Proximal hamstring tendinopathy

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Proximal hamstring tendinopathy
Opgespannen hamstrings (cropped).jpg
Attachment site of the proximal hamstring to the ischial tuberosity of the pelvis
Differential diagnosisIschiofemoral impingement, piriformis syndrome, gluteal muscle tear, pelvic stress fracture, proximal hamstring rupture[1]

Proximal hamstring tendinopathy (PHT), also known as yoga butt, is an irritation where the hamstring tendon attaches to the ischial tuberosity of the pelvis.[1] Symptoms generally include pain felt deep within the buttock which is long-term in nature.[1] Often an initial period of running improves symptoms, though they worsen afterwards.[1] Sitting on a hard surface may also worsen symptoms.[1] Complications may include sciatica.[1]

Those affected often include runners and hockey players.[1] Onset may be associated with increased training, lunges, or excessive stretching.[1] The underlying mechanism may involve flexing or bringing to midline the hip.[1] Diagnosis may be supported by greater symptoms with greater use of the hamstring and confirmed by MRI.[1]

Management may involve changing the running style to faster and smaller steps.[1] While low levels of pain during exercise may be tolerated as long as it last less then 24 hours, continuous pain should result in decreasing exercise.[1] Physiotherapy may involve gradually greater use of the hamstring.[1] A cushion to place weight on the thighs and stopping stretching of the hams may also help.[1]


  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 Goom, TS; Malliaras, P; Reiman, MP; Purdam, CR (June 2016). "Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management". The Journal of orthopaedic and sports physical therapy. 46 (6): 483–93. doi:10.2519/jospt.2016.5986. PMID 27084841.