Distal Hamstring Tendinopathy

The hamstring is made up of three muscles: semimembranosus, semitendinosus (medially) and biceps femoris (laterally). Hamstring Tendinopathy around the knee is an overuse injury. Pain is felt on the inner or outer part of the knee. There is usually a gradual onset of pain.


What Causes Hamstring Tendinopathy?

The forces of repetitive running, kicking, jumping and landing places excessive strain on the hamstring tendon. When this load is continually applied and the tendon isn’t able to repair itself degeneration and microtearing of the tendon results.


Risk factors associated with tendinopathies include:

  • Rapid increase in volume of training i.e. intensity, duration, frequency, distance
  • Poor lower limb biomechanics
  • Tight hamstrings

What are the symptoms of Hamstring Tendinopathy?

Often pain is insidious and localised to the inner (semitendinosus, semimebranosus) or outer (biceps femoris) knee. Pain may radiate up the back of the thigh or down the calf.  In the early stages of the injury it is sore after activity however,  as the injury progresses there is pain during activity. There might be pain at night with stiffness in the morning. It is worse with running and jumping activities. You may also notice weakness of your hamstrings.


Patients often respond well to physiotherapy treatment


Treatment for Hamstring Tendinopathy

Physiotherapy aims to restore pain- free range of movement with capacity to return to normal activity through soft tissue releases, knee motor control and strengthening exercises, stretches and proprioceptive exercises. Correcting movement patterns and joint mechanics will also help to prevent future episodes of pain.


The 1st Phase of treatment is pain relief using isometric exercises. Rio et al (2015) found that isometric exercises helps reduce pain immediately for at least 45 minutes. Rest and ice is also important.


Phase 2 involves an eccentric strengthening program where the muscle is required to contract while it is lengthening.


Your Physiotherapist will discuss your treatment goals and educate you about the condition, the rehabilitation process and preventative methods to reduce the risk of future injury.


To book an appointment with one of our skilled Physiotherapists please call (02) 8068 8832 or email us at [email protected].


Rio E, Kidgell D, Purdam C et al (2015) Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med 2015;49:1277-1283