Hamstring tendinopathy, unlike hamstring tears, occur over a period of time and are classified as an overuse injury. They do not involve any tearing of the muscle or tendon fibres, rather it is a progressive weakening of the tendon resulting in an inability to absorb the force output by the hamstring muscles. Most overuse injuries result from a change in activity load which can occur weeks to months prior to the onset of pain.
Hamstring tendinopathy most commonly occurs from a repetitive action such as running. If a runner changes the distance they run, their running intensity, the shoes they wear or even the surface they run on it results in a change in load through the hamstring tendons. If this change in load continues and the hamstring tendon is not allowed enough rest time between bouts of activity then the tendon fibres become progressively weaker.
As pain resulting from hamstring tendinopathy can present at any time during this weakening the treatment can vary. It usually results in a period of relative rest from the aggravating task with early and progressive hamstring tendon strengthening exercises.
Initially, these consist of isometric based exercises progressing to through range exercises. Once a strength based has been established the programme focusses on sports specific drills to return to your favourite activity or chosen sport.
Upon returning to running it is important to have a structured running plan designed by a physiotherapist, as it needs to be based on the strength of the tendon and its ability to regenerate and cope with the load it is put under.