Hamstring Tendonitis

Overview

What is hamstring tendonitis?

Hamstring tendonitis is inflammation in the tendons at the back of your thigh. Tendons are connective tissues that attach muscles to bones. Hamstring tendons attach your hamstring muscles to bones in your pelvis, knee and lower leg.

You develop hamstring tendonitis if you overuse or overstretch the tendons. You might feel pain or notice swelling at the back of your thigh. Most people with hamstring tendonitis recover within a few days or weeks with rest and conservative (non-surgical) treatments.

Is hamstring tendonitis the same as a tendon tear?

Tendonitis isn’t the same as a tendon tear. A tendon tear is a serious injury that causes the tendon to pull away from your hamstring muscles or bones. Severe tendon tears might require surgery.

Is hamstring tendonitis the same as a hamstring strain?

Strains and tendonitis both affect tendons. But a strain usually occurs suddenly, when fibers in the tendon overstretch and develop tiny tears. Tendonitis tends to develop gradually with overuse.

Who gets hamstring tendonitis?

Athletes or people who run at fast speeds (especially starting and stopping very quickly) are at highest risk for hamstring tendonitis. Sprinters, hurdlers, dancers and people who play contact sports such as football, basketball or soccer may develop this type of hamstring injury. Studies suggest that athletes between the ages of 16 and 25 are at the highest risk of hamstring injuries.

You’re also at risk for hamstring tendonitis or other hamstring injuries if you:

  • Are a young athlete who is still growing.
  • Are Black.
  • Are over 40.
  • Have had a previous hamstring injury.
  • Have inflexible quadriceps (muscles at the front of your thigh), which can put more strain on the muscles and tendons at the back of your thigh.
  • Have weak or tight hamstring muscles that aren’t properly conditioned.

Symptoms and Causes

What causes hamstring tendonitis?

Hamstring tendonitis is usually the result of repetitive stress on the tendons in the back of your thigh. Overuse can make the tendon fibers irritated and inflamed.

What are the symptoms of hamstring tendonitis?

Symptoms of hamstring tendonitis may include:

  • Dull aching around your buttocks, the back of your thigh, knee or lower leg (similar to the symptoms of sciatica).
  • Leg stiffness when walking or bending your knee.
  • Sharp pain if you suddenly overstretch your hamstring muscles or tendons.
  • Swelling, especially right after an injury.
  • Tingling that runs from your lower back down the back of your leg.
  • Weakness in the back of your thigh.

Diagnosis and Tests

How is hamstring tendonitis diagnosed?

Your healthcare provider performs a physical exam and checks the back of your thigh. They may press on the muscles and tendons to check for tenderness or swelling. They may also ask you to perform certain movements, such as bending your legs or rising up on your toes. Be sure to let your provider know if you experience pain when walking or putting any weight on your leg.

Most people won’t need imaging tests for mild tendonitis that’s not causing severe pain. But if your provider suspects a more serious injury, such as a tendon tear, they may do an X-ray, MRI, CT scan or ultrasound.

Management and Treatment

How is hamstring tendonitis treated?

Most people find relief from hamstring tendonitis after a few days of treatment with the R.I.C.E. (rest, ice, compression and elevation) method. You can do R.I.C.E. at home to minimize pain and swelling in your hamstring:

  • Apply a cold compress or ice pack to the back of your thigh (not directly to your skin) for about 20 minutes every two hours.
  • Avoid any strenuous activity, such as bending your knee, walking up stairs or otherwise straining your hamstring.
  • Keep your leg elevated, so your knee and thigh are above the level of your heart.
  • Use a compression bandage or wrap on your thigh if your provider says it’s safe to do so.

Your provider may also recommend pain relievers to keep you comfortable as you rest your hamstring. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can also reduce pain and inflammation.

Some people may find physical therapy helpful as they recover from hamstring tendonitis. Physical therapy can help you rebuild strength and flexibility in your leg.

Will I need surgery for hamstring tendonitis?

Most people don’t need surgery for hamstring tendonitis. If you have a severe tendon tear or the tendon tears away from muscle or bone, you might need surgical treatment.

Prevention

How can I prevent hamstring tendonitis?

Tips for preventing hamstring tendon pain include:

  • Do a light warm-up, such as jogging in place, before you do strenuous activity.
  • Keep your hamstring and quadriceps muscles strong and conditioned to avoid putting extra strain on the tendons.
  • Rest your hamstring tendons between periods of physical activity.
  • Stretch the tendons in the back of your thigh before and after exercise.
  • Maintain a healthy lifestyle by not smoking or using tobacco products, eating a healthy diet and keeping your weight under control.

Outlook / Prognosis

What’s the prognosis (outlook) for people with hamstring tendonitis?

At-home treatments help most people find relief from hamstring tendon pain within a few days or weeks. Some people continue to have chronic hamstring tendonitis if they’re athletes or continue to do strenuous physical activity. After you have a tendon injury, you’re more likely to injure the tendon again. Ask your healthcare provider about ways to prevent reinjury.

Living With

When should I contact my doctor about hamstring tendonitis?

Contact your doctor if you:

  • Can’t walk or put any weight on your leg.
  • Have sudden, intense leg pain.
  • Lose feeling in your lower back, buttocks or leg.
  • Notice your thigh appears lumpy or misshapen.
  • See severe swelling or bruising at the back of your thigh.

A note from Cleveland Clinic

Hamstring tendonitis is inflammation in the tendons at the back of your thigh. It’s usually the result of overuse but can also happen due to a sudden hamstring injury. The condition might cause pain, aching, stiffness or swelling in your leg. At-home treatments include R.I.C.E. and pain relievers. Hamstring tendonitis usually goes away in a few days.

Last reviewed by a Cleveland Clinic medical professional on 02/14/2022.

References

  • American Academy of Orthopaedic Surgeons (AAOS). Hamstring Muscle Injuries. (https://orthoinfo.aaos.org/en/diseases--conditions/hamstring-muscle-injuries) Accessed 2/14/2022.
  • Poudel B, Pandey S. Hamstring Injury. (https://www.ncbi.nlm.nih.gov/books/NBK558936/) [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Accessed 2/14/2022.

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