How to Deal with Nagging Pain on Your Sit Bone / Upper Hamstring

Experiencing pain in your sit bone or upper hamstring can be a frustrating and persistent issue, especially if it worsens when you sit on hard surfaces. This type of discomfort is often attributed to high hamstring tendinopathy, a condition that can linger without proper management. In this blog, we’ll explore the nature of high hamstring tendinopathy, the importance of appropriate loading, and the role of a structured rehab program in resolving this problem.

Understanding High Hamstring Tendinopathy

High hamstring tendinopathy is a condition that affects the tendons located at the top of the hamstring, near the sit bone (ischial tuberosity). These tendons connect the hamstring muscles to the pelvis, and when they become overloaded or injured, it can lead to pain and discomfort, particularly when sitting.

Causes and Symptoms

  • Causes: High hamstring tendinopathy is usually caused by repetitive strain or overuse, often seen in activities like running, cycling, or prolonged sitting, especially on hard surfaces. It can also result from sudden increases in activity or inadequate warm-up before exercise.

  • Symptoms: The primary symptom is a deep, aching pain in the upper hamstring or sit bone area, which intensifies when sitting, especially on hard surfaces. Other symptoms may include stiffness, tenderness, and discomfort during activities that stretch or load the hamstring.

Importance of Proper Loading

High hamstring tendinopathies can be particularly stubborn and may persist for an extended period if not managed correctly. Proper loading of the area is crucial to ensure that the tendon heals effectively. Here are some key points to consider:

  1. Avoid Overloading:

    • Initially, it's important to reduce activities that exacerbate the pain. Avoid prolonged sitting on hard surfaces and high-impact exercises that strain the hamstring.

  2. Gradual Reintroduction:

    • Gradually reintroduce load to the tendon through a structured exercise program. This helps the tendon adapt and strengthen over time, promoting healing and reducing pain.

  3. Eccentric Exercises:

    • Eccentric exercises, where the muscle lengthens under tension, can be particularly effective in managing tendinopathy. These exercises help to strengthen the tendon and improve its ability to handle load.

Structured Rehab Program

A well-designed rehabilitation program is essential to address high hamstring tendinopathy effectively. Working with a qualified physiotherapist or chiropractor can ensure that your rehab plan is tailored to your specific needs and goals. Here’s what a structured rehab program typically involves:

  1. Assessment:

    • A thorough assessment to determine the extent of the tendinopathy, identify any contributing factors, and establish a baseline for your current level of function and pain.

  2. Individualized Exercise Plan:

    • A personalized exercise program that includes a combination of stretching, strengthening, and functional exercises. Focus on exercises that target the hamstrings, glutes, and core muscles to provide overall stability and support.

  3. Manual Therapy:

    • Manual therapy techniques such as deep tissue massage, myofascial release, and joint mobilizations can help to alleviate pain, reduce muscle tension, and improve flexibility.

  4. Progressive Loading:

    • Gradual progression of exercise intensity and complexity to ensure that the tendon adapts and strengthens over time. This includes a mix of isometric, concentric, and eccentric exercises.

  5. Education and Guidance:

    • Education on proper posture, movement patterns, and activity modification to prevent re-injury. Guidance on how to manage symptoms and integrate rehab exercises into your daily routine.

Nagging pain in the sit bone or upper hamstring, often caused by high hamstring tendinopathy, can significantly impact your daily life and activity levels. Understanding the nature of this condition and the importance of proper loading is crucial for effective management. A structured rehab program, developed with the help of a qualified physiotherapist or chiropractor, can provide the necessary support and guidance to resolve the issue and get you back to pain-free movement. If you're experiencing persistent upper hamstring pain, don't hesitate to seek professional help and start your journey towards recovery.

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