High Hamstring Tendinopathy Injuries – Signs, Symptoms and Research-Backed Treatment Solutions for a Literal Pain in the Butt

The hamstrings are an essential muscle group in running. They flex your knee and assist in hip extension, meaning they are active at multiple points in your gait cycle.

While the most common hamstring injuries are acute or chronic muscle strains, they are also vulnerable to tendonitis at their origin, an injury termed high hamstring tendinopathy or proximal hamstring tendonitis.

While rare, this injury is difficult to treat and can become a prolonged and chronic problem. The relatively limited scientific and medical reports extant are fairly recent, and as such, there are no solid numbers on what percentage of runners come down with it.

About the injury

The hamstrings run from the top of your tibia, just behind your knee, up along the back side of your thigh and towards your pelvis.

While one branch of the hamstrings attaches to the femur, the rest course up your thigh and underneath your glute muscles, attaching to the pelvis at a bony prominence called the ischial tuberosity.

These twin “peaks” of bone are sometimes referred to as your “sitting bones,” as they support much of your weight while sitting, especially on hard surfaces. The junction between the tendons of the hamstrings and the ischial tuberosity is the area affected by high hamstring tendinopathy.

High hamstring tendinopathy feels like a vague, aching soreness high up on your hamstrings and deep in your buttock.

There will be pain when you run, especially when accelerating and when maintaining a fast pace. Sometimes the sciatic nerve, which passes very close to the ischial tuberosity, can become irritated as well, resulting in pain that radiates down the back of your thigh.

In addition to pain while running, you may feel irritation at the ischial tuberosity while sitting on hard surfaces. It also may hurt to press directly on the ischial tuberosity.

A host of other injuries can cause deep buttock pain, including piriformis syndrome, muscle strains, a sacral stress fracture, or pain radiating from low back injuries, so it’s important to get an accurate diagnosis.

Tests to diagnose

A review study published in January of 2012 outlined three physical tests for high hamstring tendinopathy.1 The first is a simple standing hamstring stretch, where you rest your foot on a knee- to waist-high support and stretch your hamstrings.

high_hamstring_stretch

The second is an assisted hamstring stretch, done while you are lying on your back. With your hip and knee flexed, an assistant slowly straightens your knee to stretch the hamstring. It may be possible to replicate this test without an assistant by using a rope or a belt, as pictured below.

high_hamstring_stretch_active

The third test is similar to the second, but this time, the knee is rapidly straightened by an assistant. High hamstring or buttock pain with any of these three tests is indicative of high hamstring tendinopathy. While these tests were fairly accurate, correctly identifying between 76 and 89 percent of the injured runners, none were perfect, highlighting the usefulness of high-tech imaging to accurately diagnose or rule out high hamstring tendinopathy.

MRIs can be very fruitful in evaluating hamstring injuries, as described by Marc Sherry of the University of Wisconsin in a recent review article.2 An MRI can spot tendon thickening, tearing, inflammation, and swelling in the bone at the ischial tuberosity. Ultrasound can also used, but unlike an MRI, it can’t visualize bone marrow edema.

Exclusive bonus: Download our full High Hamstring Recovery and Prevention Routine. It’s a PDF with images and descriptions of the 10 most effective prevention and rehab exercises for runners with High Hamstring issues. Download yours for free here.

Research backed treatment options

In one of the few comprehensive articles on treatment for high hamstring tendinopathy, Michael Frederickson, William Moore, Marc Guillet, and Christopher Beaulieu at Stanford University provide a very insightful outline of treatments their group has found helpful for high hamstring injuries in runners.3

After the diagnosis has been confirmed with a physical examination and MRI scan, the injured patient is evaluated for core strength, hamstring flexibility, and pelvic stability.

Frederickson et al. recommend that any pelvic tilt be corrected (presumably by manual or chiropractic manipulation, though the article does not specify how), as it can increase hamstring tension. They also endorse soft-tissue work to break down scar tissue along the proximal hamstring tendon, though the authors caution that direct compression of the ischial tuberosity should be avoided. Other case studies have also supported the usefulness of soft tissue manipulation, including techniques like ART and Graston, for the treatment of high hamstring tendinopathy.3

Gentle stretching of both hamstrings several times a day is also encouraged. But as Frederickson et al. point out, the core of their rehabilitation program is eccentric strengthening of the hamstrings.

Like the patellar and Achilles tendons, the tendon at the origin of the hamstrings is thick, fibrous, and has a poor blood supply, which makes healing difficult. Additionally, much like in these two more common tendon injuries, tendonitis of the high hamstrings appears to be a degenerative process, not an inflammatory one.4 This means that the fibers of the tendon are becoming frayed, damaged, and disordered.

However, because we know that both Achilles tendonitis and patellar tendonitis can be effectively treated with eccentric strength exercises, it is quite logical to base a rehab program for high hamstring tendinopathy around eccentric exercise as well.

The strength rehabilitation program begins with simple isometric hamstring and glute exercises like glute bridges.

As soon as these are tolerated, Frederickson et al. recommend progressing towards eccentric exercises as soon as the introductory exercises can be done without pain. A standing “hamstring catch” exercise can serve as a good introductory eccentric exercise, and Frederickson et al. endorse Swiss ball curls as ideal for development of both eccentric and concentric strength. These Swiss ball curls can be progressed as tolerated, moving from short range of motion to full range of motion and eventually, single-legged Swiss ball curls.

Frederickson et al. also emphasize the importance of core strength in hamstring injury rehabilitation, citing another study which found that core strengthening reduced the risk of recurrent hamstring strains.

It’s possible that a strong abdomen and hip musculature can stabilize the pelvis, taking strain off the hamstring. Frederickson’s paper focuses on the use of plank exercises, particularly with leg lifts incorporated to encourage coactivation of the glute and hamstring muscles, as a key component of recovery.

Other possible treatment options

Other options discussed in the Fredericson et al. paper include corticosteroid injections and extracorporeal shockwave therapy. Both of these treatments have the potential to weaken the tendon, so they are reserved as ancillary treatments, not a sole basis for recovery.

Corticosteroid injections are better understood, and while injections directly into the tendon itself can be quite harmful, Fredericson et al. write that, by using ultrasound imaging to guide the injection needle, the anti-inflammatory drug can be delivered to the irritated tissue surrounding the tendon without penetrating or damaging the tendon itself. They also found that patients whose MRIs exhibited more swelling around the ischial tuberosity and less thickening of the tendon got more relief from a cortisone injection than patients with more pronounced tendon thickening.

Extracorporeal shockwave therapy is mentioned briefly, as it has been found to be effective in other types of chronic tendon injuries in athletes,5 though Fredericson et al. caution that they have little experience using it for high hamstring tendonopathy and that animal studies have shown that it results in a drop in tendon strength (at least in the short term).

Finally, in a small number of cases, surgery is necessary to relieve tension on the sciatic nerve and divide up the fibrous and damaged tendon near the ischial tuberosity. The good news is that, according to a 2009 study by Lasse Lempainen and coworkers in Finland, a high percentage of athletes eventually return to the same level of sport after being referred for high hamstring tendinopathy surgery.6 Eighty of the 90 patients referred in Lempainen’s study made a return to the same level of sport, with 62 of them having “excellent” results. While this is encouraging, the mean recovery time of five months (and ranging from two to twelve) is sobering and serves as a reminder that few surgeries for a running injury are ever really “minor” when it comes to time off from running.

High hamstring tendinopathy is a persistent and difficult running injury to overcome. Additionally, due to its relative rarity (especially outside of running) and the paucity of good review studies on potential treatments, the evidence for solid treatment protocols is still lacking.

On the bright side, however, since it’s known to be a degenerative tendon issue, the same treatment strategies that work with injuries to the Achilles and patellar tendons should also be effective with high hamstring tendinopathy.

As Frederickson’s article outlines, a progressive strength program to strengthen the core, improve glute strength, and promote healing in the proximal hamstring tendon through eccentric exercises should be at the heart of any rehabilitation program. Due to the similarity of some of this injury’s symptoms with other hip injuries, it’s important to get a proper diagnosis; this will likely entail a physical examination and an MRI.

Additionally, because of the individual nature of this injury, it’s recommended that you find a good orthopedist and physical therapist to supervise your rehabilitation and advise you on your return to running.

Outline of Treatment

Conservative treatments:

Because of the recalcitrant nature of high hamstring tendinopathy, exercises for rehabilitation need to be eased into. Unlike the eccentric programs for Achilles or patellar tendonitis, you shouldn’t jump into high-load exercises right off the bat.

According to the protocol outlined in Fredericson et al., the following exercises should be incorporated into your rehab protocol in order, but only after you have been able to do the previous one without pain. Unfortunately, the Fredericson paper does not describe how many sets and repetitions of each exercise to do, but a Runner’s World article on the same injury recommends several similar exercises and advocates progressing to 3-4 sets of 10-15 repetitions of each exercise once per day.7

Double leg glute bridge

double_leg_glute_bridge

Gentle hamstring stretching, 3-4 times a day

Gentle_hamstring_stretching - Copy

Front plank

Front_plank

Double leg glute bridge with leg lifts

Double_leg_glute_bridge_with_leg_lifts  Front plank with leg lifts

Front_plank_with_leg_lifts

Standing hamstring “catch” Standing_hamstring__catch_ - Copy

Swiss ball curls and Swiss ball curls with one leg swiss-ball-hamstring - Copy

Exclusive bonus: Download our full High Hamstring Recovery and Prevention Routine. It’s a PDF with images and descriptions of the 10 most effective prevention and rehab exercises for runners with High Hamstring issues. Download yours for free here.

Aggressive treatments

1. See a physical therapist or chiropractor for manual therapy, massage, ART, or Graston Technique to break down scar tissue and adhesions in the high hamstring area. Make sure the practitioner focuses on the muscle and tendon tissue and avoids the ischial tuberosity—you don’t need any additional irritation there. many runners also find sitting on a tennis ball or other hard surface when traveling or sitting for long periods of time to be helpful when first standing up.

2. Talk with an orthopedist about a corticosteroid injection, preferably guided by diagnostic ultrasound imaging. According to Fredericson et al., this can be especially helpful in cases where an MRI shows significant swelling near the ischial tuberosity.

3. Consider talking with your doctor about the risks and benefits of extracorporeal shockwave therapy. While it’s unproven in high hamstring tendinopathy, it has shown some success with chronic tendon issues elsewhere in the body.

4. If repeated attempts at conservative treatments fail, talk with a trusted orthopedist about surgical treatment.

Return to running

High hamstring tendinopathy is reported to take a long time to recover from. Of the few case studies on runners with high hamstring tendinopathy, all report recovery times on the order of 8-12 weeks,8 a timescale echoed by Fredericson et al.

Cross training activities should not stress the lower legs until the bent-knee stretch test can be done without pain; at this point, activities like cycling and pool running can be incorporated into your routine.

Once you can perform a back plank with leg lifts pain-free on both sides (pictured below) and have normal range of motion, you can being the gradual return-to-running program outlined here:

hamstring_strength

Week 1 Walk 5min / jog 1min, build to 5 sets on alternating days(ex. 2x5min/1min, off, 3x5min/1min, off, etc.)
Week 2 If no pain, walk 5min / jog 5min, build to 5 sets on alternating days
Week 3 If no pain, advance to 20min jog, no more than 5 days per week
Week 4 If no pain, advance to 20min run at normal training pace, no more than 5 days per week
Weeks 5-8 If no pain, gradually increase running speed, volume, and acceleration as tolerated

One of our gracious readers has shared with us her differential diagnosis after dealing with this injury for over four years. Patricia Burgess wrote this wonderfully in-depth chronicle of her search for pain-free running. You can download it here. Thank you for sharing Patricia!

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References

1. Cacchio, A.; Borra, F.; Severini, G.; Foglia, A.; Musarra, F.; Taddio, N.; De Paulis, F., Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy. British Journal of Sports Medicine 2012, 46 (12), 883-887.
2. Sherry, M., Examination and Treatment of Hamstring Related Injuries. Sports Health: A Multidisciplinary Approach 2011, 4 (2), 107-114.
3. Fredericson, M.; Moore, W.; Guillet, M.; Beaulieu, C., High hamstring tendinopathy in runners: Meeting the challanges of diagnosis, treatment, and rehabilitation. Physician and Sportsmedicine 2005, 33 (5), 32-43.
4. Lempainen, L., Surgical Treatment of Hamstring Injuries and Disorders – the Clinical Spectrum from Chronic Tendinopathy to Complete Rupture. Turun Yliopisto: Turku, 2009; p 66.
5. Wang, C.-J.; Ko, J.-Y.; Chan, Y.-S.; Weng, L.-H.; Hsu, S.-L., Extracorporeal shockwave therapy for chronic patellar tendinopathy. American Journal of Sports Medicine 2007, 35 (6), 972-978.
6. Lempainen, L.; Sarimo, J.; Mattila, K.; Vaittinen, S.; Orava, S., Proximal Hamstring Tendinopathy: Results of Surgical Management and Histopathologic Findings. The American Journal of Sports Medicine 2009, 37 (4), 727-734.
7. McMahan, I. A Pain in the Rear: High Hamstring Tendinitis. http://www.runnersworld.com/injury-treatment/pain-rear-high-hamstring-tendinitis.
8. White, K. E., High hamstring tendinopathy in 3 female long distance runners. Journal of Chiropractic Medicine 2011, 10 (2), 93-99.

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69 Responses on “High Hamstring Tendinopathy Injuries – Signs, Symptoms and Research-Backed Treatment Solutions for a Literal Pain in the Butt

  1. Great article Jeff. I wonder if any of my previous hamstring pain was de to this although never as irritated while running, mostly sitting. Ever since I have begun religious about core, isolated stretching, and foam rolling, there have been no flares ( knocking hard on wood). Thanks for all of your great advice

  2. I’m pretty sure this is what I’ve got along w/my pelvic stress fracture. I’m not sure if the fracture is the result of ignoring it for so long. I knew I had recurrent issues w/my hamstring and that I could not do a bridge or stretch effectively. Despite this I started training for a marathon and got up to 50 mile weeks before the thing went pop. What was most disturbing for me is there was no pain until it went. I had two separate weeks when that leg painlessly collapsed after speed work when we were doing our quick bursts but during my daily runs, no issues. Saw a PT, she told me to keep running so I planned another 2:30 long run. I actually did feel relatively good the first hour but then after that it went quickly downhill and I knew I was done. I hope I can get myself back into shape without this thing haunting me going forward.

  3. I am assuming I have this. I experienced the exact symptoms yesterday. I have to sit all day (desk job) and this is really bothering my condition. I’m not a runner but a long time spinner. Thanks for the article and exercises to help improve it. This injury is literally a pain in the behind!

  4. Wow, I’m so glad I found others with same problem. I injured myself at 9 mile mark in NYC Half marathon. Was on track for 7minute pace finished the last 4 miles at 11min per. Its 2 weeks and pain is still too great to run.

    Sitting in my vehicle is the worst.

    I really need to run, I run every day and have another half marathon first sunday in May.

    • have you been to a ROLFER?? ITS like a heavy duty massage that uses deep manipulation of the bodys soft tissue to really get in and work out that injury. i am going and it is working and feels so much better. it relieves chronic pain, and reduces stress.
      google it and read about it…might be what you need.

      get well and so you can run strong.

    • Sitting is the worst! I find the only way to survive sitting for long periods either driving my car of sitting at my desk is using a square thermalite camping pillow that one can purchase online or at any camping shop. they semi inflate and you can add more air if necessary. Also it is discreet and can be rolled up and taken anywhere, like the cinema or out for dinner.

      • Thanks for your input Jennifer! Many of us find sitting for long periods causes pain, just more evidence that we were not meant to sit so much! That is a great idea to use the camping pillow, I am sure our readers will find that very helpful! Thanks for the suggestion :) Glad it has eased your pain!

  5. Great article, Jeff. Thanks so much. The best thing I’ve read in my continual research of high-hamstring tendinopathy. Much appreciated!

    I’ve had this off-and-on for five years, and had little success in getting rid of it, and it’s driving me crazy — and I’m thinking about surgery.

    And yes, like Alan said, sitting in a car for long stretches is positively the worst, for some reason

  6. Did I hear five years, how depressing, Ashby do you keep on reinjuring it. Did you try total rest for an extended period of time

  7. Thanks so much for the information- I got this injury a few weeks ago while cross-country skiing when one ski came to a sudden stop and I felt the tendons tear as I fell forward- immediate pain-

  8. Have had issues with this for 7 months. Had 2 prp injections, and though it has improved, I am still not doing big miles or speed work. Have been trying to strengthen core and hammys. This looks like a great article and will certainly use some of the info. Have 5 months till Melbourne marathon, am hopeful of competing there. Was training for this event last year when injury occurred. Am running 6-7km runs now but not fast, trying to build. Still gets sore but hard to tell exactly what triggers pain, as some days it hurts and others it does not, even though training schedule is the same. It still hurts to sit longer than 5min. I am sure of one thing. It is a long term injury and you have to work hard at it. Good luck to all.

  9. Man…I’m fairly sure this is what I have. Ended up snapping it during some sprints. Been about a year or so and it’s so annoying. Gonna get on this workouts and hopefully they’ll get me somewhere. Fantastic, article!

  10. I’ve had this off and on for about 2 years, rest, stretch, gradually get better, gradually get back into working out – no long runs, then boom – the cycle starts again. Right now I’m in the I can’t sit because of the pain from my butt to my front shin phase.
    Has anyone heard about ultrasound therapy? I’m just doing research and hear that by applying the ultrasound it actually encourages blood flow to help heal.
    I’d welcome any advice on healing/relief, and how to overcome.
    Thanks!

  11. I’ve been diagnosed with this and been in rehab for this for 18 months. I’ve not run or biked at all since diagnosis in March 2012. It has not gotten better, only worse. It has made my life not even worth living since I can do no exercise any longer.

    • look up ROLFER. AND see if you this helps. its a holistic way of improving injuries and getting rid of them. its like a massage on steroids..haha but it does work

  12. Well I’m convinced this is part of what afflicts me. Sitting is very painful and I carry a soft foam cushion everywhere with me. I’ve had this pain for over 6 years.

    When it first happened I could hardly bear the pain as it radiated into my hip and my sciatic nerve often got extremely irritated. Still does every now and again. No doctor seemed to know what the matter was back then although they said the MRI showed inflammation at the ischail tuberosity. Tried a cortisone shot but it made no difference.

    I was told to rest it and that it would improve after a few months. Well perhaps the pain got a little more bearable or I just have learnt to tolerate it. But I wouldn’t say it’s really improved. The hip pain is a lot less though.

    Recently I have started had the hamstring (left leg) massaged. It feels like a tough old rope! Luckily he’s a wise massage therapist and did not touch the sit-bone. I’ll try these exercises out very gently and see what happens. The therapist thinks I also have weak glutes. I gave up running about 9 years ago from an ankle injury. I enjoyed running but no longer miss it.

    I hadn’t realised that surgery was a possibility. I might consider that as a very last resort, but I’m a bit of a coward that way!

    • Have you had a chiropractor look at your lower back? I’ve had this problem for over 2 year now. I spend a lot of time and money with one sports therapist who just did lots of massage. I went to another and he said, ‘Scoliosis and trapped nerve’! He stuck his thumb into my spine and a couple of painful minutes later, it was, I reckon 70% better. The 30% remains (high tendinopathy) which is really stubborn but good to make some progress

  13. I’m very happy and thankful to the author who published this. Although I am a dancer, not a runner, I felt the beginning symptoms of this while doing deep stretches and over splits in that exact area. Now I know what to do, this article saved me a lot of headache.

  14. Very good article! Although the article states the injury as being rare, it seems a lot of runners get it. I never had a problem with running until now – in my 40’s. After a few years off, I started to gradually get back into running last year. 2 months went well but when I started pushing myself, my hips started hurting. I continued running through the pain until my right foot also started hurting. Then my knee and then my lower back and then my hamstrings high up were hurting. With 5 areas of pain, I went to a Chiropractor and he gave me a right foot heel lift. My knee pain was gone the next day. Eventually my foot got better. My hips got better and lastly, my lower back got better, For about a year, I still have high hamstring pain and just keep my strides short. I did this for months pushing myself further with low pain to no pain. I finally decided I needed to do sprints and fartleks if I was going to improve my time. That’s when my high hamstring flared up so bad I could barely walk. I’ve been sitting on a tennis ball at my desk job and also when I drive, stretching like crazy. I’ve started pilates and core strength training. I’m trying to refrain from running and just cycle until I can get back to running full stride. After a year of hamstring pain, I’m finally giving in to rest and recovery. Oh… I’ve found that biofreeze helps alleviate the pain so I’m now using that daily to help the recovery faster. I refuse to have any type of surgery… Every injury I’ve ever had with just rest and rehabilitation, I’ve been able to overcome the need for surgery.

  15. I’m 14 and i’ve been struggling with this for about 13 weeks. As i’m so young and this is an over use injury i think my rehab time might be slightly quicker than others but im not too sure when to start running again. I have had dramatic improvement after doing the nordic curl and squats and now i can lift my knee up sharply with no pain. The annoying this is, after so much improvement, i still cant do a one legged glute bridge pain free and after a run (that seems pain free) it will start hurting again when lifting my knee. I’ve missed the whole track season and i hope to be back for cross country. This has been very useful.

  16. This is a good article. I was doing taekwondo when i suddenly felt a pain in my high hamstring i went to a lot of therapist and chiropractors and people who massage alot. But i have this pain for over a year now and i am wondering if this wil ever heal i am even doing this now. After this exercise I feel no pain but after minutes the pain comes back what should i do. I even made a mri scan but they didnt saw anything.

  17. Good article my symptoms to a T, just had cortisone injection into buttock today and the information in article was beneficial to me as to recovery, been troubled with it for over a year – a real pain in the butt

  18. I am so thankful I found this article. I am an athlete, playing multiple sports year round. I recently tore my hamstring, around 3wks ago. The first week was pretty painful all throughout the hamstring to buttocks area, but over the past 2wks I have had serve local pain in my buttock only, the worst is when sitting. I am currently in therapy and they are treating the pain through ultrasound, stem and pain patches. I have found that rolling up a t-shirt and placing it under my high hamstring area close to my buttock when sitting relieves the pain.

    I hope to start the above return to running routine within the next few days. I feel ready to run, but the pain when sitting is very intense. Thank you for the great article.

    • Hey i read about your injury in your hamstring.
      I was wondering how it ended up going?
      Im currently hurt for 3 months.
      Im stil having struggles sitting. I also cant sprint and have difficulties doing physical activities.
      Please let me know how your recovery went
      Thank you

  19. After six months of severe discomfort and disability, numerous physical therapy sessions, dry needling, massage, cortisone RICE, the kitchen sink, I had a prp injection. My immediate reaction was regression to more discomfort, however at the six week point I was significantly improved. At the 12 week point, I am virtually recovered.
    My doctor, Jason DeLuigi, OD, Georgetown Hospital, Washington, D.C.

  20. One more comment, especially to Jenny. I too could not sit for six months.
    I urge you to consider a prp injection. I believe that I would not have healed had I not supplied the right healing components to this tissue which receives so little blood flow.
    Remember, tendons are barely living tissue. That is why cadaver tendons can be use for transplantation. It is essential to get blood to flow into that tissue. If you have waited a long time, you could now be in a stalled healing and week tissue situation. The prp injection coupled with needle tenotomy will restart your healing and give the tissue what it needs to heal properly. Scrape together the thousand dollars it may require and have this effective treatment.

    • Marc, I just got PRP done on my high hamstring tendinopathy and I am about 3 weeks out with only a marginal sign of improvement from pre-PRP procedure. What triggered your recovery at the 6 week point? Did you do any cardio during that period (running, bike, elliptical, etc)

      I look forward to your feedback.

      • Sorry for the delay Greg.
        Nothing triggered the improvement I experience six weeks after prp. It just happened. I am now eight months post prp, and I continue to fetal better, though it is clear that I am not the same man. Deep tissue massage helps a lot. I believe I am left with adhesions and I adequately healed tissues. I am much much better, but I’m not recovered fully. Surgery seems risky, but I may consider that after another six months.

        • I also had a PRP injection about 4 months ago for high hamstring tendinopathy on the left side that I had had for 18 months. I had continued running during that period, backing off to spin and swim when it got too bad to run. It was uncomfortable sitting in the car but tolerable since I don’t spend much time in the car. Twice during the 18 months prior to the shot, it started causing changes in my gait and I ended up with some other running problems that made me completely stop running (posterior tibial tendonitis, for one, in the right foot) . So I had an MRI, which showed a partial tear in the common hamstring tendon.

          Part of the motivation for the injection was that I couldn’t run at all, due to the PTT and the time on crutches would help heal that as well. It was painful to be on crutches with no activity for 2-3 weeks after the injection (at my doctor’s insistence) but it’s actually much better now, 4 months later. I can finally touch my toes with straight legs, and kick my shoe off with the other foot without pain.

          It hasn’t been fully tested with my previous mileage, but I ran a few 7 milers with no problem, until I somehow managed in the past month (I think going too hard at spin class) to do the same thing to the other (right) side. And this time it is very painful to drive. I now have a cushion in the car and am very frustrated. I don’t know if I should just have another PRP and somehow get through the 2-3 weeks of inactivity, or how long to cross-train and see if it goes away on its own. I’m now doing much more glute strengthening and stretching than I was before, it makes me feel better if nothing else. I was running through it until 5 days ago, when it started bothering me 6 miles into a 7 mile run. Odd. But now it’s noticeable even a bit when walking.

  21. Am really glad I found this article. I have been suffering from the same symptoms for around 9 months. I go to the gym 5 times a week and do a lot of spinning, weight lifting and a bit of running, however the pain is only really bad when I am driving and sitting at my desk. Sometimes I have to stop the car and get out to stretch. I had an MRI scan two days ago and am awaiting the results in anticipation. It will be interesting to see what shows up.

    • Hi,
      I just developed this injury (or it became mroe apparent) after this last marathon on Nov. 10 where I could barely stand the 1 hr drive home and had to have my daughter take over.
      question is – how is this diagnosed and if it is early enough in the injury, do I have hope that it will take less time to recover if I do not run and how long before I can run again. ANy hope for a spring marathon, which will require 16-18 weeks training starting mid-late Dec or early Jan??

  22. I can relate to all these things. I am going to look into the prp needle. I did my injury in 2007 while teaching karate. It was bad for a long time. Sitting was the worse. I wish I had an MRI at that time but didn’t until 2013 when I felt the tendon snap again. I can now sit thanks to massage and Dr. Lowell Grieb. But when I start to run I get a little ways and start to limp again. I am doing isolate stretches for the hamstring and balancing on one foot. I do need to strengthen my core – major work there. It is a long process. If it hurts to sit, I would recommend not to run. Good article.

  23. My ? is, I just started running, Im 50 and started walk running only 1 month into it I started having this pain in my piriformis, I thought it was piriformis syndrome, but the xray and MRI showed lower back 3 disc compressed and 2 that where herniated sticking into spinal cord and arthritis in that area. So Ive been to get a massage just on my right leg and but area for an 1 ht every week and decompression. Ive been going this since Aug with no help. How do I know if I have this injury you are talking about

  24. I am not a fan of cortisone shots or any treatment that is invasive. I treat with cold to keep inflammation down naturally. Although I treat a lot longer then just a few minutes here and there. There are some evenings I have a cold wrap on for 6 hours. A friend of mine depends on a Blood Flow Stimulation (BFST) wrap before runs. I have tried hers before but was not able to use it routinely enough to see an improvement. Apparently it just warms up the area without causing any additional strain. It seems like the pain will always be there but I am at least able to go about my day to day. Oh, and a good massage therapist who knows their stuff was a huge benefit as well.

  25. Hi,
    I finished a marathon on Nov. 10 and I knew I had some issues in my right leg. There is a strain in the innerside of my right foot which I went to a podiatrist and now going to PT and was casted for orthodics. I backed off running quite a bit in the past 20 days and have only ran a handful of times, and mostly easy from 3mi to 7 mi and I only did a turkey trot 5 mi at about 8;15mpm pace and then two long’ runs of ~7 mi. Now I think that I have this high-hamstring tendonitis – it sounds like everything you are talking about. I have a desk job and any travel in car more than ~30 min is painful and this past weekend traveling ~5 hrs to WI, was excruciating after ~3 hrs to the point that I had to have my 15 yr old daughter take over the rest of the way.

    help? I contacted my podiatrist to see if he had a referral for the hamstring so that I could possibly get PT for both the foot and hamstring injury because I already am lacking time for the one PT. Also, I had been doing cycling more than running since the marathon because I thought it would be better for the foot; now I think I may have made the hamstring worse by doing this. What is the best alternative exercise for me – eliptical, treadmill inclined walk, and/or stepper??

  26. Could iodine and/or folic acid deficiency (and it’s impact on thyroid (>hypothyroid) be partially to blame for the inability for the high hamstring to recover? I ask because almost instantly after taking the supplements (for suspected iodine deficiency) I turned 100% normal in function for the first time in many months of battling sitting/butt pain. Besides that, I was 1.5 years into knee joint pain and nerve tingling sensations and leg muscle fatigue – all of which was on the mend 6 months after it began (and after bloodwork ruled out of some of the worst suspects – I had NO inflammation at all). So only now in the last 3 weeks, have I felt 100% in 1.5 years!! Knock on wood, I’m watching closely but even my runs have been spectacularly normal – such that I forgot how easy they used to be!! Prior to this supplement, I found B12 to also be a miracle cure to the muscle fatigue. Just wanted to throw it out there since I’m shocked by the dramatic improvement. Can’t see how it would be a coincidence that everything cleared up after taking the supplements (in a prenatal multivitamin actually).

  27. I have been to three separate physical therapy clinics for my high hamstring injury; each time following all instructions and never missing an appointment. Finally, this article addresses my problem. More “core” exercises please.
    Thank you!

  28. I have had this for 1.5 years with little progress in resolving it. Mine came on suddenly whilst doing some seated twists with a medicine ball and feeling a ‘pop’.
    Other than the soreness at the top of the hamstring, i have an associated symptom which i have been unable to find any information on or concrete answers from various physiotherapy professionals.
    I get a ‘twang’ in my butt like a cord catching on something then slipping off/releasing. This happens when i do anything that stretches my hamstring beyond normal walking tension. I think it might be my sciatic nerve but i have no idea what it might be catching on. When it twangs it can also feel it behind my knee somewhat.

    Anyone else have experience of this?

    I’ve just had a Cortizone ‘wrap put around my tendon and am about to start out on a concerted rehab program, hopefully i can kick this once and for all.

  29. I’ve had this three times over the last year (as in it’s recurred three times…) and in all honesty the best thing I did was go to the physiotherapist. After a week of muscle strengthening exercises I started to notice a difference and now my hamstring is almost completely better. I feel so much safer running on it, after it went the second and then the third times I’ve been living in a state of fear that it’s going to go again. It’s so subtle when it does but it doesn’t half take FORVER to go away.

    Anyway, before spending loads of cash on an MRI or getting cortisone injections and so on, I would recommend just seeing a physio and seeing if they have any suggestions. For a number of reasons I was particularly stressing my hamstring which was also a lot weaker on the affected side. Probably because of all the downtime it’s had… still re-building it at the moment. I’m hoping to get it up as strong as the other before I try really testing it – sprinting, hill running etc.!

  30. I have what I thought has been piriformis syndrome for about 4 years and I also refuse to stop looking for a fix. I am interested as my issue may be hamstring related and this caught my attention. I have been reading a lot about hips and shoulders, I have a book called Sitting, Standing and Walking and have purchased the corewalking program (corewalking.com). All of these are opening my eyes to the psoas and our posture/alignment. Much of our issues may be related to our slumping posture (I sit at work all day too). I have only started my changes with the walking techniques so I cannot say yet if they help, but I do notice that when I use no music and concentrate on my posture running that when my butt starts hurting on one side, I lift the core and release my body and that help. Main thing I’ve learned is how tight we keep our buttocks when we walk and surely when running. I am having a hard time walking with a loose butt but am going to keep trying! By altering your posture it helps. Also ensure the feet go straight – not out to the sides! This will come with walking upright since you can’t force your feet alone to change. I have not tried any stretches that help so I am doing somatics as well. Best of luck

  31. I have had this injury for 20 years. I had a waterskiing accident and it tore my hamstrings severely. For sometime I went to PT. I had always been active…biking, jogging, weights & aerobics. I can do nothing in the way of exercise and my muscles have wasted away. It injured my S.I. too. Both legs went up over my shoulders.
    I am now in daily pain and cannot get off of meds. I wish I had known about what you are detailing here. I’m so sick of this and the docs can’t give me injections more than twice a year.
    It gets aggravated and I can’t sit for too long. Can’t ride, run.
    Any hope?

  32. I had this injury for about a year from doing sprints. This was the worst and most depressing thing ever, i coudnt run and i was always in constant pain. I must say corticosteroid injection & 2 sessions of ART fixed the problem. Now im pain and can run again!

  33. I have had both Knee and Back Surgery’s like 12 and 13 years ago now. No total knee though, but my knee is shot and seems to shift when I walk. 2 years ago, I fell down our stairs, about 3 stairs only, my word the pain was so intense in this area you have described here. my doctor sent me for an MRI, I could not even get though it, due to the horrible spams. 3 months in a wheel chair, and prescription meds. It finally felt better until last week. This time I have done nothing such as falling, just up and down our stairs at home and standing on chairs lately, as we have been packing for an up coming move. I feel like a baby going to the ER with this pain, but it keeps me awake and hurts so bad. my reg doctor does not have any thoughts on this, since he not a specialist. I am no athlete, I’m 55, but my symptoms sound exactly as described here.

  34. I have similar pain high in my hamstring near the connection to my sitz bones, but my physical therapist has diagnosed it differently. Pushing or massaging the tendon gives no pain or tenderness. Rather, I have had prolonged issues with my sciatic nerve passing through my piriformis muscle. It also is aggravated by sitting. My treatment is getting the hips aligned properly to get rid of the sciatic nerve irritation. Once I get that adjustment, my pain goes away. I use a standing desk and sit on a pillow when I need to sit.

  35. It wasn’t until I had a high resolution 3 T MRI that I was diagnosed with two high grade near full thickness tears in both hamstrings at the point where the hamstrings attaches to the IT. For 15 years I was told I had one ‘small’ tear, but was never given any advice on how to treat it other than a little RICE, and because I had other seemingly more critical injuries at the time, treatment of my hamstrings were never a priority.

    I cannot sit in a chair or drive for more than 10 -15 minutes due to excruciating sciatic nerve pain, and often while driving, I have to pull over. Recently, I had Proximal Tibial nerve and Common Peroneal nerve surgery on my calf to relieve nerve compression pain. This has helped the shooting, burning nerve pain in my calf. I was almost about to have my PFCN (Posterior Femoral Cutaneous Nerve) removed in one leg (my neuro-surgeon thinks that because it’s damaged from the hamstring tears, it’s causing the nerve pain when seated). I decided to see a hip and hamstring specialist first to see if the hamstring tears can be repaired. If they cannot, I will have the PFCN removed. The PFCN is a branch of the sciatic nerve that travels down over the lower part of the buttock and over the IT where the hamstring attaches.

    I wish patients with this condition were treated more seriously, especially non-runners. In general, hamstring injuries are considered a ‘sports injury,’ and if you’re not an athlete (football, soccer, running, etc.), you aren’t taken seriously by orthopedic surgeons. I found this to be especially true as a slightly older female. Even though doctors knew I was a dancer, but they seemed unaware of how extremely athletic dance training is.

    It is time providers address preventive hamstring care, and not simply tell patients to RICE. If you’re an athlete or dancer, you’re going to push yourself for the love of what you do. If you’re told it’s not serious and will heal with a little rest, you aren’t going to be aggressive about treatment or preventative care for the rest of your life. If we now know that the hamstring is fickle, easily re-injured, etc., let’s incorporate that knowledge into patient care.

  36. Ms Burgess’ account of her ongoing quest for diagnosis and recovery has got to be one of the most depressing things I’ve read yet about this injury. I have had a hamstring overuse injury for about nine months now, finally diagnosed as high hamstring tendinitis, and have at this point not run for over three months. I never had an acute injury; rather, it was overuse during marathon training. In addition to having mid and high hamstring soreness I also have pain at the ischial tuberosity while sitting – as I must do five days a week for my desk job. I had about nine weeks of physical therapy but then saw another therapist who pointed out that most of the exercises I had been prescribed were working, rather than resting, the hamstring. Now I have started a completely different therapy regimen to address ‘sleeping glutes.’ While this explanation makes more sense to me, I’m not yet convinced that it’s helping any better than the other therapy. I have increasing concern that this is a condition that is just not going to go away. As for Ms Burgess, my loss of running is a significant one in my personal and emotional, as well as physical, well being. My activities are becoming increasingly more constrained. I have read repeatedly that little is known about this injury and how to treat it. I wish there was a more clear protocol for diagnosing and treating this problem.

  37. I have been doing lots of research and I am convinced this is what I have. I can’t pinpoint the exact moment the injury occured but this has been going on since February. So 5 months now. I am 53. I do a bit of running but I think the injury must have happened playing hockey.

    Like many that left some comments I cannot sit comfortably. Working at the office and driving are the worst. It`s literally a pain in the butt. Sometimes radiating down to the side of the knee. When I avoid sitting the pain goes away somewhat.

    I do core exercises and leg strenghning. I will add the exercises mentioned. I am never sure if I should rest or keep exercising.This is really making my life miserable. I would like to avoid the cortisone shot as some say it only heals temporarily.

  38. Great article – thank you. I’ve just today injured myself (severely) with this high hamstring injury playing competitive indoor cricket. Will describe my history more later and post my rehab and recovery notes.

  39. I’m a multi-sport athlete and damaged my right hamstring doing a deep split (which I had never-ever had any problems with). I have had pain off and on for about 2 years now when I tweak it or sharply increase my training load. Core strengthening, yin yoga and self myofascial releases have been VERY helpful! Yin has been absolutely transformative for my body (not just my high-hammy injury)..yin involves working the soft, connective tissue and fibers… I highly suggest attending a class and make use of the props- let your body settle in and hold for time- WOW!

  40. I want to cry. I think this is exactly what I have and I have been in denial. I’ve been doing a lot of these exercises, but I’ve also been trying to run through it and it is only getting worse. I have all these races coming up and I probably shouldn’t even be running. I am so sad

  41. I’ve had this for about 5 years now. I injured my hamstring while running. Went to see a PT who made it worse, so that it hurt to sit. Now I have pain on both sides, and it’s torture to sit through meetings, drive for more than an hour, etc. I don’t even try to run anymore. I’ve had steroid injections on both sides twice, PRP on both sides TWICE – and they did help for several months, but the pain returned. And the physiatrist basically gave up on me after that. Went to see another doctor, who did an sacroiliac joint injection, and that didn’t really help. Have been in PT on/off the entire time. I’m so tired of hurting. And no one has given me a clear diagnosis. I walk around with cushions to sit on, and I’ve actually decided not to pursue a graduate degree because I don’t think I can handle sitting at a computer or in a classroom. It’s just crazy.

  42. This article and the essay by Ms. Burgess resonate so strongly for me. My story began in March 2013 when I was training for a half-marathon. I, too, blame overtraining and lack of strength training and cross-training for my injuries. It started with tweaking on the inside of my left ankle which ran up and across my left knee – that took me out for a couple weeks. Shortly after resuming training – and hill repeats – the backs of my legs were strung so tight from my gluts through my plantar fascia that I could barely move. This eventually led to a sudden tearing in my right Achilles, which actually provided some relief but simultaneously caused tremendous havoc. I was forced to sit even more than usual (I also have a desk job) and I compensated for the injury with my left side. It wasn’t long before a hamstring strain on my left side led to high hamstring tendonitis, ishial tuberosity bursitis, and finally troncheric bursitis. I couldn’t sit, stand, lie down or walk without significant difficulty and pain. I had to stop working for 8 weeks and then returned to a sit-stand work station at which I am yet to be able to sit. It’s now been 7 months and I’m still unable to sit down for a meal, go to a restaurant, go to a movie theatre, or drive in the car for more than 5 or 10 minutes – let alone run. It affects every area of my life. The time when I’m not working is spent trying to heal enough so that I can continue working. I feel like I’m caught in a vicious cycle. I’ve tried PT, massage therapy, cranial sacral therapy, holistic nutrition, yin yoga, swimming, cortisone, ultrasound, RICE, etc. Now I’m getting an MRI and going to try shockwave therapy, and if that doesn’t work, more cortisone. If I don’t have any success, I will seriously consider surgery. I am desperate to get my life back. I would be interested in hearing from others with similar challenges and welcome any advice or recommendations on treatment options.

  43. I’m in pain. I have done spinning class for a few years. This year I have slacked in working out and regular excercise. I had not done spin class’s in a month and decided to get back at it. I did a 1 hour advanced hip hop spin class on last Saturday a fairly moderate class Monday. I noticed even with my gel seat cover the seat hurt. By Wednesdaymy legs felt like workout pain but wasn’t too bad. Thursday I started feeling pain under my right buttock. Now it is bad, it hurts to sit,get up bend down, and stretching is out of the question. I believe it’s the hamstring. What can I do for this??

  44. Thank you, thank you to author of this article and to everyone who is posting. I have been suffering through this for 2 1/2 to 3 years now; I am not a runner, but exercise regularly. I received accurate diagnosis only about a year ago. For the first nearly 2 years, orthopedic doctor was baffled – I had x-rays, steroid injections, SPECT scans, MRIs, etc. The bone SPECT scan combined with the MRI finally pinpointed the high hamstring tendinopathy. Tried physical therapy last year, but it didn’t help. Sitting is the worst. I have a sit/stand desk at work, which helps, but my hour commute in the car twice a day is an absolute killer. I end up standing in the back of a movie theater halfway through the movie because I can’t sit that long. I stand at the end of a nice dinner, because everyone wants to stay and visit and have coffee/dessert, but I can’t sit that long. Doctor says surgery is out of the question for me, so going back to physical therapy to try again, but if that doesn’t work, maybe next step is PRP. Thanks again to everyone who posted. We’re all in this together.

  45. Wow…! Thanks for the article and thanks to all that have posted and provided info. I never reply to anything like this, but since the origination of my experience with this pain in the a** – sounds a bit different-thought I would. I first experienced these symptoms rowing crew in College in the late 70’s. Like many of you, sitting in the car or straight up on a bench was very painful, but I ignored it. After college I had a long career in triathlon and cycling which included a lot running including power/speed/agility drills, stairs and marathons. Quick accelerations/sprints/bounding were the worst. I managed it with weight and core workout and then added yoga in 2002 which helped tremendously. But with yoga, particularly heated yoga, I tended to overstretch, but didn’t pay attention to the fact that pain is a messenger. I finally quit running in 2007. Since, I still compete at a high level as a cyclist, which does NOT aggravate this area the way lifting, stretching or yoga can-which probably has more to do with me being to aggressive or not listening to the pain/inflammation. Two weeks ago I sat back down on a rowing machine to prepare for a race in November and BAMM!! In the first minute I felt like I was rolling up and over hot, inflamed cords with my sit bones and after only 3 days of attempted rowing for 20 minutes – I’m toast and now searching for help and reading this article. Think I’m going to go sit on some ice. Best to you all!

  46. If you have this type of injury for a long time and you are in an older age group which makes it difficult to fix and are getting no improvement speaking as someone who did everything over two years physio programs x 2, steroids orally and injected, glucose injections and 3 PRPs get an MRI! It showed in my case the tendon and completely separated from the bone and surgery was the only option. it won’t be the case for everyone and surgery is not always an option. I have had surgery and it is a slow road back. Take care and good luck!

    • Good luck also to you Karen. I too have had surgery. It is a very long, very slow road back, but it is worth it. Every day every slow run, it is worth it. Not one day since surgery have I regretted finally having surgery. I just wish I had acted earlier. Saw someone that specialising in this horrible injury earlier, and had surgery sooner. But I have done it now. 17 months since surgery, and I am so thankful to my surgeon. I sincerely wish you all the best in your future running career.

  47. Was diagnosed with upper hamstring tendinitis on my left side about a year and a half ago. I went to pt and began running in about 3 weeks again. Off and on it has been bothering me mostly just when I run. I have been doing core strength training for about 3 years and I believe that it has helped. Just recently it has acted up again and I received a cortisone injection my first in 60 years of sports. It did not help. I have no pain while driving or sitting. Rolling it with a small ball gives u a nice deep tissue massage and helps reduce the scar tissue. Biking is fine and also elliptical machine. I am going to take a couple of months off from running,very difficult since it is very enjoyable for me. Heat in the morning when I wake up and ice before I go to bed seems to really help.

  48. I was diagnosed with proximal hamstring tendonitis about two months ago. I began experiencing pain/soreness/discomfort about 4 months ago. I’m now going to physical therapy and am on my 11th week of not being able to run. I am a runner and was typically running 20-25 miles a week. I believe that I gave myself the injury by using the hamstring curl at the gym… It gave me some micro tears in the tendon and then I continued running on it for a little over a month before giving in to the fact that I was dealing with more than just soreness and something was wrong. I was not very good about stretching my hamstring before this. This article sums up my experience in many ways. Not being able to sit for more than an hour without pain & stiffness and a frustratingly slow healing process. The PT doesn’t seem to be helping very much. At times, it has been very depressing because cycling and even swimming hurt so all I’m left with is walking. For a runner, this feels devastating. I’m so grateful to find this article and read the comments. I haven’t tried cortisone injections yet, although I’m now thinking it may be necessary to give it a try.

    • Heather, you sound exactly like me. I was running a lot, but I think adding in too many hamstring weight exercises (like curls and squats, etc.) caused microtears. I continued running through the pain and eventually got to the point I couldn’t run. After resting the injury (not running at all) for 3 months, it was still no better. I went through 4 weeks of PT…with no improvement. Saw Ortho Doc and MRI confirmed high hamstring tendonopathy. I just finished up my first PRP injection (4 weeks out) and tomorrow I go for my 2nd one. I’ve seen a little improvement…but definitely not enough to even think about running. Still hurts to sit for any longer than 30min. I’ve heard that if PRP doesn’t work, a tenotomy could help. Hope your hammy is feeling better! Hopefully I’ll have good news in the next month or so after the 2nd injection and more PT!

      • Hi Shannon, sorry to hear about all the trouble you are having with your hamstring. Hopefully the injection will give you some time to allow it to heal. Have you tried Active Release Therapy to loosen the muscles around it? Keep us updated with how it is going! Best of luck!

  49. Oh, my heart goes out to you all! Thank you for sharing, it is so good to know I am not alone. I have been battling this pain in the butt (literally) injury for seven months and have tried physio, regular (weekly) deep massage, chiro, acupuncture, glute and core strengthening, specific stretching exercises, yoga, Bowen therapy, Ortho-bionomy and rest – pretty much all at the same time and for prolonged periods, but nothing seems to help permanently. Apart from being frustrating, and time consuming doing all the exercises, it is costing me a fortune!! From what I read here there does not appear to be any reliable treatment or cure. Very depressing – and suprising. Surely, with all the advanced medical and alternative therapies out there someone has the answer. Like many of you, sitting – at my desk and particularly in a car – can be excruciating. And like most of you I am pretty desperate and would do just about anything to find some permanent relief. I’m sorry I can’t offer any suggestions for a wonderful solution myself but it seems the best course of action for me is to run less – less distance, less intensity – and swim, cycle and walk more. I find if I take anti-inflamatory tablets a few hours before I run I don’t get nearly as sore either during, or after the run. Obviously, however, this is not a great practice to get into as anti-inflamatories can mask warning pain and should not be taken as a long term solution. I empathise with you all and am grateful to have found this article and to hear your similar stories. Good luck!

  50. Thanks for the article and now the associated ‘support group’ for people with this condition. I have been struggling with this for 9 months which seems an eternity but a blip compared to some of the stories here. I am a PE teacher and a CrossFit affiliate owner and I can do any and all exercises without pain. Deadlift heavy, squat full ROM, toes to bar, you name it – no problem, BUT put me in the drivers seat of a car and in 15 mins I am in agony. With a lacrosse ball under the high hamstring I can get a squirmy one hour drive accomplished but it is extremely frustrating and impacts life considerably. Has anyone had any success with Rolfing? I intend to start soon now I have exhausted 3 separate treatment practitioners without any improvement whatsoever.

    • Sorry to hear that James, but sounds like you are at least able to do all the exercises that will strengthen the muscles around it. I actually am going through this myself right now, so I understand what you are saying! Hopefully some of the other readers will be able to give you their experiences with Rolfing, myself, I have found that ART is great, and actually the kinesio/mcconnell tape works quite well. Hope this helps, and hopefully it continues to get better for you!

  51. I am a personal trainer. I injured myself after working out last Friday. Saturday morning I was in a lot of pain, as some of you have accurately described a real pain in the butt. Wow. I stayed off my feet Sat and Sun. Monday I was no better. That is when i found this blog. It is very informative and I took notes on what exercises and stretches that i could implement. Yesterday I stopped by the gym to talk to the owner. He works with a lot of athletes. Of all the people I know I thought he would have bumped into our shared pain in the butt (high hip tendinopathy). He handed me a tool, he use on some of his athletes. It is a metal device called a DMS, Deep Muscle Stimulator. He said To turn it on and rum it on the back of my leg. It took a minute to get use to but then I got more comfortable with it. I rubbed it on my hamstring for several minutes. It felt like the hamstring was warm, he said it was increased circulation. It took about half of the pain away. I still babied it. I went to the gym this morning and used it again. The muscle felt a lot less tender than yesterday. I then drove to my job using a pillow under my hamstring just to be safe. I sat through a two hour conference call, no pillow and then drove home, which is an hour away from my home. My condition feels much improved. My hamstring still feels like it could flare up, so I am not pushing it yet.
    The owner of the gym where i work out described what I have as a muscle that had contracted and when it did it pulled on the point of origin, the iscial tuberosity. That was why it was so point tender. By using the DMS to relax the muscle it could then release the tension I was feeling at that point of origin. It is probably not easy to find. Google it or if you are close to The Lake Geneva area of Wisconsin, I would be more than happy to show you. Good luck, I am very grateful to have stumbled onto this solution.

    • Interesting Bob, glad to hear that worked for you. Hopefully yours continues to improve. Some of the other readers will likely find this information very helpful, and is definitely worth a try if they can find it. Thank you for the input!

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