Tendons are the tissues that attach the bones to the muscles in your body. The hamstring muscles in your buttocks have many tendons that connect your hip, back, and legs together.
Hamstring muscle tendinopathy is when these tendons become inflamed. With hamstring tendinopathy, this usually happens with the muscles at the origin of hamstring muscles, which are located deep in the buttocks, right below the two boney points that you feel when you are sitting. These are often called the “sitting bones,” and their medical name is the ischial [his-a-AL] tuberosities [too-bear-OS-it-ees].
When this happens, the tendon will swell and sometimes also become red. As the tendinopathy gets worse, the outside of the tendon, called a sheath, can thicken or get bigger, and get darker red in color. Most of the time, when the tendon turns a darker shade of red, it is because of the inflammation in the tendon. If the tendon gets too inflamed, it can tear easily.
Usually, the pain will develop over time, and get worse and worse until it is treated. It can even make it difficult to stand or walk in some extreme cases. Most of the time, it can be healed with physical therapy. Sometimes proper stretching can help prevent it.
(Tendinopathy refers to several types of tendon problems, including tendinitis.)
Pain or weakness in the hip or hamstring are the most common symptoms of hamstring muscle tendinopathy. The pain is usually located around the back of the hip bone, on the “sits bones,” where the hamstring starts. Pain will often get worse when trying to walk, or jump, or with other activity. Sometimes this pain goes away after the hip “warms up.” Other symptoms may include:
- Achiness in the hip or glutes (buttocks)
- Snapping sounds or sensations in the hip or buttocks
- Stiffness in the hip, buttocks, or hamstring
Hamstring tendinopathy is often caused by playing sports that require a lot of jumping, or other overuse. Hamstring tendonitis can also be caused if the nearby supporting muscles are too weak or too strong, which can cause a muscle imbalance. Sometimes, a weakness in the core muscles can also lead to this type of injury.
Tendon overuse can cause tiny micro-tears in the tendon. The body will try to heal these tears, but sometimes they are made faster than the body can fix them, especially if you are exercising a lot or training hard.
As the number of tears increases, they can cause pain from inflammation, or weaken the tendon. Previous injuries can also lead to this type of injury. Females trend to have this type of injury more than males.
To find out if hamstring tendinopathy, is the cause of your symptoms, your healthcare provider will perform a physical exam. During the exam, your healthcare provider may press on the area where the tendons attach to the hip to see if they can feel any hardness or swelling. Your healthcare provider may also ask you to move your hip or leg to assess your range of motion. You may also be asked to perform simple hip or leg exercises that will help your healthcare provider determine how strong your hamstring is.
Before you see the healthcare provider, you should get together as much information as you can about your pain and other symptoms. Try to think about or write down:
- When your symptoms started
- If the symptoms are getting worse
- If your pain comes with swelling, buckling, locking, or snapping
- If your symptoms gotten in the way of, or prevented, you from doing regular activities such as walking, running, standing, or using stairs
- If you have you tried any self-care, or at-home treatments
If your healthcare provider finds that you have the symptoms of hamstring tendinosis, your healthcare provider may perform an x-ray, ultrasound, orMRI to confirm the diagnosis.