Can’t Sit, Can’t Sprint? It Might Be Proximal Hamstring Tendinopathy

You're crushing workouts, chasing PRs, or just trying to stay active, but something deep in your butt or upper hamstring is screaming every time you sit down or push off for a sprint. That annoying pain isn’t just tight muscles—it could be proximal hamstring tendinopathy.

This injury loves to creep in slowly. One day, you notice a twinge during a run or after a long drive, and the next thing you know, sitting hurts, stairs sting, and your power during workouts just isn’t there.

If that sounds familiar, you're not alone. This condition shows up in runners, lifters, CrossFit athletes, and weekend warriors.

Here’s what you need to know:

• It’s not just a “pulled hamstring”

• It often gets worse with stretching or sitting

• Sprinting, deadlifts, or hill runs can fire it up fast

• Ignoring it usually drags recovery out longer

Let’s break down what’s really going on—and how to get ahead of it before it sidelines you completely.

Healing Your Proximal Hamstring Tendonitis With a Physical Therapy Exercise Program

If sitting through a Rockies game or grinding up the Manitou Incline leaves you with a sharp, deep ache in your upper hamstring or buttock, you're not imagining things. That kind of pain often points to proximal hamstring tendinopathy—an issue we treat often at Rise Rehab and Sport Performance.

This isn’t just soreness from leg day. It’s chronic, stubborn pain right where the hamstring tendons connect at the ischial tuberosity, especially after long runs, hill sprints, or prolonged sitting.

Understanding the Proximal Hamstring Tendon Complex

The proximal hamstring complex includes three main muscles:

• Biceps femoris

• Semitendinosus

• Semimembranosus

They all anchor at the ischial tuberosity, and any repetitive strain can lead to tendon pathology.

We often see this condition in:

• Long-distance runners prepping for Colfax Marathon or BOLDERBoulder

• CrossFit athletes during high-volume deadlift cycles

• Cyclists training for events in Boulder or Golden

Chronic proximal hamstring tendinopathy develops when you overload the affected tendon without letting it recover. You’ll feel it most during:

• Sitting

• Sprinting

• Deadlifting

• High hip flexion activities

This isn’t just about pain. Left untreated, it limits performance and increases your risk of a severe tendon tear.

Phase One: Load Management and Isometrics

Early on, you need rapid pain relief without complete rest. Isometric exercise induces analgesia and helps you stay active while treating tendon pain.

Start with:

• Isometric hamstring bridges: Hold for 30–45 seconds, repeat 4–5 times. Use a bent-knee bridge position.

• Standing isometric hamstring curls: Push against resistance like a band or bench and hold.

• Keep reps slow, controlled, and pain-free

These calm the tendon and begin tendon loading without aggravation. That helps reduce pain and lets you maintain strength early on.

Phase Two: Eccentric and Heavy Slow Resistance Training

Once pain levels decrease, it's time to rebuild strength. You’ll focus on eccentric exercise and heavy slow resistance training.

We usually progress you through:

• Nordic hamstring curls (modified if needed)

• Single-leg Romanian deadlifts

• Hamstring sliders on hardwood or turf

• Hip thrusts with tempo control

All of these target the hamstring tendon complex and promote human tendon adaptation. This is essential for long-term healing of chronic tendinopathy and hamstring injuries.

You’ll often see similar methods used in treating patellar tendinopathy and achilles tendinopathy. The principles translate well across lower limb tendinopathies.

Phase Three: Sport-Specific Loading and Plyometrics

Once you've rebuilt strength through mid-range movements, we introduce exercises that mimic your sport or activity. If you're aiming to run the BOLDERBoulder again or ski at Breckenridge this season, this phase matters most.

Key movements here include:

• Bounding drills

• Skater hops

• Sprint mechanics drills

• Deadlift and hinge progressions under load

This stage often includes soft tissue work an movement analysis to support healing and reduce latent pain.

When to Consider Additional Support

If you’ve had symptoms longer than 3 months or have tried several exercise programs without success, the issue may involve deeper tendon pathology or sciatic nerve irritation. In rare cases, imaging might show a partial tendon tear.

At that point, we talk with you about:

• Referral for imaging and clinical diagnosis

• Review of evidence based treatment modality options

• Coordination with sports medicine for platelet rich plasma or conservative treatment methods

Surgical treatment is a last resort. Most cases respond to personalized sports physical therapy and progressive loading.

Your Road Back Starts in the Clinic

At Rise Rehab, every treatment plan is built for your lifestyle. Whether you’re hiking Eldorado Canyon or pushing sleds at your CrossFit gym in LoHi, we meet you where you are and help you heal without losing progress.

Your tendon pain doesn’t have to define you. Let’s get you back to the activities you love—stronger, smarter, and without fear of another setback.

Start Healing Proximal Hamstring Tendinopathy Pain With Rise Rehab and Sport Performance

At Rise Physical Therapy, we help active adults and athletes overcome tendon pain with targeted, one-on-one sessions built around what you need to get back to your sport.

Whether you're managing chronic proximal hamstring tendinopathy or bouncing back from a strain that just won’t let go, we guide you every step of the way.

What Makes Rise Rehab and Sport Performance Therapy Different

You won’t get passed off to an assistant or handed a generic printout. Your session is a full 60 minutes with a Doctor of Physical Therapy who listens, assesses, and treats with purpose.

We focus on:

• Clinical diagnosis through movement analysis and strength testing

• Sports-specific rehab tailored to your lifestyle

• Progressive loading strategies that actually strengthen the affected tendon

• Manual therapy and soft tissue techniques when needed

• Return-to-sport planning that doesn’t rush your body

We don’t just want you pain-free. We want you sprinting, hiking, lifting, or pedaling without fear of re-injury.

Our Proximal Hamstring Tendinopathy Treatment Approach

Proximal hamstring tendinopathy is complex, but with the right load management and tendon loading plan, your body adapts and heals. We use tools that many clinics skip because we know precision matters.

We integrate:

• Strength programming with heavy slow resistance

• Eccentric training to reduce tendon pathology

• Isometric exercise to reduce pain quickly and safely

• Return-to-running or sport progression for real-world durability

We’ve helped Denver runners preparing for the Colfax Marathon and Boulder athletes training for BOLDERBoulder stay on track and finish strong.

Local Athletes, Mountain Climbers, and Desk Warriors—We’ve Got You

Tendon pain doesn’t just hit competitors. If you’re training for the Manitou Incline, riding in Golden, or stuck in prolonged sitting all day, that deep buttock pain is real. It affects the way you move, work, and live.

Let us help you:

• Rebuild strength in your hamstring tendon complex

• Decrease pain using research-backed strategies

• Avoid the need for steroid injections or surgical treatment

• Stay active throughout your rehab

We understand Colorado's active culture. We live it too. Whether you're hiking Eldorado Canyon or prepping for ski season, we help you stay strong and mobile.

Call Now to Start Your Personalized Rehab Plan

You're not meant to push through pain. Let us show you how to heal it instead.

Call Rise Rehab and Sport Performance at (720) 248-4386 to schedule a Discovery Call with a Doctor of Physical Therapy. Let's start your recovery with purpose.