Proximal Hamstring Tendinopathy: A Systematic Review of Interventions

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Science

Background:

• Proximal hamstring tendinopathy causes persistent buttock pain in athletes and non-athletes.
• It is prevalent in track and field, long-distance running, and field sports.
• Evidence-based management strategies are needed.

Approach:

• A systematic review evaluated surgical and non-surgical interventions for proximal hamstring tendinopathy.
• Twelve studies (2 RCTs, 10 case series) involving 424 participants were analyzed.
• Outcomes included symptom improvement, physical function, quality of life, and adverse events.

Key Points:

• Very low-quality evidence suggests shockwave therapy may outperform multi-modal interventions for long-term symptom and function improvement.
• No significant difference was found between autologous whole-blood and platelet-rich plasma injections for medium-term physical function or quality of life.
• Surgery showed potential for large long-term reductions in symptoms and physical function, though based on very low-quality evidence.

Conclusions:

• Current evidence is insufficient to recommend one intervention over another for proximal hamstring tendinopathy.
• A pragmatic approach, starting with interventions successful in other tendinopathies, is suggested.
• Further high-quality research is warranted.