Hamstring tendinopathy, also known as high hamstring tendinitis, is a common overuse injury that affects the tendons at the top of the thigh where they attach to the sitting bone. The hamstring muscles, which consist of the semimembranosus, semitendinosus, and biceps femoris, are responsible for flexing (bending) the knee and extending the hip (bringing the leg backwards). The tendons attach these muscles to the bones in the pelvis and knee.
Hamstring tendinopathy is most common in individuals who participate in activities that involve repetitive hamstring movements, such as running, jumping, and sprinting.
The main symptoms of hamstring tendinopathy include:
Pain at the back of the thigh, particularly at the top end at the location of the sitting bone. Pain is felt during or after activities that involve hamstring use, such as running, jumping, or when sitting for long periods. Patients often notice significant discomfort when driving for long periods.
Increased sensitivity to touch at the sitting bone which can also result in the need to sit awkwardly, in order to offload weight from the tender spot, shifting weight to the other sitting bone.
Difficulty and pain on flexing the knee or extending the hip.
Decreased strength in the hamstring muscles with pain on attempts to activate the muscles.
Reduced ability to bend the knee or extend the hip.
Diagnosis of hamstring tendinopathy typically involves a physical examination, medical history review, and sometimes imaging tests.
Treatment for hamstring tendinopathy focuses on reducing inflammation (paratendinitis), alleviating pain, and restoring function to the hamstring muscles and tendons. Non-surgical treatments are usually effective and may include:
At The Joint Injection Clinic, these injections are performed after a thorough consent process, whereby the risk and benefits of the procedure are discussed in detail with your doctor. The experienced medical doctor will then place you in a front lying position. The skin is cleaned using a cleaning solution to ensure that the procedure is performed under sterile conditions. Local anaesthetic is injected from the skin to the tendon under ultrasound guidance. After giving the local anaesthetic a few minutes to take effect, the tendon injection is performed with a small dose of steroid and local.
The injection itself is normally completed within 30-60 seconds, after which a plaster is applied and post-injection advice is given. The patient is advised to look out for any signs of infection, specifically to check whether the local area becomes red, hot, tender, swollen or if they develop a fever. If this occurs then the patient is asked to contact the clinic immediately at which time a formal reassessment will occur and if needed oral antibiotics can be prescribed. The patient is also warned that following any injection they may notice a short-term worsening or flare in their symptoms after the local anaesthetic has worn off (4-5 hours). This may last for 3-5 days and the patient is advised to consider icing of the area using an ice pack for 10-15 minutes every hour as required.
