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Episode Summary

In today’s episode, we welcome back Matt, who originally shared his success story in Episode 95. Two years ago, he successfully overcame proximal hamstring tendinopathy (PHT) in his left leg. However, in the past year, he faced a new challenge—PHT on his right leg. Unlike his previous experience, this case proved to be more stubborn and took nearly a year to resolve.

Matt’s journey provides deep insights into the complexities of PHT rehab and highlights the importance of strength training, patience, and persistence. This episode is a must-listen for runners struggling with recurring injuries, as Matt shares his key takeaways from his rehab journey, the role of gym-based strength work, and the adjustments that finally led to full recovery.

Key Takeaways from This Episode

The Reality of PHT Recurrence

• After successfully treating PHT on one side, Matt developed it on the other leg a year later.
• Despite applying the same rehab strategies, this case was more stubborn and required new approaches.

What May Have Caused the Second PHT Case

• Started a new training cycle with a strong emphasis on strides and uphill sprints.
• Simultaneously introduced gym training, leading to a hamstring strain near the knee.
• Once the strain healed, mild PHT symptoms began to develop, possibly due to hamstring weakness.

Rehab Attempts That Didn’t Work

• Performed targeted home-based hamstring strengthening exercises, focusing on painful movements.
• Experimented with different exercise frequencies, intensities, and recovery strategies.
• Symptoms remained at a mild but persistent 1-2/10 pain level for nearly a year.

The Breakthrough Moment

• Started going to the gym twice a week with a full-body strength program after running.
• Increased load with heavier weights and compound exercises (e.g., squats, deadlifts).
• Adopted a “one-set-per-exercise” approach to maximize exercise variety.
• Noticed improvements within 4 weeks, and symptoms completely resolved within 2 months.

Possible Reasons This Approach Worked

1. Heavier Strength Work – Increased tendon load beyond what was possible with home workouts.
2. Exercise Variety – Instead of focusing only on painful movements, he incorporated full-body training.
3. Running Before Strength Training – This may have helped fatigue healthy tendon fibers, forcing the injured portion to adapt and strengthen (as explained by tendon researcher Keith Baar).

Takeaways for Runners with PHT

• Strength training is non-negotiable if you want to avoid PHT.
• Ignoring symptoms early on can lead to longer recovery times. Address small flare-ups before they become chronic.
• The “Easy Interval Method” allowed Matt to include speed work without triggering symptoms.
• Runners should expect some setbacks. PHT recovery is not always linear, and adjusting training when needed is key.

Final Message from Matt

If you’re dealing with mild but persistent PHT, don’t lose hope! The right training adjustments can help you return to pain-free running. Matt’s key lesson: Running alone makes you weaker—strength training is essential to stay resilient.

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