6 Hamstring Tendinopathy Exercises For Better Pain Management

If you’re suffering from localized pain to your hamstring tendons, located to the back of the thigh, this could be caused by hamstring tendinopathy.  

The condition should be diagnosed by a physical therapist who may recommend treatment options such as rehab exercises, shockwave therapy, physical therapy or corticosteroid injections among others.  

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In this article we’ll suggest some specific hamstring tendinopathy exercises to help manage pain and alleviate common symptoms.  

Before that, let’s look at what the condition is along with the potential causes.  

What Is Hamstring Tendinopathy & What Causes It

Hamstring tendinopathy, also referred to as hamstring tendinosis or tendonitis, is a common overuse injury that results in pain and swelling to the hip area.  

In the most severe cases it may also cause degradation to the fibrous tissue of the hamstring muscle to the affected leg.  

While it tends to be associated with long distance runners, weightlifters or those who make sudden changes to their workout routine, it can also be caused by certain lifestyle factors like sitting at a desk for long periods which may result in the glutes and adductors to become weak.  

The pain is usually felt where the hamstring tendons connect at the ischial tuberosity.  

The ischial tuberosity is a small bony prominence (of the hip bone) that serves as an attachment point for various muscles and ligaments, including the hamstring muscles (the biceps femoris, semitendinosus, and semimembranosus muscles).

These muscles play a crucial role in hip extension and knee flexion.  

When the proximal hamstring tendons are placed under excessive or compressive loads this may contribute to hamstring tendinopathy.  

Activities that could do this include the following:

• Long distance running or uphill running.
• Stretching during activities such as Yoga or Pilates
• Spending too much time sitting
• Sprinting
• Strength training exercises that involve deep hip flexion such as squatting

What Does Hamstring Tendinopathy Feel Like

Hamstring tendinopathy can cause various symptoms, and the severity and specific experience can vary from person to person.

Common symptoms include the following:

Pain in the Hamstring Region

Persistent or recurrent pain to the top of the hamstring or back of the thigh, often near the sit bones (ischial tuberosity) or lower down the thigh, where the hamstring muscles and tendons are located.  

Pain can even be felt to the back of the knee where the hamstring tendons attach or a deep buttock pain.  

Pain During Activity

Any pain will usually become worse during activities that engage your hamstring muscles.  

This can include activities such as running, jumping, or bending at the hip or knee.

Tenderness and Swelling

Tenderness to touch or pressure over the area where the hamstring tendons attach to the ischial tuberosity or along the back of the thigh.

Swelling may also be noticeable.  

Stiffness and Reduced Flexibility

You may notice that you have difficulty fully straightening out your knee or flexing your hip due to stiffness in the hamstring muscles and tendons.

Pain with Stretching

Pain or discomfort when stretching the hamstring muscles, particularly during movements that lengthen the muscles.

Difficulty Sitting

Discomfort or pain when sitting for prolonged periods, especially on hard surfaces that may put pressure on the ischial tuberosity.

The symptoms often develop gradually over time, initially starting out as mild discomfort that worsens with continued activity or overuse.

It’s important to note that hamstring tendinopathy can range from mild to severe, and the symptoms can interfere with daily activities and athletic performance. 

Hamstring Tendinopathy Exercises For Pain Relief

Now that we know more about this common hamstring injury, below we offer some examples of exercises you can do to help reduce symptoms. 

Usually exercises focus on isometric contractions which require very little, if any, movement meaning they can be well tolerated by most people.  

The exercises mentioned in this article are for example purposes only, so before performing any of them please consult with a medical professional or your physical therapist.  

After a physical examination they can determine if they are right for you based on the severity of the condition, your ability, and any hamstring injuries you may have.  

Double Leg Glute Bridge

This is a low impact exercise that overtime will help to strengthen your glutes and hamstrings.  

Even though it’s one of the less demanding hamstring tendinopathy exercises, when doing it it’s a good idea to stick to a range of motion that’s pain free, so you don’t aggravate the muscle.  

Once you can easily complete the suggested repetitions you can progress this exercise to a single leg bridge which is a little more challenging.  

Performing The Double Leg Glute Bridge:

1. Start off by lying on your back with your knees bent and feet flat on the floor at a hip width distance. 
2. Keep your arms down by your sides with palms facing down. 
3. Brace your core for stability by squeezing your belly button towards your spine. 
4. Push through both heels and raise your hips off the floor going as high as you feel comfortable. 
5. Aim to form a straight line from your shoulders to your knees. 
6. Squeeze your glutes holding this position for a second before lowering back down. 
7. Complete 3 sets of 10 to 15 repetitions. 

Standing Hamstring Curls With Resistance Band

This hamstring tendinopathy exercise is a great way of loading the hamstrings but with minimal hip flexion.  

The best way is to perform it as an eccentric exercise.  

This means you’ll want to move very slowly and use control when lowering your leg back down to the starting position.  

If you need some extra stability, then hold on to the back of a chair when doing this exercise.  

Performing Hamstring Curls With A Band:

1. Stand with one foot on a resistance band with the other end wrapped around the ankle of the opposite foot. 
2. Bend your knee 90 degrees behind you.  Tension in the band will increase and you should feel a strong hamstring stretch.  
3. Pause briefly before using control to lower your leg back down to a standing position.  
4. Perform a total of 10 reps for 3 sets.  

Double Leg Hip Thrust

The hip thrust is very similar to the glute bridge but with a larger range of motion.  

This is because your upper back is resting on an elevated surface, such as weight bench, as opposed to the floor.  

As this exercise becomes easier you can perform it unilaterally by lifting one leg off the ground or you can add some weight by placing something like light dumbbell on the top of your thighs.  

Performing The Double Leg Hip Thrust:

1. Begin by sitting on the floor with your upper back resting against a weight bench (or similar). 
2. Bend your knees and place your feet flat on the ground, keep them hip width apart. 
3. Your shoulders should be on the bench and your head in a neutral position. 
4. From here push through your heels raising your hips off the ground.
5. Continue extending your hips until your thighs are parallel to the floor.  
6. At the top of the movement your torso should form a straight line from your shoulders to your knees. 
7. Hold this position and squeeze your glutes.  
8. Lower back down and complete a total of 10 reps for 3 sets.  

Hamstring Ball Curl

The ball curl is a great way of targeting your hamstrings and calf muscles without loading your spine.  

You’ll also be engaging your glutes and core which will help to stabilize your raised torso as the roll the ball towards you.  

You’ll need an exercise ball with a diameter ranging between 20 to 26 inches.  

How To Do The Hamstring Ball Curl:

1. ​Lie on the floor with your arms down by your sides and palms facing down. 
2. Place the bottom of your legs and heels so they’re resting on the ball. 
3. Engage your core and raise your hips off the ground so that you form a bridge position.  This is the starting position. 
4. Flex your knees and slowly roll the ball towards you while keeping your hips off the ground. 
5. Use control to roll the ball back to the start.  
6. Perform 10 reps 3 times.  

Standing Hip Extension

The hip extension exercise is great for strengthening your hamstrings and glutes without putting excessive strain on your hamstring tendons.  

It’s essential to perform this exercise within a pain-free range of motion and to progress gradually.

Step By Step Instructions For The Standing Hip Extension:

1. Start by standing upright with your feet hip width apart.
2. Keep your arms relaxed and down by your sides or you can place your hands against a wall for support if you prefer. 
3. Raise the foot of the affected leg off the ground and bring your toes up to help keep your leg straight. 
4. Slowly take the leg back behind you so you feel a gentle stretch to your hamstring. 
5. Make sure you don’t arch your back or swing your body. 
6. Do 3 sets of 10 to 15 reps. 

Step Ups

Step-ups can be a useful exercise when you have hamstring tendinopathy as they can help strengthen the muscles around the hip and thigh, including the hamstrings, quadriceps, and glutes.

Progressive loading is easy to achieve by holding a weight in each hand making the exercise more challenging.  

You’ll need an exercise step at least 30cm high to do this one.  

How To Do Step-Ups:

1. Stand upright with the step in front of you. 
2. Place one foot on the step ensuring it’s fully supported. 
3. Keep your back leg engaged to help with balance. 
4. Drive through your front foot to extend the front leg so you can raise up to the top. 
5. Place the back foot next to the front foot and hold briefly. 
6. From here lower your foot back down to the floor by flexing your front hip and knee.  
7. Repeat the exercise for around 10 reps and 2 to 3 sets.  

Wrapping Up

Targeted exercises can play an important role in managing hamstring tendinopathy effectively. 

Incorporating exercises that focus on strengthening your hamstrings, glutes, and surrounding muscle groups.

Hamstring tendinopathy exercises promote flexibility while helping mitigate symptoms and improve overall leg function. 

The careful selection of the above hamstring tendinopathy exercises such as double leg glute bridges, standing hamstring curls, and step-ups, performed within a pain-free range of motion and under proper guidance, can help to enhance muscle strength, mobility, and ultimately contribute to a better quality of life when suffering from hamstring tendinopathy. 

We like to hammer home the importance of consulting a healthcare professional or a qualified physical therapist who can tailor an exercise program that suits your needs and ensures a safe and progressive recovery from hamstring tendinopathy. 

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