renowned expert in this field. I spent many an evening reading about his approach, his technique and philosophy. As mentioned in previous posts, my insurance would have been happy to pay for surgeries and drugs….what a waste. Prolo was affordable and effective. I wish you well and good luck with the dry needling. Take care.

    • Cooper says:

      Hey Vicki. Hope this finds you well. I was at the local Fruitful Yield and came across a supplement called Super Collagen +C that contains complex structural proteins which is supposed to support collagen strength in tendons and ligaments etc… I would imagine you might find that online. Basically that is what Prolo was doing, building collagen at the proximal tendon. Thought I would pass it on. Take care.

      • Vicki says:

        Hi Cooper, thanks for that, I’ll look it up. Am already taking iron, magnesium, vitamin D, vit K2 and calcium everyday. Might as well add another!

        I’m ok. Was making some progress with gentle strengthening and needling. Physio said last week that it was the first time he could feel anything that felt like the form of a tendon. I guess they have a considerable amount of scar tissue around them…..Nice. It was noted that the hospital registrar upon looking at my MRI in January said when I asked, there is no scarring. What can you do. Somewhat off-putting. Anyway, he’s gone now. Hurrah!

        I’ve had a set back though, on Monday. As I was waking up, I turned over and did a long, contended stretch, heels down the lot. 6/7 Hours later return of the pain. Back up to a 7.

        That’s done now so put it behind me. Spoken to physio and am to carry on with exercises and pain killers and is under the impression it’s not as bad as I think which is positive.

        Thanks for thinking of me. Hope you remain fully fit.

        Best wishes


      • Cooper says:

        Hah, I can relate to the multitude of supplements! Have a whole basket full. I never heard of a collagen supplement until yesterday otherwise I would have tried it long ago. This is supposed to support strengthening and rebuilding collagen in tendons and ligaments among other things. I bought a bottle and thought I would give it a try. I am still not 100% but short runs I am still pain free. Took a long trip over the weekend and was very stiff in the glute.

        I would think your MRI would be the most accurate diagnosis. As mentioned, this is confusing as each influence in medicine has their own approach to this injury. A lot of misdiagnosis in the process. Hopefully it wasn’t a setback when you stretched. After my 5th treatment I was released to run/walk. A few minutes into it, I felt that reoccurring nagging tightness in the glute/hammy. Took another week off and started the tun walk again. My fear was that maybe I re injured and reversed the 5 months of treatments. The following week I was better. I think part of the problem was muscle weakness due to lack of lower body exercise.

        Take care and I hope in the long run you get passed this thing. I know it’s not for lack of trying!

      • Vicki says:

        Hi Cooper, thanks for the positivity. I’m seeing the physio tomorrow and will ask him for his thoughts on Super Collagen + C. I’ve checked where I can ordered it from too.

        In considerable pain last night and today. I seemed to recover quickly from the stretching episode and think it’s to do with the strengthening exercises I’m doing but who knows! Half the time there’s no rhyme or reason as to why some days are better than others pain wise.

        I have this vision that my tendons are covered in a mass of undergrowth (scar tissue) and need a good pruning!

        I hope you manage to build up your runs successfully. Do you feel that is happening?


      • Cooper says:

        Hi Vicki
        I’m glad the stretching didn’t cause you to regress in your healing process. Light strength training will cause soreness especially if you’ve laid off from any lower body work for 2.5 years. As far as scar tissue build up (you and I joke about all the supplements) but I was doing two things to prevent scar tissue. 1) was electro therapy with a Tens unit. According to my chiro, this reduces inflammation and scar tissue build up. 2) was a supplement called Serrapeptase. To read about it’s many benefits, you would think it is a miracle supplement. Both are sold on Amazon.

        As far as building up my runs, I am taking it slow and steady. The past few weeks I an doing 2 miles straight running. Saturday I really let my hair down and stretched it out to 3 miles. Yahoo! So far no pain felt in the proximal tendon. Still doing light weights and only 1 boot camp ore week. I refuse to come back too hard and fast only to regret by re-injuring. Psychologically I find it gratifying to be out there again even if it is short and slow. Hope to build up gradually as I see fit. Thank you for asking. Nice to discuss with someone who’s been there.

        Here are a few insights from the caring medical web site as it relates to collagen and ligaments. The same applies for tendons as well. I thought this was and interesting read.

        “Exercise does not notably increase the blood supply to ligaments. Ligaments are made up primarily of type I collagen. This particular type of collagen is very resistant to stretching (has a high tensile strength). Collagen is a type of protein and is therefore made up of amino acids, building blocks of protein. What most people do not know is that the collagen in ligaments is thought to remain relatively metabolically inert, with a half-life on the order of 300 to 500 days. This means that the metabolism of collagen is very, very slow. It is a good thing this is true, because blood supply to ligaments is so poor. This is another reason ligaments heal so slowly and are so prone to injury. Anything that decreases the metabolic rate or blood supply to the ligaments will further promote the decline of the ligaments, and profoundly delay their healing.”

        That us why he is against ice and anti-inflammatories. It slow down the blood flow which slows down the healing process. Enough of my pontificating for one evening. Take care and let me know what your physio says about Collagen supplement. Worst case scenario you’ll have thick hair and strong nails? Ha ha. Keep me posted.

      • Vicki says:

        Hi Cooper, I didn’t have time to ask my physio as I’d decided I wasn’t getting enough out of my sessions. (I’ve got it written down though and in my bag for next time). We get on so well that we talk for 20 mins and I end up with 10 mins of treatment. This time I had decided this wasn’t going to happen so I requested what I wanted doing.

        He and I read a lot and then we enjoy discussing our opinions. We both learn from it and I feel a sense of relief that he understands. He doesn’t talk nonsense like some professionals and keeps it positive. However, I wasn’t receiving enough treatment.

        Last session I had 26 needles in my tendons, lower back, right leg and hip plus we discovered a rib was displaced at the attachment to my spine so he manoeuvred that. Also had ultrasound on feet to stave off the plantar fasciaitis. Got my monies worth then!

        Thanks for the new info. I stopped icing a year or so ago and have refused to take anti inflammatories except for a month of NSAIDS in the early days and nothing since.

        I’ll let you know if I make any headway.

        Best wishes


  206. Pingback: Dealing With High Hamstring Tendinopathy – A Practical Guide … | Lapband Help

  207. curtst says:

    I know this is old, but hopefully you are still monitoring.

    Thanks for the info. I am in the Air Force and only run as far as I have to. Usually between 1.5 mi to 2 mi 2-3 times a week. I suffer from shin splints a lot. Then I started to get the same pain you described. The docs won’t give me a diagnosis, and all the PT folks told me was, ice, motrin, and no running or anything similar. Well, with regular physical fitness testing, not running isn’t really an option. Right now I am walking on the treadmill for about an hour. It starts to hurt about 25-30 mins into it, but nothing bad.

    Your foam rolling, how often did you do it and for how long? Do I need to do that for a set amount of time or repetitions?

    Any info would be great. Thanks and happy new year!

    • Vicki says:

      Hi Curtst,

      I’d have an MRI scan done to confirm diagnosis first off. If it is HHT then you should use active rest but realise this is not an option for you.

      On the assumption you are in the States, if you had a confirmed diagnosis and evidence, shouldn’t the Air Force have policies and support in place to accommodate ill health? Naive?

      I had to see 6 physio’s, none of which gave me a diagnosis and then diagnosed myself through research which a later MRI confirmed. This is in the UK.

      Having tried more or less everything, there are two options to aid recovery. PRP or eccentric exercise combined with dry needling (IMS). Cooper on here used PRP and can advise.

      I’ve used the eccentric exercise and IMS route. I also combine this with Serrapeptase, an enzyme extracted from plants that eats scar tissue. Cooper recommended it to me and have been on it for two weeks only so can’t comment further on this. I’ve also used daily supplements of: iron, vitamin c, magnesium, vitamin D3, vitamin K2 and calcium.

      I manage the pain with paracetamol only as and when. Don’t take NSAIDS as they inhibit collagen repair. I also regret having two steroid injections but that’s a personal choice for you to make having researched pro’s and con’s.

      I’ve a year to go (hopefully) until recovery using the said treatment but mine was severe. So this option in not a quick fix. Actually, I’m not sure there is a quick fix.

      Cooper any advice?

      • Cooper says:

        Hi Vicki

        Hope you had a happy and healthy holiday.

        Sorry, been out of town for a few days. I agree with your advice to Curtst. Also, I would like to think if Curtst has accurately identified his injury, he would have government benefits that would allow treatment for HHT or Ischial Tuberosity. His career and life depend on it. We both know the medical profession is perplexed by this injury. Stem cell or PRP is known to be a few of the fastest roads to recovery. I had Prolotherapy which was effective, but took a little longer than the other treatments. If I had it to do over, I would gave opted for PRP. I am still at 80% but would not be this far along without alternative medicine. Curtst, if you have time to do a little research, this web site is invaluable…. You can look up your injury and the available treatments. Also, look up ischial tuberosity on the web site

        Most who suffer with this injury go through conventional methods only to conclude they’ve wasted time and money with little or no relief. Vicki, you’ve offered good advice. No ice, no NSAIDS, no high velocity adjustments. My therapist allowed elliptical, swimming or biking….no running for 5 treatments. The biking didn’t make sense seeing how most of us gave a hard time sitting. The bike seat didn’t agree with me. Exercise is advised as long as you avoid aggravating the tendon. Slow and steady wins the race. Good luck.

        Vickie, how’s the dry needling working?

      • Vicki says:

        Happy New Year Cooper!

        My physio (trust him totally) is pleased and positive with my progress and says I’ve improved. I’m still not able to buy into his happiness yet (which I have told him) until my life returns to normal physical functionality.

        Needling started beginning September 2013 weekly. Gradual physio started end of October 2013. Wasn’t able to do any before then. Could only manage ten reps of hamstring curls laying on my front with no trainers on (due to the weight) and unable to sit at all. Also other exercises at that level.

        When needling first started, the needles would bend and have to be changed every session but this hardly happens now and it’s not nearly as painful when being done.

        I couldn’t drink coffee, alcohol or consume lemon juice etc.

        Now I’m doing 3 sets of 10 reps nordic curls with 2.5lb ankle weights holding for 10 seconds at a 45 degree angle and lots of other hamstring, glutes, quads exercises of the same level including basic squats. No increase in pain, on a consistent 2 out of 10.

        Can also drink coffee (as much as I want), lemon juice no problem and risked a glass of champagne New Years eve and was fine, no stinging!

        Am sitting for 2.5 minutes at a time.

        Well that’s it in not so brief but creates an accurate picture of IMS (needling) combined with the right exercises at the right level of progression.

        Thanks for asking Cooper. Appreciate it.

        Oh by the way, out of interest, the biggest improvements I’ve had have been since taking the serrapeptase.

        For others reading this, I can’t state enough how important it is to keep going until you find the best medical professionals. Most of them that I have seen have been ineffectual and that’s being polite. Clueless covers it more and two have caused more damage than progress.

        There are some top professionals and I’ve finally been lucky enough to find one.

        Will keep this updated if there’s anything to report.

      • Cooper says:

        Awesome Vicki!!!

        Sounds like you made quite a few sacrifices in the name of this injury. I am happy you’re showing signs of improvement! It is almost a surreal feeling when you slowly work into exercise with either low or no pain. The doubtful side of us carries a certain fear that the “other shoe will drop” and we’ll regress into the old painful and nagging feeling that we first experienced. Your working weights back into your exercise regime, that’s great! Ease back into it. For 7 months I refrained from lower body work. Once allowed, I worked light weights into my routine (quads, hammy’s and calves). Slowly I was able to build up to heavier weights (not too crazy). Feels good doesn’t it? The fact that the tendon is holding up is great news!!!

        Your physio sounds like he has a good understanding of this injury. Stick with what works!
        In October my running was progressing nicely over the course of 6-8 weeks. Things were going great! I had a bit of a relapse one day where I was in the car for 8 hours for work. After the trip I decided to go for an easy 3 miler. In the last quarter mile I felt that same nagging feeling high on the hamstring as I did when I first injured. I immediately stopped and refrained from running since. Probably shouldn’t have run after sitting for 8 hours. Bad decision on my part. Still doing the weights and elliptical. My hope was to give the tendon a little more time to regenerate. I am heading to Florida next week and will attempt a few runs on the beach to see how the tendon reacts. First time since October. If I have a negative response, I will make an appointment with my therapist for a PRP treatment or two. Fingers crossed, I hope the tendon holds up! I don’t know what’s more taxing, the psychological or the physical ramifications caused by this injury! Thank you for the update, sounds encouraging. 2.5 years almost feels like a lifetime I’m sure!

      • tonyafeller says:

        I’ve been looking into having prolotherapy or PRP but someone today suggested the MLS laser or K laser anyone have experience or knowledge of either one of these . I’m just trying to make an informative decision how to move forward here I’ve tried physical therapy , pelvic floor therapy chiro and steroid injections I have made an appt for PRP but someone suggested laser therapy indicating the same results as PRP. Has anyone had this done ? What were you results. The lady I spoke with had both and felt the MLS was pain free and had better results . Please share

      • tonyafeller says:

        I have an appt for steroid injection in isch tuberosity bursitis in 3 days but after researching more into it and all of your comments I am canceling my appt. I thought I made up my mind to move forward with PRP but then today someone spoke to me about laser treatments . Has anyone had any experience with MLS laser or K-laser treatments ?

      • Cooper says:

        Hi Tonya

        I believe I answered your post from December 26th. It was up the chain a bit so I did not see it for a few days. There is a reply above. Good decision on the steroid injections. As mentioned they give you a false sense of healing. It is a bandaid!!! It inhibits tissue regeneration. Actually, it can cause soft tissue degeneration over time. In fact some who have gone with a steroid injection feel as though they can continue their exercise regime only to cause more damage to the tendon. When the steroids wear off, the pain returns and the soft tissue has degenerated further due to the continued abuse.

        I have not researched the effects of laser treatments and HHT. Prolo, PRP and stem cell treatments that have a 90% success rate. I did 6 prolo treatments and gradually worked back into running pain free for 6-8 weeks. I had a relapse in October and blame myself for forcing a run in on a day I should have laid off. The two worst things you can do are sit for long periods (cuts off the blood flow) and run during the healing process. I did both on the same day. I am at 80% and will attempt to resume running next week. If the tendon is still weak, I will contact my therapist and try PRP. It us supposed to be more effective than Prolo but also more expensive. Some insurance companies may not give financial relief for this type of treatment.

        I think you may have scheduled a consult at Caring Medical? If you’re not the same Tonya above, I apologize. Try the web site is I hope this helps!

      • tonyafeller says:

        Hi Cooper , Thanks for responding yes I have scheduled an appt with caring medical group to proceed forward on this long journey I ve been on with this pain in my butt. Someone had just suggested yesterday to possibly try laser therapy in which I had never heard so I was curious if anyone else had either . I haven’t had much time to research it but PRP sound like the direction I m going to go. So was it too painful and does it matter if I see Danielle or Dr Hauser? What was your experience and preference ? Thanks Tonya

        Sent from my iPhone


      • Cooper says:

        Hi Tonya

        I had Danielle but it was more about who could squeeze me in the soonest. Dr Hauser is one of the best in his field and Danielle was trained under him. I don’t think there is a bad choice there. I did the Prolotherapy per her suggestion at the initial consult. Prolo consisted of about 25-30 shots in and around the injury site. Not all prolotherapists induce that many shots. Their technique named after it’s founders is called Hackett Hemwell technique. The goal is to insure the entire area gets treated, cause the body’s natural response to send blood to the area and regenerate and rebuild collagen that was damaged during the initial injury. The only pain I experienced is when the therapist went beyond the areas with the topical numbing agent. I am sorry, I am not sure if the same quantity of shots are given with PRP treatments. You might need more than one treatment depending on the severity of the injury. They do numb the area with a topical agent and they proceeded to inject in and around the injury site (at least with Prolotherapy). I had a sports Doc prescribe PT but I couldn’t wrap my arms around how it would help a degenerated tendon. I skipped PT and went right to prolo treatments. I read an article written by Dr Hauser and his approach contradicted standard remedies as prescribed by most medical practitioners. As you can probably relate, this injury doesn’t heal quickly and we want to get back to a normal lifestyle ASAP. I cannot vouch for laser therapy but I truly feel you’re heading in the right direction. Not mandatory but If you have any MRI pics, you might want to bring those with you. There are videos of the treatment on their web site but if you watch them, you might change your mind. Don’t! It looks worse than it feels. Hope this helps. Good luck!

  208. hiker1313 says:

    Thanks for your article. I have been dealing with Tedinopathy in my left hamstring since June 14 and it is now January 15…..Sucks! I have done shots, RFA, chiropractic, and PT…I am an avid hiker….all sessons. I have been doing all the exercises and stretches regularly too. I an 54, in great shape, former runner, and triathlete. IT band syndrome caused me to stop running. So my question is this; how long did you rest, no running or walking for fitness purposes, for? Were you still able to lift weights, at least upper body? Any help, would be awesome. Thank you…Howard

    • Vicki says:

      Hi Howard,

      One thing I wouldn’t be doing is stretching. I’m not the best person to ask regarding how long to rest for as mine’s so bad I can’t sit down. I’ve been “resting” (please google the definition of active rest for this) for 3 years.

      Everyone has varying severity of HHT so there is no black and white answer as to how long to actively rest for. It’s different for everyone.

      All the best.


    • Cooper says:

      Hi Howard

      Speaking for myself, I refrained from running for 6 months. My workout regime consisted of upper body strength training and the elliptical trainer for cardio. Running would cause further degeneration to the tendon in the early stages of the injury. Running was probably the cause of tendon degeneration. Rest isn’t recommended either. Other forms of cardio less invasive to the tendon is actually recommended (swimming, elliptical etc…).
      You can still stay in shape but you should work around the injury. The thing I enjoyed about the elliptical trainer is the fact that there is a ramp setting on the club machines that take the focus off of the hamstring muscles. A higher ramp setting only focuses quads and glutes. The lower ramp settings add the hamstrings and the calves. Good luck!

      • hiker1313 says:

        What do you think of hiking?

      • Cooper says:

        I’m not sure I am qualified to answer. I would assume if hiking consists of steep inclines, that might put undo stress on the injury. I avoided any strain on the hamstring area such as running, stair climbing etc… Even refrained from high velocity chiro adjustments. Bottom line, I would avoid stressing the tendon for awhile.

  209. Vicki says:

    Hi Cooper, sorry just seen I haven’t replied. For me the mental side is the hardest with this injury. I could live with the pain but not the restrictions. It has been life changing.

    My physio has confirmed since taking the serrapeptase my tendons have shrunk from 75% thicker than they should be to 25% thicker. So a very big thank you. I’d never heard of it before and was surprised to find it on Amazon UK.

    He thinks it’s a combination of needling, eccentric exercise and the serrapeptase that’s instigated the improvement. However I’m sure it’s mainly the supplement.

    I’ve ordered MSM to work alongside the serrapeptase. I’ve also increased the amount.

    Having researched, there seems no upper limit of how much you can take.

    Have you managed some pain free runs now?


    • Cooper says:

      Hi Vicki. No worries, I was out of town for the past week. I agree the psychological repercussions were far worse for me as well. I am so glad to hear that your rehab is going in the right direction. Sounds like the scar tissue is subsiding as well. Hopefully that enables the soft tissue to redevelop. Is there a chance running might be in the forecast anytime soon?

      One of the articles I read about Serrapeptase indicated that athletes will take up to 3-4 times the recommended dosage to accelerate the healing process. There doesn’t appear to be a limit on the dosage that would cause concern for harmful side effects. As I mentioned in an earlier post, to read about this supplement, you would think this was a miracle drug. There is no down side to taking it. Kudos to your physio as well. Your patience and hard work sound like they’re finally paying off!

      I am happy to say my running last week went very well. Thanks for asking. I only ran 2 days (with one day of rest in between). Didn’t want to push the envelop. I didn’t set any speed or distance records (running with caution), however, the tendon help up!!! Talk about an emotional high! It felt good to get back out there again. I hope to slowly work running back into my exercise regime 1-2 times per week. Eventually over time I will build on that! The fear is having another relapse by pushing too much / too fast.

      Thank you for the update. Stay in touch with your progress. Take care!

  210. Anand says:

    Good morning,
    Read the entire blog. It’s very informative. I have a few questions though.
    When you started your excersice regime w’re you still in pain or totally pain free?
    How many months into the injury did you start swimming?
    I have had this injury since January 2014 and I do have pain while sitting but I’m good while standing.

  211. Anand says:

    Can you use the elliptical in the gym with this injury if you are pain free standing.

  212. Anonymous says:

    Hi Anand,

    When you say, “when you started your exercise regime” do you mean exercise or physio?

    I’m still at the physio stage and unable to exercise except slow walking.

    Everyone’s HHT is different with regards to timings as the severity of the injury will differ.

    Look out for Cooper’s reply – he’s knowledgeable.


  213. Anand says:

    This post and the comments are really helpful….
    Can squats and lunges be done in this injury?

    • Anonymous says:

      They can be but you need to be careful as it depends at what stage of degeneration/recovery you are at. I haven’t progressed onto lunges yet. If you haven’t already got one, I’d suggest you find a recommended physiotherapist that has successfully dealt with this injury in the past.

  214. Cooper says:

    Hi Anand. Don’t let Vicki fool you, she’s very knowledgable about this injury. Sounds like you and I share an anniversary as far as our injury date. Mine was the first week in January 2014. The best thing you can do is work around the injury. My therapist endorsed swimming, elliptical and biking (lower impact on the tendon). Biking wasn’t for me since sitting was painful. Running and boot camp (where we did many lunges and squats) were off limits during the the recovery period. No high velocity chiro adjustments as well. Bottom line you don’t have to refrain from cardio, just from exercise that will do further damage to your tendon. For 6 months I did weights (upper body only) and elliptical. The key is to allow the soft tissue (tendon) to regenerate new collagen. In order to allow soft tissue to regenerate, refrain from using NSAIDS such as ibuprofen or ice. These actually slow the blood flow to the injury site which in turn slows the healing process. Heat is your friend. Been sitting on a heating pad for over a year. I am presently easing back into running and boot camp relatively pain free. Still not 100%. Good luck.

    • Anonymous says:

      Ha Ha! The other half of the Mutual Appreciation Club here!

      I agree with Cooper. I only last week had an in-depth conversation with my physio about bio mechanics and chiropractor adjustments and that is definitely out. Too much emphasis is placed on bio-mechanics and subsequent adjustments with HHT. Chiro’s tend to go at a problem like a bull in a china shop and that is not the way forward with this injury.

      You will get to know how to handle this as you go along. By nature you will take two steps forward and one back which will affect you mentally. Stay strong and persevere.

      At the moment I’m on a step back with re-injury. If you can’t rise above the pain and aren’t allergic, take paracetamol. This won’t affect collagen repair.

      Best wishes.


  215. Cooper says:

    Hi Vicki. I’m sorry to hear about the setback. How did you re-injure?

    • Vicki says:

      Arrr thanks Cooper, I tried to drive. All I wanted was to shop at a supermarket for once instead of order on-line but I knew as soon as I got there (only 16 mins drive) I was in trouble. Went without another driver so had an hours break and had to drive myself back.

      All in all it wasn’t such a bright idea after all.

      Saw my physio yesterday and he thinks it’s not too much of a problem. Says reduce remedial physio back for a couple of weeks i.e take weights out of basic squats etc. and should catch up with where I was. So in effect, if physio is correct, I’ve been set back about three weeks.

      What can you do but press ahead.

  216. I’ve had this (a mild version) for a few days now. Based on the reports of taking months for healing I need to know how to prevent this from worsening into a real injury. It starting out with just minor soreness, what felt like typical muscular (er, tendon) soreness. But then I tried to stretch it with the single legged deadlift stretch and that aggravated it. I tried some glute bridges and stuff. Hopefully that will strengthen the hamstring/glutes without stressing the ishial tuberoscity too much. I think a combination of vigorous track workouts (alas, a 150m indoor track two-mile race) and too much squats and deadlifts (which I’m laying off of now) might have overstressed my upper hamstrings. Any suggestions for preventing this from worsening?

    • Vicki says:

      I’d see a good sports physiotherapist not a basic physio. If you aren’t happy with the first one, move on until you feel you trust who you are seeing. You can’t take too many chances with this injury so get professional help.

      If they are any good, they should be able to advise on correct active rest, dietary changes etc. and may sound a bit extreme but get a vitamin D blood test if you aren’t in a sunny country.

      • Anonymous says:

        Hi Vikki I’ve been following this site on and off I’m not a runner however I’ve had a similar injury after surgical procedure that has left me in quite a predicament it happened after a hysterectomy probably due to positioning of my leg but the mri showed tendonopathy I have been to 2 phy med drs 2 pelvic floor specialists for on off 7 months 8 weeks physical therapy and 3 steroid injections in my SI joint , hip and ischial bursa and referred to ortho which referred me back to physical therapy no one knows what to do but Its def where my muscle attaches to ischial tuberosity so I think the hysyerectomy procedure throws everyone completely off its actually my hamstring and butt that are inflammed it’s been 15 months now but mine never gets any better no matter if I stretch it roll it rub it I also forgot to mention I’ve seen a chiro and had weekly massages on my butt with no help the muscles piriformis and glut s all stay tight along with hamstring but my glut s have large knots which are probably scar tissue you mentioned you no longer had these knots and scar tissue what helped you get rid of these this is where my pain comes from the knots and I can’t sit in so much pain nothing seems to make it better or worse it just it always there help !

  217. Anand says:

    Thanks for the input
    My therapist has stopped me from doing hamstring stretching and rolling
    Walking for an hour is pain free
    Cycling was allowed but it’s pain so stopped
    Not running yet 😦
    Will see next week

  218. Vicki says:

    Good luck Anand. Therapist sounds like he/she is on the right track with no stretching or rolling of the hamstring tendons.

    That comes at the very end of the healing process when the tendons are healthy to condition them ready for running etc.

    • Cooper says:

      Hey Vicki
      Sorry, haven’ t been on the site much. Thought I would check in to see how you’re doing since the setback? How’s the physio therapy coming along? Are you on the mend? I hope you are seeing progress since our last chat. Spring is finally here and I’ve been able to get outside for few runs per week. So far, so good. Still tender back there but the tendon feels much stronger. I think strengthening the hamstring is paying off. I hope all is well with you. Take care.

      • Vicki says:

        Hi Cooper, good to hear from you. I keep relapsing. About once a week at the moment. So I get two or three days of pain I can cope with then a relapse.

        My physio has scanned me recently and confirmed there is no physical barrier preventing tendon repair now. All the scar tissue and knots have gone but the tendons are weak from under use so have to build them up with daily eccentric exercise.

        He reckons another 6 months. I’ve gone down to seeing him fortnightly for catch ups. IMS has finished.

        I must say, I’m trying to stay positive but I find it hard to do so at times.

        Thanks for checking in and I’m really pleased you are running again.


      • Dawn says:

        Hi Vicki,
        Know it’s difficult to stay positive about this “issue”. Mine has been on-going for 17 months. I’m someone who could forget her own birthday but not the date this journey began. Being in a car for very long (30 minutes tops) will definitely bring on the worst pain for me. I’ve learned that a heating pad is my very best friend and I’m ready to buy a couple more so I can leave one in each of my favorite chairs and my bed instead of moving one with me everywhere I go. Do they make a battery powered version, I wonder? That would be great in the car! It’s almost funny. But not quite! Still, it always helps me to know others understand life with HHT. I’m wishing you the best, whether healing or just dealing with it.

      • beccakahn says:

        Good idea about the heating pads. Also funny is I have one tennis ball in the car, one in my office and one in pocket book so I always have one to sit on to release the muscle. I’ve gotten so many strange looks when I get up, forget the ball was there and it drops on the floor!

      • Cooper says:

        Hi Vicki

        Glad to hear the scar tissue has subsided. Have you discussed the use of collagen supplements with your physio therapist? When we lose collagen, our tendons and ligaments start moving with less ease, leading to stiffness, swollen joints, and more.
        They say ingesting collagen is like greasing a creaky door hinge: it’ll help your joints move more easily, reduce joint pain, and even reduce the risk of joint deterioration.

        This injury can definitely rob you of your self esteem. I know you are doing all you can with the treatments that are available to you. The doctors were part of the problem, not the cure. Probably prolonged the healing process.

        Keep up with light strengthening exercises. Important to work hamstrings, quads and glutes. When I first started lower body strength exercises, I kept it very light. You need to work into it slowly. Your physio sound like a sharp guy.

        Thanks for the update. One day I hope to hear that you’ve returned to a healthy routine. Take care and stay in touch.

        Ps: I think you have a post from anonymous on April 10th. Scroll up a few replies.

      • Cooper says:


        A blast from the past! How’d the PRP work for you? Working back into running?

      • beccakahn says:

        Hi Cooper! Thanks for checking in! Like you, I’m doing the elliptical. And like Kevin Mullinjs, who posted today, I have come to the conclusion that this is an injury that I will have to manage forever (or, close to it!) The PRP seemed to really be helping, but it stopped working in January and I just couldn’t afford another one. I’m so drained (of money and mental energy) at tis point, that I’ve basically decided to just live with it. I don’t run, but I use the elliptical and I can still ballroom dance, although not competitively. I actually joined a competitive team in February but it was too strenuous and I had to quit after a few weeks. For the moment, I’ve stopped looking for a “cure” and just modify and balance rest time with exercise. Sorry to sound like a downer! I’m actually trying to be more accepting and try not to mourn what I’ve lost. Not being able to be as active actually prompted me to go back to school. I figured that’s something I can do rather than just focus on what I’ve lost,.

      • Cooper says:

        Hi Becca. I’m sorry to hear that you’re learning to deal with the pain. I understand all to well about expense of treatment. Mine treatments were all out of pocket. Unfortunately the insurance companies do not assist financially. The irony lies in the fact that PRP is more cost effective than surgery with better results. They’d rather pay for the surgery. I’ve been told sometimes multiple PRP treatments are necessary to push this thing over the top. Prolo got me to 85-90%. In the beginning they recommended 4-11 treatments. They said I would know when to stop. After 6 treatments I was running (easy) and feeling stiff but pain free. In October I had a relapse. I refrained from running for 4 months and eased back Into it slowly. Light lower body weight training helped. I don’t have the inflammation during long periods in the car like in the early stages of this injury. I am considering trying a PRP treatment with hope that it would get me to 100%. Mostly pain free with some stiffness is where I’m at presently. Hang in there, sounds like your making the best of a bad situation.

  219. Anand says:

    I had been on rest and now the therapist has allowed a bit of running every day with strengthening and 20 mins cycling alternate days
    So far so good
    But since last week I have started having cramps in the left hamstring after about twenty mins of running.
    I’ve been rolling also as adviced.
    Please can you suggest something else. Will swimming help??

    • Cooper says:

      Yes. Actually all I did for 6 months was elliptical training for cardio. Swimming is good too. I couldn’t bike due to the pain sitting. I think he’s got you running too soon. If you’re an avid runner, that’s probably what injured your tendon by causing it to degenerate over time. Soft tissue needs time to regenerate new collagen. That’s what the tendon is made of, collagen. I am about 85-90%. Been 16 months since the injury. I came back too soon once and re-injured in October. I realize it is difficult to stay away from running so long. Starting over is even worse. Be patient and make good decisions. Good luck

    • Vicki says:

      Anand have your bloods done to check your vitamin D and nutritional levels are correct.

  220. I’ve had this injury since 2010 and have seen many, many specialists, none of whom have been able to “cure” this injury. In fact, I fully believe now that it is not actually possible to beat this condition at all. I don’t recall reading about anyone in the vast blog who has actually overcome HHT?

    I’ve given up and now “manage” it as best I can. I can no longer race or do speed work, but can run up to 10 miles at a fairly gentle pace. For me, it’s just about rest and not running too fast or too hard. I also find lifting heavy stuff plays havoc with this injury, so would advise avoiding that if you can.

    • Vicki says:

      Hi Cooper,

      Thanks for mentioning the person above who posted. I saw it yesterday but haven’t had a chance to reply.

      Can you recommend a good collagen supplement? I tried Trec Joint Therapy for some time about two years ago but it caused bloating and then I realised that it was the amount of water you had to drink with it that was alleviating the pain not the tablets.

      To be fair, I was in a much worse place with this injury back then. Pain levels were continually high and I was still sitting or standing for most of the day plus it took to find the right person to tell me I had a large amount of scar tissue and knots.

      Yes you are right, you could almost fall in love with a good physio!

      I’m continuing with daily eccentric programme at home and realised I have to build up sitting by using the fattest pillow I have on top of my mattress. The sitting just for 9 – 10 mins once a day on my bed was one of the causes of inflammation/flare ups.

      I cannot give up. I’ve recently started a Higher Hamstring Tendinopathy Support page on FB as so little is out there for people with this. Don’t even know if I can say that on here but I just have!

      I really appreciate everyone checking in again. xx

      Oh and just for good measure one of my ribs has displaced itself from my spine. Am on co codamol until physio practice opens again. Fourth rib in four months!

      • Cooper says:

        Hi Vicki

        I’ve been taking Neocell Super Collagen type 1&3 6000mg with vitamin C. Also available on Amazon. I cannot attest as to whether or not it’s been effective in my healing process. My getting to 85-90% could be a combination of time, rest, Prolotherapy, light strength training and/or supplements. Who knows what the catalyst was in getting me to this point. The supplemental Collagen claims to enhance ligament and tendon health. These’s no downside. As I said before, worst case scenario, you’ll have great hair and nails. Good luck. Fingers crossed you’ll beat this thing.

      • Vicki says:

        Thanks Cooper. I’ll look into it.

    • Cooper says:

      Hi Kevin

      I understand your frustration. Surrendering to this injury is difficult. Especially if running has been a big part of your life. When first researching this injury, I found a lot of valuable information on this web site – Under “find my condition” – look up “ischial tuberosity pain”. This clinic practices an unorthodox approach to soft tissue repair. As I told Becca, insurance doesn’t offer much assistance for this type of therapy. I’ve had some success with Prolotherapy treatments. Enjoy the info, it’s an interesting read. Good luck!

      • Hi Cooper, I’m in the UK and not even sure if prolotherapy is available at all here? When you say “some” success, I take it you’re not cured? Do you even know for sure it’s the prolotherapy and not some other aspect that is making you feel somewhat better?

        Like I said before, I’m of the opinion there is no cure for this literal “pain in the ass”. Maybe surgery could help, but the surgeon I visited said there was no procedure he was aware of for this condition. He said I won’t do any more harm by running, but would have to deal with the pain.

        With my own situation, just to add a further complication, I also have mild Von Willebrans blood disorder (missing one clotting agent), meaning I can’t take any anti-inflammatory drugs.

      • Cooper says:

        Hi Kevin

        If you’re in the UK then you probably don’t have Prolotherapy available to you. I am not 100% but after 6 treatments (and I could have opted for more) they had me easing back into running in 6 months. I was doing great for a month and I had a relapse last October. Partially my fault. I was in the car for 8 hrs and decided to squeeze in a short run before dinner. Not using better judgement I ran after cutting off the blood flow for 8 hours. The last quarter mile of my run I felt the tendon pull as it did when I first injured. Now I could have gone back for up to 5 more treatments but they left it up to me to decide. I laid off running for 4 months and continued elliptical for cardio and strength training upper and light hamstring,quad and calves. I started taking collagen supplements to aid regeneration of the tendon. 4 months later and I am running relatively pain free. It is a little stiff at times but no Inflammation on long car rides. When they treated my ischial tuberosity they were kind enough to treat my lower back as well. The is one cause (of many) that causes tendon degeneration. High velocity chiro adjustments could also cause this. In summary, my back is better than it has ever been and my hamstring is at 85-90%. I would say that’s progress. Most like yourself have had this for years. To answer your question I believe Prolotherapy got me to this point in my healing process sooner than if I just lived with the injury.

        I think your doctor was wise in not promoting surgery. I think he gave you bad advice about not doing any damage and living with the pain. I have not heard many success stories regarding surgery. It is usually a misdiagnosed. I cannot understand how surgery would assist with tissue regeneration. That’s what you have, a worn out tendon that needs time to regenerate with heat (not ice or ibuprofen). Be thankful that you are unable to take anti- inflammatory drugs, that actually works to your advantage. Both therapies slow down the blood flow which slows down the healing process. The tendon needs blood flow to regenerate. I’ve been sitting on a heating pad for 16 months.

        As I told Vicki it could be a combination of rest, heat, non invasive exercise for cardio, Prolotherapy and supplements. It could be all of the above. Running is probably the cause of the injury and continuing to run is counter productive to allowing tissue regeneration. I don’t believe in the “just live with it” approach. It might take some time but the tendon needs a break and pounding out 10 mile runs in pain cannot be good for the tendon. Very sorry for the long synopsis but I think it’s possible to beat this thing. I too get impatient and want to get back out there a bang out a 10 miler. But not at the expense of further damaging the tendon which I firmly believe you are doing with your doctors blessing. You’ll never heal which makes your beliefs about this injury a self fulfilling prophecy. Doctor Hauser, on the web site I gave, you goes into great detail about soft tissue damage, repair and treatments. Even though you might not have his treatments available in he UK, he discusses the fallacies of western medicine and it’s contradictions to soft tissue treatment. In my experience, he’s been more correct than anyone else that is out there including doctors and chiro’s.

      • vicki says:

        Sorry to nudge in. Yes we have prolotherapy here. Is 12.30 pm so get back to you tomorrow.

      • Cooper says:

        Nudge away Vicki! Glad to hear there are options in the UK. Please let Kevin know if he’s interested. I notice I should have done a little spell checking on the last post. I was in a hurry and regurgitated some random thoughts. Pardon my French but clueless doctors are starting to piss me off.

      • Vicki says:

        I won’t re read it to proof read…..although it is tempting! Lol! Don’t worry about typos, don’t think anyone’s bothered.

        Think it comes across on here to a degree about what I think of doctors but have tried to play it down.

        An example from last week. Went to see the top man at what is considered one of the best sports injury clinics in the country and was asked what treatment I was having elsewhere. I replied IMS (intramuscular stimulation) and he looked phased and then said oh yes intra mechanical servicing!!! Am I car now!!

        Then I lost faith.

      • Cooper says:

        Amen to that! I rest my case.They have a place in medicine, but not very helpful or knowledgeable about this particular injury.

    • Tuomo says:

      Maybe surgery is still one kind of option.. but i guess it has to be done by someone who has done lot of similar surgeries earlier. You can search by google pdf file, which name name is “Hamstring syndrome – proximal tendinopathy” (Sakari Orava, he was the one who developed the technic) , there is some results of surgery: Results
      Excellent 46, Good 31, Moderate 10, Poor 2, Reoperations 6 (patients).

      I got this for one year now, but i didn’t go to surgery. It was extremely bad in beginning, nowadays it’s quite ok even thou im not able to do all things as much as i would like to do.

      • Tuomo says:

        Here’s the link

      • Tammy Marie says:

        I had the surgery done almost 2 years ago. I can run and SIT!!! (not on bleachers and not for hours at a time, but I’m not sure that will ever happen). In laymans terms here is what my doc did: he split the tendon and re-attached it using 3-5 anchors (mine required 4) back onto the bone, then repaired the tendon. It was a very long recovery process, like 18 months!! And it’s still not perfect, but it’s 90% of what it was before surgery, so I’ll take it. If you can find a doc that knows and understands what this injury is, and it’s recommended for you, and you’ve tried everything else that is possible I recommend it. Good Luck!!!

      • Tuomo says:

        This is what i feel has helped me most

        +rest enought
        +go to masseur who is familiar with the injury
        +giving self massage (for example with back rest of chair or with adjustable trekking pole). When there was strong sitting pain, usually after massage is become better.
        +right kind of stretching (timing of beginning is critical). I think careful streching even at quite early stages will prevent grow of scar tissue. I started too late (about 5-6 months after injury).
        +do exercises in gym, follow physiotherapist instruction (when it becomes possible)
        +doing versatile sports

        the opposite
        -didn’t take the injury serious enought at beginning
        -walking in forest where is no paths (need to lift up legs too high)
        -picking up berries in forest (position is not good)
        -walking in wet swamp
        -cycling with full power too soon

        I got injury from cycling, i used to do long trips and riding 8-9 hours almost every day, also bike seat was not good enought.

      • Tuomo says:

        one useful stretching is laying on floor foot against wall, and try to find all different kind of positions (adjust leg angles and foot distance) and keep them several minutes.

      • Tuomo says:

        I found out that all kind of practicing with heavy backpack (20-30 kg) is good for this issue. For example carry it 1-3 hours / day while you are inside, or carry it while go up and down in stairs. Also standing still without backpack is useful, laying on bed is not.

      • Amanda says:

        Have any of you had a successful surgery for Hamstring Syndrome? And if so, which surgeon did you see?

      • Tuomo says:

        I’ve heard that Sakari Orava (finnish) has made succesful surgerys.

        I’ve been free from symptoms about year now, without surgery. I went working in a factory, where work included lots of different kind of lifting etc. I also did lot of stretching, but always with warm muscles (after exercise).

      • I had surgery in January of 2017 after suffering from HHT for 3.5years. I am a pro runner and am back to running now. It’s not perfect but I have seen some big improvements. Certainly there is always a risk to surgery, but if you’ve suffered long enough and tried everything else, it can be worth it. You can follow my progress on my blog;

  221. Vicki says:

    Hi Dawn,

    Don’t stretch, roll or rub the tendons. If you can, have an MRI or see a good sports physio who can feel if there is scar tissue and or knots during examination plus perform an ultrasound scan to locate exactly where they are for treatment. IMS much better than massage for these. I’ll come to that.

    Use a Trigger Point foam roller (they’re the best). Got mine off Amazon. Roll the three hamstring muscle elements but stop before you get to the HH tendons and don’t roll over the top of the “hip shelf”. Also roll the calves, IT bands, glutes and quads.

    You may notice that as the day goes on, the HHT’s hurt more because the hamstrings are tightening. Rolling will alleviate the pain as you are stretching out the hamstring muscles and stopping the pulling higher up.

    If you can, try to roll more than once a day to maintain length, aid pain relief and healing. There’s some good you tube videos on how to do this.

    Personally, I avoid chiros. Too many people have warned me off and I’ve heard first hand stories of permanent soft tissue and nerve damage but of course it is every individual’s choice.

    To get rid of the knots, see good sports physio who is qualified in IMS. Intramuscular stimulation also known as dry needling. Ask them about their hygiene/infection control practices first. If they are any good they shouldn’t take offence at this and in no way should they reuse sterilised needles. You should see your one for your session come out the pack after the physio has sterilised his hands and your surface area to be worked on with alcohol gel.

    To rid yourself of scar tissue, I used serrapeptase as recommended by Cooper. Bought this off Amazon too. Tasteless, colourless tablets that I found had no side effects.

    Read up on and check with your doc re serrapeptase first. Although I found no one here had heard of it.

    Sports physio should also give you daily eccentric exercise at home too for tendon/muscle strengthening.

    It’s possible you have a mix of both tendinitis and tendinosis. It was first thought years ago, this was tendinitis, then later tendinosis but now thought has changed and it is believed there is some inflammation involved when this injury is chronic. Try to read up on both.

    Do you sit for a living?

    Have you had your vit D, calcium, magnesium, iron, zinc, vit E and vit B (all of the B group) levels checked? Plus take vit c as an antioxidant to remove toxins from breakdown processes.

    I mentioned in my post to Cooper that I’ve started a Higher Hamstring Tendinopathy Support page on FB if you would like to access it.

    One other thing, ladies of a certain age may want to consider getting their hormone levels checked. Low oestrogen levels affect collagen repair.

    Hope this helps. Stay strong. Don’t give up!!

  222. Deb says:

    So Thankful for your post and recommendations. I am experiencing this – I been going to upper cervical Chropractior seems to help. Until the last time my Dr. Over did it now I’m in server pain. In the morning, after rest especially! I sure hope your doing better. Do you think a sports PT would really help? What have you found that really helps? Since you posted this?

    • Vicki says:

      I’ve had another relapse Deb, yesterday, so no improvement, I’m worse.

      I found it best to see a sports physio. I’ve mentioned before, I’m not keen on Chiro’s as they can cause further problems.

      My consultant and physio think it’s a good idea to take Amitriptyline (muscle relaxant, pain killer and anti depressant combined) which I’ve been delaying for months if not a year

      Sports Med Consultant says it doesn’t impede collagen repair. Which was one of my reasons for not taking. Plus the antidepressant – didn’t fancy it.

      The main reason though, was when you’re on it how do you know if you are over-doing it?

      Can you imagine, you’re on it for six months, you come off it and you are no better or worse because you couldn’t judge how much to do as there is no pain.

      They’re both saying because my pain is chronic (like a lot of people on here so this may be good to know and follow if I go for it) my pain receptors have physically multiplied to cope with the strong messages and where I may have had one, lots more have grown off that one making my brain over sensitive to pain.

      They both think there is nothing physically wrong with my H.H.T.’s. following an ultrasound scan.

      So I’ve decided I can’t continue relapsing, It’s not working out and I could carry on like this for life.

      I’ve given it long enough without the amitriptyline and it hasn’t worked. (Obviously the IMS and serrapeptase got me to a point where there were no physical barriers to recovery).

      They say that eccentric loading produces more collagen. Idea is to take Amitriptyline and continue with eccentric programme for collagen production, strengthening and to kill of the extra unwanted pain receptors.

      Cooper, do you have any thoughts on this?

      Obviously, I realise this is my choice and my choice alone.

      Many thanks.

      • Cooper says:

        Hi Vicki

        Below are a few random paragraphs from a web site I researched long ago. So sorry about the recurring relapses. I hope some of the info below helps. Take care…

        Exercise does not notably increase the blood supply to ligaments. Exercise does not have the profound stimulatory effect on ligaments that it has on muscles. Ligaments are made up primarily of type I collagen. This particular type of collagen is very resistant to stretching (has a high tensile strength). Collagen is a type of protein and is therefore made up of amino acids, building blocks of protein. What most people do not know is that the collagen in ligaments is thought to remain relatively metabolically inert, with a half-life on the order of 300 to 500 days. This means that the metabolism of collagen is very, very slow. It is a good thing this is true, because blood supply to ligaments is so poor. This is another reason ligaments heal so slowly and are so prone to injury. Anything that decreases the metabolic rate or blood supply to the ligaments will further promote the decline of the ligaments, and profoundly delay their healing.

        In addition to weakening of the ligaments themselves, immobilization decreases the strength of the fibro-osseous junction where the ligament attaches to the bone. If rest and immobilization hinder ligament and tendon healing, then studies should show that early mobilization helps soft tissue healing. This is exactly what has been shown. Bekerom et al reviewed 11trials involving 868 ankle sprain patients.13 The results revealed those who included early mobilization compared to those following the standard RICE treatment reported a shorter sick leave with faster return to sport participation, less days missed from work with less visits to a clinic for follow-up, and improved range of motion with better functional scores.

        Muscles commonly contract to stabilize a joint when a ligament is lax or weakened. As a result, muscle spasm may cause ischemia, which is a decreased flow of blood and poor oxygen to tissues. This can stimulate pain receptors that are sensitive to chemicals. The blood vessels are compressed and blood flow is decreased with a muscle spasm, accompanied by a concurrent increase in the rate of metabolism in the muscle tissue. Trigger points can be caused by a number of factors, including sudden trauma, fatigue, repetitive motions and over-activity, nutritional deficiencies and nervous tension or stress. The most common cause, however, is chronic ligament laxity.

      • Vicki says:

        Thanks Cooper. This confirms to me that Amitriptyline is a good idea. The muscle relaxant within will help prevent muscle spasms and decreased blood flow.

        The pain killer will enable me to mobilize more increasing blood flow and strengthening my muscles and tendons.

        Your info spurred me on to read more about the half life of tendons and this is what I found:

        Story Source:

        The above story is based on materials provided by American Society for Biochemistry and Molecular Biology. Note: Materials may be edited for content and length.

        Through this method, the researchers found that non-collagen proteins in tendon have an average half life of 2.2 years in SDFT and 3.5 years in CDET, which would be expected. However, SDFT collagen had a half-life of 198 years, compared to 34 years for CDET collagen. That means that every year, only 0.25% of the injury-prone collagen gets replaced in SDFT tissue. Over time, degraded protein and other mechanically-induced micro-damage could reduce the overall integrity of the tendon, which could lead to large-scale injuries. As to why the body would seemingly put its more important tendons at greater risk, the researchers suggest that it may be a trade off; too much repair may compromise the strength and stiffness of these tendons which are used heavily, so the body tries to preserve their structural integrity at the expense of increased injury risk later in life.

        0.25% of collagen gets replaced a year!!

        I’ve done two years this August but admittedly a year of that was active rest i.e. no sitting or physio because everything I did made it worse. I’m now thinking I’m on the right route even if I have to stay on Amitriptyline for another two years. Gosh! The thought of it!

        Obviously I will reduce down every 6 months to see how I’m doing.

        Thanks again and hope you are nearing full recovery.

      • Cooper says:

        Hi Vicki

        Glad to help. I’m sure you did your due diligence as well. I had to look up Amitriptyline. It appears this medication is used to treat nerve pain (such as peripheral neuropathy, postherpetic neuralgia) among many other things.

        Sounds like its worth a try? The good news from your post was the fact that your consultants didn’t seem to think there was anything physically wrong with your HHT’s. Therefore regeneration of soft tissue sounds like a possibility. I was concerned that prior procedures may have caused irreparable damage. This treatment sounds like it has promise. I wish you all the best. Good luck!

  223. Vicki says:

    Meant to say, look up neovessel ingrowth.

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  225. Florence says:

    Hi, 3 months ago while doing a lunge at the gym heard a loud pop felt excruciating pain and my leg went from under me, I was taken to hospital and a ruptured hamstring diagnosed. I was on crutches for 6 weeks and started physio at week 9, meanwhile was being seen by an orthopaedic surgeon who sent me for an MRI scan. I finally got the MRI 11 weeks after my injury which appeared normal. I continue to have pain in the hamstring on walking I find any kind of small incline or hill impossible continue to have pain under buttock area on sitting bone, I can’t walk fast or for long distances and cannot lift this leg when lying flat on my back and cannot lift this leg out to the side using my hip, I don’t understand how the MRI can be normal

    • Vicki says:

      Hi Florence, I had an ultrasound that missed a tear and golf ball size bleed in the belly of the bicep femoris. Unfortunately this sort of thing can happen. Are you in a position to get a second opinion?

  226. sharon says:

    OMG, this is the first time something has sounded similar to what my daughter is going through. She is only 15. She is not sporty at all so did not injure herself in that area. However, she has beeing dealing with a problem foot and after several months she got orthotics. But in the mean time she started getting this terrible pain and her hamstrngs were so tight it was ridiculouts. Only on the right hand side which is the side with the dodgy foot. Anyhow , physio made it worse and he stopped seeing her as he felt she needed an MRI

    Dr said not to the MRI and said she just needed to stretch and take pain relief.

    Pain relief would not help except codeine which she had to take due to a separate small procedure she had on her right foot. She got so sick from it she stopped taking it of course. Took 2 weeks to recover from the codeine. so now she was back to constant pain.

    I had to pull her out of school because she couldnt sit. it was ridiculous. She hasnt been to school for weeks now and doctors are not giving us any clue as ot what to do except stretch.

    So we found a lady who did dry needling and that really helped the muscles. They are now nice and loose. BUT, she is still in pain and went to work for 3 hours today for the first time in weeks. She has a part time check out job at Kmart. She was in agony after 3 hours. not sitting, just standing. Her leg was screaming after only half hour and she had paracetamol before she went to work.

    I dont know how I am going to send her back to schoool. She cannot sit for long and she is in agony after stnding or stiting for too long. Drs say her hamstrings have not grown with her bones. She is very very tall for her age and very slim and not sporty at all but walks a lot at school.

    I am going to look at compression shorts, and the ball or roller you speak of. SOunds awesome.

    Have you ever heard of it being this bad in a teenager? Her muscles are nice and loose now but she is not out of pain. She spends most of her time lying down as thats the only relief she gets.

    Any other ideas? SHe had massage and mud packs on thursday, hasnt helped yet. We are trying traditional acupuncture next week.

    We have 3 weeks to get her back to school

    Hoping to get some ideas.

    • Dawn says:

      Sharon, I’m so sorry your young daughter is dealing with this. Not that it will lead to an obvious path of action, (which doesn’t exist for this issue) but I sure think an MRI would be wise to help identify exactly what’s going on. My issue is what was described as a “small tear in the tendon” and after two years I’m getting used to the pain management techniques I’ve developed. Mostly not sitting too long, and on a cushion and heating pad as much as possible. Your daughters issue sounds worse and I hope you find a healing path for her.

    • Cooper says:

      Hi Sharon. Below is information from a web site that does work with soft tissue regeneration. Hopefully this will give you a better understanding of what could possibly be your daughters problem. As you are aware of by now, the tendon does not heal quickly. Good luck!

      The ischial tuberosity is a swollen part or broadening of the bone in the frontal portion of the ischium, the lowest of the three major bones that make up each half of the pelvis. As the point of fusion of the ischium and the pubis, it is attached to various muscles and supports the weight of the body when one is sitting. Ischial tuberosity pain may be experienced by a wide range of athletes, including soccer players, cyclists, baseball players, figure skaters, cheerleaders and any type of jumpers or runners. It is often misdiagnosed as ischial bursitis, an extremely painful condition.

      Ischial tuberosity pain can be very debilitating and severe, especially when sitting, standing, or running. It can be aggravated by prolonged sitting, since we sit on the ischial tuberosities.

      How does an ischial tuberosity injury develop?
      The ischial tuberosity is the point of origin of the adductor and hamstring muscles of the thigh, as well as the sacrotuberus ligaments. The forceful pull of these muscles, such as can happen during a variety of sports, as a result of a trauma such as a fall or other type of injury, or through the overuse of the hamstrings, as is common among runners and soccer players, results in a separation or detachment, also called an avulsion, of an open ischial apophysis.

      What are the symptoms of ischial tuberosity pain?
      The symptoms of ischial tuberosity pain are, plain and simple, “a pain in the butt.” Pain on the bottom of the buttock, especially when sitting and running is typical. The area may also be quite tender and sensitive to touch.

      The typical pain management route
      Ischial tuberosity pain is often misdiagnosed as ischial bursitis, especially with athletes. The treatment modality commonly prescribed in modern medicine usually involves the RICE protocol, which consists of rest, ice, compression and elevation. The problem with this approach is that it does nothing to repair the injured tissue in the area, in this case ususally the sacrotuberous ligaments and/or the hamstring tendon attachment, and, thus, does not alleviate the chronic pain that people with this condition experience. Rest and ice are particularly serious culprits when it comes to soft tissue damage because they decrease circulation to the area, which actually hinders rather than helps the healing process.

      Physical therapy is commonly ordered and has its place for the treatment of ischial tuberosity pain, but once again, does not address the issue of weak or injured ligaments or tendon attachments.

      Steroid injections and anti-inflammatory medications are another standard recommendation of modern medicine. These treatments may provide short term relief, however, in the long run do more damage than good.

  227. Vicki says:

    Hi Sharon, sorry your daughter has this going on, it must be difficult for both of you.

    I don’t know what everyone else thinks so please jump in if you think what I’m saying is wrong.

    I find any sort of compression (rolling higher hamstring tendons on a ball or foam roller or tight clothing including compression shorts makes the pain worse as the tendons are being squashed against the pelvic bone. Obviously the same with sitting but with the upper body weight pushing down again squashing the H.H. tendons between the pelvic bone and chair.

    Foam roll the hamstring muscles to keep them lose but not the tendons. This should stop the hamstring muscles tightening up and pulling on the tendons higher up. Sit on the fattest cushion your daughter can find.

    Did your daughter have her hamstring tendons needled as well as the muscles? Tendons can get knots in them too.

    Even if the hamstring muscles have been satisfactorily treated, it can take sometime for the higher hamstring tendons to recover as they are made of a different more fibrous material with far less blood flow.

    Try an anti-inflammatory diet.

    Get a second opinion.

    Ask your physio for a gradual eccentric exercise programme for higher hamstring tendinopathy .

    • Cooper says:

      Hey Vicki. I hope all is well. I apologize, haven’t been on the site much. I wanted to check in to see how the Amitriptyline therapy is working? Seeing any improvement? Hope you’re finding some relief.

      • Vicki says:

        Hi Cooper, the Amitriptyline is greatly reducing the pain. Enough so I can increase eccentric loading with very few relapses. When I do aggravate the tendons, inflammation lasts for a day or two which is much better than the two or three months at one stage.

        I’m not sure if it’s working with regard to killing off the extra pain pathways that have grown and calming down my brain chemicals so the brain isn’t over sensitive to pain. Think that’s going to take a long time and that’s if it works.

        This has been a lesson in listening to your body for sure!

        My physio is back temporarily from Dubai so seeing him again but he’s off to live there in three or four weeks. He said it was a shame as he wanted to see me through it until I’m better. He’s so confident and positive re these injuries.

        I’ve been referred by my GP to our local pain management service and am awaiting an appointment. They’re going to asses how I am on Amitriptyline and possibly mix other brands of painkillers in with it, until they decide they’ve found the right dosage/brands etc. for my problem. This is not only to get rid of the pain but to kill off these extra pathways and calm the brain’s sensitivity to pain.

        Amitriptyline is not without it’s side effects but I can put up with them so I’m not in pain. Thanks for asking.

        Are you fully recovered now? I really do hope so.

  228. Cooper says:

    Hi Vicki. Thanks for the update. Sounds like progress to me! Fewer relapses, that’s great! Remember, inflammation is a good thing. It signals the body to respond to the injury site by sending blood to the degenerated tendon. That is why they don’t recommend anti inflammatories or ice. The last thing you want to do is slow the blood flow to the injury.

    I’m sorry your physio is detained. I know you’ve developed a special working relationship (and trust) relative to your injury. Continue your exercise regime and treatment in his absence and hopefully when he gets back he can resume with your therapy.

    It is not uncommon for them (GP) to narrow down the correct chemical balance relative to your situation. It might take a few visits. There are so many drugs in combination that accomplish the same thing. Some are more effective than others. Everyone’s body chemistry is different. Hopefully they find an effective dosage that suits your needs.

    As far as my situation, I’m almost 100%. My running has gradually improved. I’ve managed to ease back up to 8 miles virtually pain free. When I sit for long periods, the tendon does get stiff periodically. The inflammation has subsided. Still sit on a heating pad (19 months and counting). Still taking supplements. I’m extremely happy (and grateful) to be running again! Thank you for asking.

    Vicki, I am wishing you the best of luck with your most recent therapy. Please keep me posted regarding your progress. You’ve been at it for a long time and I hope this therapy, along with your physio regime, will lead you to a quicker recovery. Keep listening to your body!

    • Vicki says:

      That’s all such good advice.

      I very recently saw a musculoskeletal specialist physio via the NHS (our National Health Service). My General Practitioner hadn’t mentioned the service existed although he’s been our family NHS doctor since I was 17 and I’ve been seeing him since HHT started yet he never mentioned this very local service – A mile away.

      The point of me saying all this is the Specialist Physio (who was brilliant) said the exact same thing…..listen to your body. No one in all of this has said that and I know that’s basic advice but this severe HHT that I have is so confusing because I was never pain free, I couldn’t listen to my body because it shouted on high volume all the time.

      It’s somewhat easier to listen to since taking meds as the meds are dealing with the neuropathic pain leaving just the inflammation pain.

      My physio is leaving for good to live in Dubai in 3 weeks but I’m staying at the same practice seeing someone else. I feel more confident in my ability to manage HHT though as I’ve read and experienced so much that if I don’t agree with the programme, I phase in my own gradual exercises instead. I’ve checked with my physio now he’s back temporarily and he said they were the right exercises

      Really pleased you are running again without aggravation. It must be the best feeling in the world. If I could run pain free and have a bit of stiffness if I sat for too long, I would throw a party with a marching band and cheer leaders!!!!

      I’ll stay in touch. Thanks for your support.

      • Cooper says:

        Hi Vicki. Thanks for the laugh. I am astounded how the medical profession is so baffled by this injury. Don’t get me started!

        I misunderstood, I didn’t realize your physio was moving permanently. What a loss because he was making great progress with your injury. I realize the inflammation pain is annoying, but it is the body’s way of trying to heal itself. When I received the Prolotherapy injections, they had one chemical which induced inflammation to cause the body’s natural response to sending blood to the injury. Blood Flow = Collagen Repair. The fact that you’re only experiencing the inflammation is a positive sign.

        Are you able to increase your eccentric exercises? That will play a big role in your healing process. Are you continuing to see the musculoskeletal specialist physio?
        Sounds like your making all the right moves and surrounded yourself with professionals that understand your situation.

        Best of luck and please stay in touch.

      • Vicki says:

        I’m doing nearly two hours of eccentric physio everyday (depending on whether I’m watching something good on TV while doing it, then it’s over two hours as I loose the thread.

        We (the physio and I) keep adding to and adapting my eccentric programme as I complete previous exercises. This will continue until I can sit like a normal person and run/walk etc. I’ll probably have to continue with the final eccentric programme for life but I’m happy with that if I can regain the parts of my life I’ve lost.

        I must say, it’s much appreciated that you’ve remained supportive to guests on here including myself. Thanks very much.

        If you have Facebook, I’ve set up a page to help amalgamate everything in once place – what I’ve learnt, my experience of having H.H.T. treatments I’ve had, nutrition etc. and a place for other sufferers to ask questions or post things that were helpful to them. It seemed on here, people had more questions than answers so I thought it would be helpful.

        Anyway, if not, I’ll pop back here and let you know how I’m progressing.


      • beccakahn says:

        Vicki, your FB site is awesome! I’ll have to look through it more thoroughly after work today. I haven’t had a chance to respond, but I, too am on Amitriptyline but not for HH pain. I was prescribed 10mg per day for my Irritable Bowel Syndrome. It seems to be helping, but has done nothing for the hamstring pain. Just curious what dosage you’re taking?
        Thanks! Enjoying your updates.

      • Cooper says:

        Hi Vicki. Thanks for the invite. Needless to say I’m a bit of a dinosaur when it comes to Facebook. I understand it is an effective way to reach out and communicate with a broad audience. The community is lucky to have you. You’ve been a great source of information and support to many on this site. It is we who should be thanking you.

        All the down time during my healing process made me realize how much I took for granted. Returning to my old lifestyle was like running into an old friend. I’ll check in from time to time with hope that I find you are sitting (normal), walking (pain free) and eventually running again! I look forward to hearing from you. Good luck!!!!!!

      • Vicki says:

        Oh thanks Cooper, I simply don’t want anyone else to go through this. It’s like being frustratingly stuck.

        I only got Facebook 3 or 4 years ago as I wasn’t keen either. Like everything it’s got it’s pro’s and cons. I must say though, it’s kept me in touch with the outside world while I’ve been like this so it’s been beneficial.

        I definitely took my body for granted and I too have had a wake-up call and changed everything.

        I used to run around at speed, cramming in as much as possible. Too much. I’ve slowed down completely and think this is a positive from having HHT.

        Anyway, I’ll be back here soon.

        All the best. Take care.


  229. Erik says:

    First of all, thanks for the original blog post and to everyone for all the follow-up posts. If you are reading this then you know there are many conflicting opinions on treating HHT, so reading everyone else’s experiences is very valuable for me.

    Without going into detail, I will say that I have a very bad case of HHT because I honestly did not think it was running related, so I continued running long after I should have stopped. In fact, after sitting all day the pain would build, and an evening run seemed to help it. But eventually it got unmanageable and I figured out what was going on, but by then the damage was substantial. I have not run since (about 6 months). I want to wait until the damage is healed, and I also want to figure out what caused the damage in the first place (ie: something in my running gait) before returning to running. In my case I had a bad bicycle crash about 3 years ago and I came down very hard on my hip – my PT thinks that may have subtly affected my running gait, leading to the problem. But I am 52 years old and have been running and cycling for 30 years, so it may just be an overuse issue.

    Here are a few of my observations from my own experience:

    (1) The wrong kind of stretching will set you back terribly! I may have avoided the problem in the first place had I done more stretching all along, but once you have HHT you need to lay off the aggressive hamstring stretches – especially those that pull the entire lower back/glute/hamstring chain. The “downward dog” yoga pose is just about the worst thing you can do for this, followed by the “airplane” pose (single legged warrior). In fact, I think anything that causes you to bend forward at the waist will subtly irritate the hamstring/ischial tendons once they are damaged. So kneel down when you empty the dishwasher; use a cup rather than bending over the sink when you brush you teeth; and bend your knees every time you pick up something off the floor.

    (2) I think walking too much when you have HT is just as bad – maybe worse – than running. When you walk you you reach forward with your heel and pull yourself along with your hamstrings, whereas if you run correctly most of the propulsion comes from your glutes and calves. But even if your running technique is good, running uphill over-engages the hamstrings, so avoid hill running while you are recovering. I will probably never do serious hill runs again.

    (3) Bicycling with HHT also set my healing back, I believe. When you are in the aero position (or any aggressive riding position) you are leaning forward and therefore pulling/stretching that lower back/glute/hamstring chain, and those damaged tendons will be the weak link. In fact, I think long-term cycling probably contributed to my HHT, b/c when you ride your knees never fully straighten so over time your hamstrings will shorten. Also, you really don’t engage the glute muscles much riding, so mine have weakened over time relative to my hamstrings and quads, and may have created an imbalance that impacts my running technique. Even a subtle imbalance becomes significant when you consider the repetitive nature of distance running.

    I actually think I could have gotten back to some easy, slow, flat runs quite a while ago, but I want to wait until the PT gives me the go-ahead, and does some gait analysis with me. In the meantime I have ramped up my swimming, but I have an uneasy feeling that it may be slowing the healing process too. It’s all very frustrating, but in 30 years of running I have never had an injury until now, so I still consider myself lucky.

    Vicki, I look forward to following your FB page. Thank you for contributing your time for the good of all of us HHT sufferers!


    • Vicki says:

      Hi Erik,

      From personal experience, I agree with everything you’ve written.

      I do all of number 1.

      I’m not a cyclist so I can’t give an opinion but from what I’ve read this is also a cyclists injury.

      I ran a lot of steep hills and increased my exercise programme too much too quickly. I also gave up strength training at the gym so I could work more hours. If you run, strength train.

      Very interesting point about walking. Thanks for that. It makes sense. I can only walk for 30 – 40 minutes slowly twice a day without a painful flare-up.

      I’ve tried swimming and both front crawl and breast stroke action also cause a flare-up but saying that the severity of HHT differs for everyone and mine aren’t good.

      Oh no worries regarding giving my time, If I can get a positive out of this by helping other people, then I’ve had it for a reason.


  230. Peachrunner says:

    Did the injured hamstring feel loose and the healthy hamstring tight?

  231. Vicki says:

    Hi Everyone,

    Sorry you are going through this painful and debilitating injury. If you think you would benefit from extra information, help and support, along side Golden Trails thread, I’m running a Facebook community support page for H.H.T. The page amalgamates everything that has helped me and what hasn’t. Plus what caused the injury and the latest research and treatment options.

    I struggled to find anyone who could give me a diagnosis for a year and a half and then couldn’t get the correct treatment for two years from the onset (which I now have). Along the way, I learnt everything I could to help myself and wanted to share this with other sufferers to speed up the potential recovery process.

    • Cooper says:

      Hey Vicki. I hope this post finds you well. I thought I would check in to see how you’re doing. Any progress with the Amitriptyline treatments?

      • Anonymous says:

        Hi Cooper ad Vicki! I’m on amitriptyline as well, but it was prescribed by my gastro for IBS. I take 20mg a day and it hasn’t done a thing for my hamstring pain. So, I’m definitely wondering what your experience has been and what dosage you’re taking. My best to you both!

      • Vicki says:

        Hi Beccakhan,

        I’m on 30mg of Amitriptyline. I took it up to 50mg and had unwanted side effects so took it back down to 30mg and the side effects stopped.

        It could be that you have mainly inflammatory pain (noiceptic pain) i.e. you feel the pain when you are dancing etc. not all the time. From what I understand, Amitriptyline helps relieve neuropathic pain. (Nerve pain). So in a way, Amitriptyline not helping your tendon pain could be a good thing. It may demonstrate that you don’t have nerve pain.

        As a comparison, this is why I have pain all the time and Amitriptyline helps relieve it. The Amitriptyline may undo and reset my nerves if I’m lucky, resolving that part of my pain problem.

  232. Cooper says:

    Hi Becca

    I hope all is well. I believe that Vicki’s consultants were prescribing Amitriptyline as a muscle Stimulation of her pain receptorsrelaxant to enable the tendon to heal. If I understood correctly, there was nothing physically preventing her tendon from eventually regenerating. Her pain receptors had multiplied which magnified the intensity of her pain levels. Conversely, the muscles contract which can cause ischemia reducing blood flow to the tendon. The receptors cause muscles to spasm which was reducing blood flow to the tendon therefore preventing collagen production and impeding the ability to heal. It is not a direct cure for tendon degeneration. It is dealing with the obstacles getting in the way of the healing process.

    I hope this gives you an idea of the role Amitriptyline plays in this process. The theory is to help the body get out of its own way to allow the tendon to heal. Muscles relax, blood flow increases and therefore collagen production increases.

    How are you doing? Any progress?

    • Cooper says: