Overcoming Proximal Hamstring Tendinopathy

Brodie Sharpe
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Sep 9, 2025 • 25min

Why It Is So Hard to Overcome PHT (And What You Should Do About It)

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE 🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice. 
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Aug 26, 2025 • 24min

The Latest on Education of Proximal Hamstring Tendinopathy (2025 Research)

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.In this episode of the Overcoming PHT Podcast, I dive into a valuable supplemental resource created by researchers at La Trobe University as part of their clinical trials on proximal hamstring tendinopathy (PHT). This patient education file breaks down everything from diagnosis to discharge advice—and I highlight the key takeaways that can help you better understand and manage your recovery.What You’ll Learn in This Episode:CHECK OUT THE PAPER HEREUnderstanding PHT – what causes it, why tendinopathy is the accepted term, and the typical prognosis.Treatment options explained – the pros and cons of rest, injections, surgery, shockwave therapy, and why individualized physiotherapy remains the gold standard.The role of strength training – how heavy, slow resistance can improve muscle strength, tendon stiffness, and even brain-muscle connections.MRI myths – why structural changes don’t always match up with pain and function.Pain monitoring principles – why tendons respond differently, and how to use the 24-hour pain response as a guide.Compression and load management – understanding high vs low tendon loads, how sitting and stretching impact PHT, and why gradual reintroduction is key.Discharge advice – the importance of ongoing strength work, flare-up management, and avoiding extreme “all or nothing” approaches with sitting and stretching.Why This MattersWhether you’re new to PHT or have been struggling for years, this episode gives you a clear, research-backed framework for understanding your pain and making smarter rehab choices. It’s not just my perspective—it’s guidance from some of the leading tendon researchers in the world.
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Aug 12, 2025 • 42min

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

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.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 HEREWhat 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:Isometrics – for pain relief and warm-up effect.Isotonics – to build strength and endurance.Kinetic chain training – targeting glutes, calves, adductors, and lumbopelvic control.Compressive load reintroduction – safely restoring tolerance to hip flexion positions.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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Jul 29, 2025 • 26min

Paper Review: Do Male & Female Tendons Heal Differently?

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.🧠 Episode SummaryIn this episode, Brodie dives into a newly published paper titled “Female Tendons are from Venus and Male Tendons are from Mars: But Does it Matter for Tendon Health?” by Gerard McMahon and Jill Cook. The paper explores how male and female tendons differ in structure, adaptation, healing, and injury risk—and what it means for those dealing with tendinopathy.🔍 What You’ll LearnKey structural differences between male and female tendons (size, stiffness, collagen synthesis)Why female tendons may stretch more but adapt less to trainingHow men and women respond differently to tendon rehab protocolsSurprising findings about pain, healing, and tendon blood flowWhether injury prevention or rehab should differ based on sex📌 Key TakeawaysFemale tendons are more compliant, have lower stiffness, and show slower collagen production—even at rest.Male tendons respond more favorably to traditional rehab (like eccentric loading), often reporting greater pain reduction and functional improvements.Despite men experiencing more frequent tendon injuries in some data, women may be closer to their strain “danger zone” during exercise, possibly increasing injury risk.Women may need longer rehab timelines, heavier resistance training (beyond just eccentrics), and closer attention to recovery, nutrition, and hormonal cycles.Men should be cautious about overloading tendons due to higher force-generating capacity and should still progress gradually.💡 For Runners With TendinopathyDon’t compare your progress to someone of the opposite sex—recovery is sex-specific.Trust the process: healing may be happening at a microscopic level even if pain relief is slow.Tailor your rehab by considering not just gender, but also age, training history, injury severity, and more.
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Jul 15, 2025 • 17min

Exploring the Impact of Vitamin D on Tendon Health

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.In this episode, Brodie explores the latest research on vitamin D and its role in tendon health, diving into a 2024 comprehensive review that examines both cell-based and animal studies. You’ll learn how vitamin D influences tendon healing, inflammation, and collagen production—and how low levels could delay your recovery. Plus, Brodie shares practical advice on vitamin D testing, optimal levels, sun exposure, supplementation, and the potential role of vitamin K2.🧠 What You'll Learn:How tendons respond to training and stress via collagen synthesisWhy vitamin D is like a “site manager” during tendon repairThe difference between in vitro (lab) and in vivo (animal) studiesWhat research shows about vitamin D deficiency and tendon healingThe importance of maintaining adequate vitamin D levels (and what’s considered optimal)Whether supplementation is necessary—and how to combine it with vitamin K2🧪 Research Highlight:Study: Exploring the Impact of Vitamin D on Tendon Health: A Comprehensive Review (2024)14 studies analyzed: 5 in vitro, 9 in vivo (mostly animal models)Key takeaway: Vitamin D deficiency may impair tendon healing and increase re-injury risk🛠️ Practical Takeaways:Ask your GP for a 25-hydroxyvitamin D blood testAim for blood levels between 75–125 nmol/L for optimal musculoskeletal healthGet sun exposure for 10–30 mins/day (arms and legs, mid-morning or afternoon)Include dietary sources like fatty fish, egg yolks, and fortified foodsSupplement with 1,000–2,000 IU/day if needed; higher doses may require supervisionIf supplementing long-term, consider pairing vitamin D with vitamin K2 to support bone health and calcium balance🎯 Ideal For:Runners and athletes recovering from tendinopathyPeople looking to optimize tendon repair and performanceAnyone curious about the role of micronutrients in injury recovery
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Jul 1, 2025 • 1h 16min

The Role of Nutrition On Injuries, Pain & Recovery with Ian Seels

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice. Guest: Dr. Ian Seels | Specialist Musculoskeletal Physiotherapist🧠 Episode SummaryIn this thought-provoking episode, Brodie chats with Dr. Ian Seels, a private musculoskeletal physiotherapist with over 35 years of experience and a co-author of the paper The Relevance of Diet in Musculoskeletal Clinical Practice – A Narrative Review. Together, they explore the emerging science behind how diet influences inflammation, pain, and injury recovery—with a particular focus on what this means for recreational runners.If you're battling persistent niggles, chronic tendon pain, or just want to run pain-free into your later years, this episode offers a fresh perspective you might not have considered: what you eat could be the missing link in your recovery journey.🔍 What You’ll LearnWhy inflammation matters more than weight when it comes to injury and painHow a high-carb Western diet may be quietly sabotaging your recoveryThe 3 pillars of "active management" for injury: mechanical, mental, and metabolicThe basics of an anti-inflammatory diet (very low carb, high fat, moderate protein)The difference between nutritional ketosis vs. metabolic acidosisHow to train your body to burn fat instead of carbs for enduranceSimple ways to reduce oxidative stress and support your gut healthWhy omega-3 to omega-6 balance is critical for joint and tendon healthLabel-reading tips that might surprise even the most health-conscious runnersWhether CRP and ketone testing is worth doing to track inflammation🧪 Practical Takeaways for RunnersA 4–6 week anti-inflammatory diet “trial” could help reduce pain and improve energyReducing processed foods and increasing healthy fats can shift you into a less inflamed stateBerries, leafy greens, herbs, and spices are powerful sources of antioxidantsKetone testing can “gamify” your dietary changes and provide real-time feedbackOmega-3s from oily fish, grass-fed meats, and free-range eggs support healing🛠️ Resources Mentioned📄 Paper: The Relevance of Diet in Musculoskeletal Clinical Practice – A Narrative Review📺 YouTube: Diet, Health and the Wisdom of Crowds (2018)🌐 LowCarbDownUnder.com.au – A go-to hub for evidence-based low-carb/keto nutrition
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Jun 17, 2025 • 30min

Q&A: Bridges, Tears, Flare-Ups, Walking Triggers & Rehab Without Deadlifts

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HERE❓ Questions Answered in This Episode:How do I correctly perform Keith Barr’s isometric bridge for PHT?Can I build a rehab routine without deadlifts if I have knee issues?Can diseased tendons or partial tears ever fully heal?Should I keep doing strength sessions if I’ve flared up?What do I do when I can no longer progress my exercises?Could walking on a treadmill cause a flare-up?💡 Key Takeaways:Keith Barr's Isometric Strategy: Use an anterior pelvic tilt during a single-leg bridge to target the proximal hamstring tendon more directly.Training Around Knee Pain: Modify deadlift range, keep the shin vertical, and experiment with tolerable load zones to stay active during knee flare-ups.Partial Tears & Recovery: Tendons with partial tears can often recover without surgery—track your strength, function, and symptom trends instead of obsessing over scan results.Managing Flare-Ups: You don't need to wait for a full return to baseline—1–3 days of rest followed by finding a new adaptation zone is often ideal.Progression Plateaus: When nearing max capacity in exercises, micro-progressions (e.g. +1 rep or +2 lbs) and reduced frequency (e.g. 2x/week) may be best.Walking Flare-Up Clues: High frequency, speed, incline, or insufficient recovery might turn a low-load activity like walking into a trigger.🧠 Brodie’s Insight:“Consistency and experimentation are key. You're not just following a plan—you're learning how your tendon responds. The more data points you collect, the smarter your rehab becomes.”🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice. 
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Jun 3, 2025 • 43min

Q&A: Gym Work with PHT, Flare-Up Triggers, Mental Struggles, When to Progress

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HEREIn Part 3 of this special series, Brodie tackles more insightful questions from listeners navigating their PHT recovery journey. With practical advice and personal stories, this episode is packed with actionable takeaways for anyone dealing with chronic hamstring pain.🧠 Topics Covered:Training other leg muscles during rehab: Are squats, leg presses, and calf raises safe? What about creating muscle imbalances?Flare-ups after rehab: Are they normal? When should you start worrying?Toughest client experiences: Brodie shares the most challenging cases he's worked with—and the common thread between them.Psychological struggles: How to shift your mindset when it feels like you’ll never get better.End-stage rehab guidance: For those almost fully recovered, how to know what exercises to keep, drop, or progress.Running warm-ups: What’s necessary when reintroducing running post-injury?Strength progression pacing: How to safely increase weights, reps, or volume—especially for seniors or those easily flared up.Does slower recovery = weaker tendon? Brodie breaks down the myths and shares what really influences recovery time.🧰 Key Takeaways:Keep training unaffected muscles to prevent deconditioning and stay mentally engaged.Flare-ups are learning opportunities—not failures.Progress rehab slowly and smartly—especially if you're prone to setbacks.Your mindset matters. Reframing rehab as your new “sport” can be a game-changer.Progress only one variable at a time—reps, weight, or frequency—not all at once.Recovery time from soreness is multifactorial: nutrition, sleep, age, and stress all play a role.📚 Brodie Mentions:Book: Rebound by Carrie Jackson Cheadle (A great read for injured athletes struggling with identity and motivation.)🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice. 
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May 20, 2025 • 41min

PHT Q&A: Why You’re Still in Pain Despite Doing Everything Right

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HEREIn this milestone Q&A episode, Brodie tackles your most pressing questions about proximal hamstring tendinopathy (PHT) — covering flare-ups, long-term pain, sleeping issues, training setbacks, and even how tight hip flexors fit into the picture.Whether you're just starting your rehab journey or stuck in a plateau, these answers will help you adjust your plan and regain control.🎧 What You'll Learn:✅ Cycling & PHT — When cycling to work becomes part of the problem ✅ Long-Term Recovery Doubts — “Will I ever be pain free again?” ✅ Tight Hip Flexors — Do they relate to PHT or are they just noise? ✅ Flare-Up Triggers — Why some weeks you feel great… and others fall apart ✅ Running Strategy — When to stop, reduce, or push through ✅ Speed Work — The right time to reintroduce faster running ✅ Sleep Disruption — Why some flare-ups hit hardest at night ✅ Nervous System Involvement — How chronic PHT becomes more than just tendon pain ✅ Hot or Burning Sensations — What it means when your tendon feels “hot” ✅ Post-Rehab Maintenance — What to do after symptoms go away🧠 Key Takeaways:Pain rules matter: Mild discomfort (<4/10), return to baseline by the next day, and a positive weekly trend are your north star.Setbacks are part of progress: Use them to tweak—not trash—your rehab plan.Training load ≠ just running: Cycling, gardening, and even long sitting can tip the load-recovery balance.The nervous system matters: Chronic pain is often more than just a mechanical issue.Hotness ≠ progress: It might be a sign of irritation or nerve sensitivity.🛠️ Helpful Resources Mentioned:🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
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May 6, 2025 • 56min

Still Struggling with PHT? These Answers Might Surprise You

🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉Learn more about Brodie's PHT AI Assistant 📄🔍Sign up for the FREE PHT 5-Day Course HEREIn this listener-driven episode, Brodie answers 10 of your most pressing questions about proximal hamstring tendinopathy (PHT). From isometric training to pain rules, sitting tolerance, and tendon healing potential—this Q&A is packed with practical insights to help you take control of your recovery.🧠 What You’ll Learn in This Episode:📉 Is gentle running delaying healing? How to use "pain rules" to guide your load management.✅ Can PHT fully heal? Yes—and Brodie explains how research supports complete tendon recovery (with some important caveats about pain).🧱 Isometrics revisited: Brodie shares how his views have shifted after his chat with Dr. Keith Barr and what exercises he now recommends.🏋️‍♀️ How should isometrics be programmed? Duration, intensity, and how to pair with RDLs, curls, and step-ups.🚶‍♂️ When to do loading exercises vs walking: How to time your rehab and avoid diagnostic confusion.💪 Am I getting stronger if I still have pain? Why strength and pain are different metrics—and how to track both.🚗 Sitting pain: annoying or damaging? Whether long car rides are actually harming your tendon and how to modify.🤔 Is it still PHT? Brodie explains why he avoids making remote diagnoses and what to do when symptoms are vague or lower down the leg.📈 How do I progress my running? A guide to adding a third running day without flaring up symptoms.🎭 Living with PHT as a performer: Does pushing through mild pain lead to long-term damage? Plus, are foam rollers helpful or harmful?🔁 Stay Tuned:This is just part 1 of a multi-episode Q&A series—more listener questions and in-depth answers coming soon. If you’d like to submit a question for a future episode, sign up for the free email course and keep an eye on your inbox!🛠️ Helpful Resources Mentioned:🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.infoRun Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.

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