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Understanding Proximal Hamstring Tendinopathy (PHT): Causes, Symptoms & The Right Recovery Approach
If you’ve recently discovered this podcast because you’re dealing with deep buttock pain, pain with sitting, or a stubborn “high hamstring” issue that just won’t go away… you are not alone.
In this updated foundational episode, I break down everything you need to know about proximal hamstring tendinopathy (PHT): what it is, why it develops, why it’s so commonly misunderstood, and what successful rehab actually looks like. I also share parts of my own journey overcoming PHT and the common patterns I now see after helping hundreds of runners navigate this condition.
We dive into:
- The true causes of PHT and why overload + recovery balance matters
- Why speed work, hills, sitting and compression can flare symptoms
- The “warm-up effect” and why tendons can feel better during a run… then worse the next day
- Common misdiagnoses including sciatica, piriformis syndrome and back-related pain
- Why stretching and complete rest often fail
- The difference between reactive vs degenerative tendons
- How modern rehab focuses on gradually rebuilding tendon capacity rather than avoiding movement altogether
Whether you’re newly diagnosed or have been battling PHT for years, this episode is designed to give you clarity, direction and hope. There is a path forward — and understanding the condition is the first step.