Thigh / hamstring · Proximal Hamstring Tendinopathy
Upper Hamstring Tendon Pain
Hamstring tendons attach at your sitting bone. Irritation can hurt during sitting, bending and hill walking.
Changed loading and repeated attachment compression can exceed tendon tolerance.
How it typically shows up
Gradual pain near the sitting bone aggravated by prolonged sitting and loaded hip flexion. This tendon-loading program addresses persistent nonoperative proximal hamstring symptoms, rather than an acute muscle strain.
How long recovery takes
Begin low-compression loading, strengthen, then gradually restore comfortable bending. Tendon capacity changes over months, so prioritize daily function over quick cures.
The phased recovery approach
Phase 1 · 2–3 weeks
Comfortable loading
Start loading the tendon without deep bending at the hip.
What you get back: comfortable daily movement.
- Isometric Hamstring Bridge Hold: 5 sets × 30–45s hold · This is a calm activation, so stay pain-free. · Lie on your back, knees bent, heels planted on the floor.
- Double-Leg Glute Bridge: 2 sets × 10–15 reps · Move slowly through your heels. Ease the effort if pain builds or stays worse the next morning. · Lie on your back with knees bent and feet flat.
- Clamshell: 3–6 sets × 10 reps · Move slow and controlled and feel it in the side of the hip, pain-free. · Lie on your side with knees bent and stacked, heels together.
- Double-Leg Heel Raise: 2 sets × 12–15 reps · Lift and lower slowly and evenly. · Stand tall, feet hip-width apart, optional fingertip on a wall for balance.
Phase 2 · 3–4 weeks
Hamstring strength
Build strength with smooth bends before adding deeper hip positions.
What you get back: stronger everyday steps.
- Isometric Hamstring Bridge Hold: 5 sets × 30–45s hold · This is a calm activation, so stay pain-free. · Lie on your back, knees bent, heels planted on the floor.
- Comfortable Walking Warm-Up: 1 set × 2–5 min of activity · Keep the pace easy and the stride comfortable. · Walk at a comfortable pace on flat ground for the time shown.
- Single-Leg Bridge: 2–3 sets × 10–15 reps · Hold a small weight across your hips when the final reps feel easy. · Lie on your back, one knee bent, heel planted, other leg lifted off the floor.
- Double-Leg Glute Bridge: 2–3 sets × 10–15 reps · Hold a small weight across your hips when the final reps feel easy. · Lie on your back with knees bent and feet flat.
Phase 3 · 3–4 weeks
Bending tolerance
Bring comfortable bending back in gradually while keeping the hamstrings strong.
What you get back: easier bending and sitting.
- Isometric Hamstring Bridge Hold: 5 sets × 30–45s hold · This is a calm activation, so stay pain-free. · Lie on your back, knees bent, heels planted on the floor.
- Barbell Romanian Deadlift: 2 sets × 4–6 reps · Use a load that matches your everyday lifting. Keep the bend comfortable and add depth gradually. · Hold a barbell or dumbbells and push the hips back.
- Backpack Romanian Deadlift: 2 sets × 4–6 reps · Use a load that matches your everyday lifting. Keep the bend comfortable and add depth gradually. · Hold a book-loaded backpack near your thighs, knees soft.
- Bodyweight Hip Hinge: 2 sets × 4–6 reps · Use a load that matches your everyday lifting. Keep the bend comfortable and add depth gradually. · Stand tall with your feet hip-width apart and your knees soft.
Phase 4 · 2–5 weeks
Your path from here
This part depends on your goal. Your program follows one of these.
Running again
2–5 weeks for this path
Running
2–5 weeks
Start running again as short jogs inside a walk, and keep your strength moves going on the same days.
What you get back: easy runs without the sit-bone pain.
- Isometric Hamstring Bridge Hold: 5 sets × 30–45s hold · This is a calm activation, so stay pain-free. · Lie on your back, knees bent, heels planted on the floor.
- Run-Walk Intervals: 1 set × 4–25 min of activity · Keep to flat ground at an easy pace. Hills and fast running come later, and no more than twice a week. · Walk easily a few minutes, then jog the shown interval easily on flat ground.
- Single-Leg Bridge: 4–5 sets × 6–8 reps · Hold a small weight across your hips when the final reps feel easy. · Lie on your back, one knee bent, heel planted, other leg lifted off the floor.
- Double-Leg Glute Bridge: 4–5 sets × 6–8 reps · Hold a small weight across your hips when the final reps feel easy. · Lie on your back with knees bent and feet flat.
Just everyday life, pain-free
3–4 weeks for this path
Everyday capacity
3–4 weeks
Keep the strength and comfortable bending that daily life needs. Drop to twice a week once the side is as strong as the other one, which often takes three to six months or more when this has been going on a while.
What you get back: a dependable daily routine.
- Isometric Hamstring Bridge Hold: 5 sets × 30–45s hold · This is a calm activation, so stay pain-free. · Lie on your back, knees bent, heels planted on the floor.
- Barbell Romanian Deadlift: 3 sets × 6–8 reps · Use a load that matches your everyday lifting. Keep the bend comfortable and add depth gradually. · Hold a barbell or dumbbells and push the hips back.
- Backpack Romanian Deadlift: 3 sets × 6–8 reps · Use a load that matches your everyday lifting. Keep the bend comfortable and add depth gradually. · Hold a book-loaded backpack near your thighs, knees soft.
- Bodyweight Hip Hinge: 3 sets × 6–8 reps · Use a load that matches your everyday lifting. Keep the bend comfortable and add depth gradually. · Stand tall with your feet hip-width apart and your knees soft.
Exact exercises, sets and progression depend on your severity, equipment and goal. This is the shape of the program, not a one-size prescription.
What matters while you recover
Reduce pressure while it settles
Pressure on the tendon is what stirs this up: long sitting, hard seats, stretching the hamstring, and deep hip bending. Keep sitting spells short and use a soft cushion.
Add bending gradually
Start shallow and add depth gradually. Some ache while you work is fine. What matters is the next day: anything clearly worse after 24 hours means ease the load.
Give each set time
Rest 90 seconds between holds, one minute between strength sets and two minutes between hinges. Keep loading on separate days.
Common questions
- How hard should the exercises feel?
- Keep the movements controlled. Stop a movement if it causes sharp pain and use an easier range or load next time.
- What does finishing this program mean?
- The program builds a foundation for everyday activities. Finishing it is not a test of readiness for competitive sport.
- How should I pace the sets?
- Rest 90 seconds between holds, one minute between strength sets and two minutes between hinges. Add hinge depth only after two or three sessions leave symptoms settled the next day.
Related thigh / hamstring conditions
Sources
- Treatment of Proximal Hamstring Tendinopathy with Individualized Physiotherapy: A Clinical Commentary · Rich et al., International Journal of Sports Physical Therapy, 2025
- Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy · PMC4396672, 2015