Proximal hamstring tendinopathy: pathophysiology, diagnosis and treatment

Br J Hosp Med (Lond). 2018 Jul 2;79(7):389-394. doi: 10.12968/hmed.2018.79.7.389.

Abstract

Proximal hamstring tendinopathy is a chronic degenerative disease associated with progressive morbidity and functional decline. There is a growing incidence of the disease process but diagnosis is commonly delayed as patients present with vague and indolent symptoms, often without a specific precipitating injury. Treatment is also challenging as the existing literature varies in the nomenclature used for proximal hamstring tendinopathy and clinical trials use different management protocols with variable follow-up times. This review explores the existing literature on proximal hamstring tendinopathy and discusses the relevant anatomy, pathology, medical history, differential diagnosis, clinical assessment, diagnostic imaging and treatment of patients with proximal hamstring tendinopathy. This structured approach to proximal hamstring tendinopathy will enable clinicians to better understand the pathophysiology of the disease process, improve referrals to diagnostic imaging, and follow a stepwise approach to medical treatment and surgical referral.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Diagnostic Imaging
  • Exercise Therapy
  • Extracorporeal Shockwave Therapy
  • Glucocorticoids / therapeutic use
  • Hamstring Tendons / anatomy & histology
  • Hamstring Tendons / physiopathology*
  • Humans
  • Physical Examination
  • Platelet-Rich Plasma
  • Tendinopathy / diagnosis*
  • Tendinopathy / physiopathology
  • Tendinopathy / therapy*

Substances

  • Glucocorticoids