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.