Hamstring tendonitis/tendinopathy is inflammation or degeneration of one of the hamstring tendons at the point where it attaches to the back of the knee. This occurs most commonly in the tendon of the biceps femoris muscle.
Medically reviewed by Dr Chaminda Goonetilleke, 8th Dec. 2021
Symptoms of biceps femoris tendinopathy
Symptoms consist of:
- Tenderness and swelling over the outside back of the knee.
- Gradual onset of pain, possibly starting as a mild discomfort.
- Stiffness at the back of the knee, particularly worse in the mornings or after prolonged sitting.
- Pain may temporarily subside as the tendon warms up, only to reoccur later.
Assessment tests
Assessment for Hamstring Tendonitis/Tendinopathy:
A thorough assessment by a professional therapist involves various tests and obtaining a comprehensive case history to evaluate your injury. One specific test, “resisted knee flexion” (attempting to bend your knee against resistance), may replicate symptoms at the back of your knee. Additionally, signs of tight hamstring muscles may be observed during the assessment.
Causes & anatomy
Hamstring tendonitis or tendinopathy commonly arises from overuse or inadequate healing of a tear.
The hamstring muscles
The hamstring muscle group, consisting of the biceps femoris, semitendinosus, and semimembranosus muscles, plays a crucial role in knee flexion and hip extension.
Activities like sprinting and jumping subject the hamstrings to significant force, particularly when your foot is about to touch the ground during a sprint. This happens because the muscles contract eccentrically while simultaneously lengthening, effectively decelerating the forward motion of your lower leg.
Mechanism of injury
Inflammation or degeneration of the biceps femoris tendon typically arises at its insertions into the tibia (shin bone) and fibula. This condition is commonly associated with overuse or inadequate healing following a partial tendon rupture. The biceps femoris tendon is frequently implicated in such cases.
Tendonitis or tendinopathy?
The term tendonitis is most commonly used, however, usually, this is not strictly accurate. Tendonitis refers to an acute inflammation of the tendon where in actual fact unless the injury is very recent the pain is more likely due to long-term overuse and degeneration of the tendon. A broader and more accurate term for this type of tendon injury is tendinosis or tendinopathy.
Treatment of Hamstring Tendonitis
To effectively treat hamstring tendonitis, a comprehensive approach is necessary, focusing on pain and inflammation reduction followed by a gradual rehabilitation program.
Cold Therapy: If the injury is recent or acute, it is advised to rest and apply ice or cold therapy for 10 to 15 minutes every hour during the first 24 to 48 hours. This helps alleviate pain and inflammation.
Medication: Anti-inflammatory medications like ibuprofen can be used in the early stages to reduce pain, swelling, and inflammation. However, it is important to consult your doctor or pharmacist before taking any medication, especially during the later stages of rehabilitation.
Knee Supports: Wearing elastic knee support can assist in reducing swelling and providing additional support to the knee joint. As the injury progresses or becomes chronic, applying heat and using a heat retainer-type knee support may prove more beneficial.
Electrotherapy: Utilizing ultrasound or laser treatment can aid in reducing inflammation and promoting the healing process.
Massage: Cross-friction massage techniques can be applied to the tendon to help alleviate symptoms. Additionally, deep tissue massage focusing on the hamstring muscles can improve overall muscle condition.
Preventing hamstring tendonitis injuries
Always prioritize a proper warm-up before training or competition. Prioritize hamstring muscle stretching both before and after training sessions. It is essential to stretch daily, regardless of training schedules.
Strengthen the muscles to adequately handle the demands placed upon them, with particular emphasis on eccentric strengthening.
Ensure regular sports massages to maintain optimal condition of muscles and tendons. Minimize excessive acceleration/deceleration runs or hill work.
