Proximal Hamstring Tendinopathy (PHT) – VALD Testing, Gluteal Recruitment & Hip Rotator Cuff Strengthening

Proximal Hamstring Tendinopathy (PHT) is a stubborn injury that plagues runners, especially those doing long distances, hills, or speed sessions. It causes deep buttock pain where the hamstring attaches to the sitting bone, and it can last for months if not treated properly. At Up N Adam Physio Newcastle, we use VALD testing, glute recruitment strategies, and hip rotator cuff strengthening to fix PHT and stop it from coming back.

Why Runners Develop PHT

The hamstring tendon at the top of the thigh absorbs huge forces during running. Over time, if the tendon is overloaded or weak, it becomes painful.

Contributing factors include:

• Sudden spikes in hill running or sprinting.

• Weak glutes, forcing hamstrings to work harder.

• Poor pelvic control or hip rotator cuff weakness.

• Long sitting hours (compressing the tendon).

Symptoms of Proximal Hamstring Tendinopathy

• Deep ache in the buttock, near the sitting bone.

• Pain with sprinting, hills, or acceleration.

• Discomfort when sitting for long periods.

• Stiffness when starting to run.

  
  

Why PHT is Hard to Fix

Runners often stretch their hamstrings to “relieve” tightness, but stretching actually compresses and irritates the tendon more. The real fix is progressive loading + hip control training.

How We Treat PHT at Up N Adam

Step 1: Assessment

• VALD Dyno and NordBord testing → measure hamstring strength.

• Hip rotator cuff assessment → check pelvic control.

• Training load review.

Step 2: Pain Relief & Early Loading

• Isometric hamstring holds (reduce tendon pain).

• Soft tissue release of surrounding muscles.

• Avoid aggressive stretching.

Step 3: Strength & Recruitment

• Heavy slow resistance (hip thrusts, Romanian deadlifts).

• Gluteal recruitment drills (bridges, step-ups, split squats).

• Hip rotator cuff strengthening (side planks, banded rotations).

Step 4: Return to Running

• Gradual reintroduction of hills and speedwork.

• Plyometric drills once tendon capacity improves.

• Re-testing with VALD to confirm readiness.

Book your Hamstring Physio Newcastle appointment today

FAQs – Proximal Hamstring Tendinopathy

Should I stretch my hamstrings for PHT?

No — stretching usually irritates the tendon further.

How long does it take to recover?

Anywhere from 8–16 weeks depending on severity and training goals.

Can I keep running?

Often yes, with modified loads and progressive rehab.

Final Word

Proximal hamstring tendinopathy won’t go away with rest or stretching alone. With targeted testing, gluteal recruitment, and progressive tendon loading, you can overcome PHT and return to strong, pain-free running.

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com .

Bookings also available on our website for the following services at Up N Adam Performance Training & Physiotherapy:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fuelling www.nutrientnation.com.au

• VO2 Max testing with Lucas McBeath - to discover more effective ways to train efficiently www.flowitri.com.au

• Strength & Conditioning Programs with Adam Clarke - contact us or book via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage with Katheryn Rodgers - to relieve accumulative muscle tension & keep you training well.

• CycleFit by Physiotherapist Dean Waterman - At Up N Adam, for all your bike fitting solutions www.cyclefitphysio.com