The hamstring tendons originate at the ischial tuberosity (the “sit” bones) at the base of the buttocks. Tendinosis refers to disorganization and dysfunction of a tendon. Hamstring tendinoosis or tendinopathy is typically a condition associated with overuse and is commonly seen in runners, cyclists, dancers, gymnasts, etc.
This condition is most often associated with overuse. Sprinters/runners will often have pathology in the biceps femoris, one of the 3 hamstrings. Dancers/yogis may injure the semimembranosus. Muscle imbalance as well as other biomechanical factors (such as poor technique, ill fitting equipment) may predispose to overuse.
As with any tendinopathy, pain and decreased performance are the major symptoms. At early stages, the pain may initially improve with activity, worsen towards the end, and cause soreness that night or the next day. Sometimes pain can radiate down the back of the upper thigh. There may be subjective and objective strength loss.
Procedural options for chronic tendon dysfunction include regenerative-type injections (such as platelet-rich plasma [PRP] that can theoretically provide long lasting pain relief and improved function by stimulating the body’s own natural healing response. There is some evidence that needling the tendon alone can stimulate bloodflow and healing.