2025 Research: Treatment of Proximal Hamstring Tendinopathy: A Clinical Commentary

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In this episode, Brodie reviews a brand-new 2025 clinical commentary on the treatment of proximal hamstring tendinopathy (PHT) with an individualised physiotherapy approach. The paper, authored by experts including Jill Cook and Aidan Rich, outlines a comprehensive, stage-based rehab protocol grounded in tendinopathy principles and adapted for the unique demands of the hamstring complex.

CHECK OUT THE PAPER HERE

What you’ll learn in this episode:

Why recent systematic reviews still show insufficient evidence for one superior PHT treatment.
The three core pillars of the proposed protocol: education, progressive strengthening, and graded exposure to compressive/sport-specific loads.
How the five rehab stages work:
1. Isometrics – for pain relief and warm-up effect.
2. Isotonics – to build strength and endurance.
3. Kinetic chain training – targeting glutes, calves, adductors, and lumbopelvic control.
4. Compressive load reintroduction – safely restoring tolerance to hip flexion positions.
5. Energy storage/release drills – for athletes with high-speed or power demands.
The importance of pain monitoring, “hurt vs harm” education, and avoiding rapid spikes in load.
How to individualise the program based on goals, deconditioning level, and activity demands.
Practical tips for combining stages, structuring training cycles, and maintaining long-term tendon health.

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