What it is

Hamstring and adductor tendinopathy are overuse conditions where the tendon becomes sensitive to load. Proximal hamstring pain sits near the sitting bone, adductor pain sits in the groin near the pubic bone.

Symptoms rise with running, acceleration, kicking, or prolonged sitting for the hamstring.

What happens when it occurs

Repeated tensile and compressive loads exceed current tolerance. Tendons adapt when loading is matched to capacity and progressed correctly.

Common causes and risk factors

  • Rapid increases in running or kicking volume
  • Weakness or endurance deficits in the posterior chain or adductors
  • Poor lumbopelvic control and long sitting times

Who is most affected

Runners, field athletes, and people in sitting or kicking-dominant roles.

Typical symptoms

  • Pain at the sitting bone for hamstring or at the groin for adductor
  • Start-up stiffness that eases with movement
  • Pain with acceleration, hills, or kicking

When to seek care

If pain persists beyond two weeks or limits acceleration, hills, or kicking.

How we diagnose

History and examination including palpation at the tendon origin, strength testing in long and short muscle lengths.

MRI or ultrasound is used when a tear is suspected or when progress stalls.

Management

  • Relative deload with tendon-specific heavy slow loading
  • Address compressive positions such as long sitting for hamstring and deep adduction for adductor
  • Gradual return to running, hills, and kicking

Rehabilitation milestones

  • Phase 1 weeks 0 to 2: pain control, isometrics, reduce compressive postures.
  • Phase 2 weeks 2 to 6: heavy slow resistance at progressive lengths.
  • Phase 3 weeks 6 to 12: plyometric preparation, graded running and kicking.
  • Phase 4 weeks 12 to 16: full workload with speed and direction changes.

Readiness to progress

  • Next-morning pain no higher than 2 out of 10
  • Strength within 90 percent across test positions
  • Hop or sprint and kicking drills without flare

Prevention

  • Maintain eccentric strength for hamstrings and adductors
  • Limit long sitting without breaks for proximal hamstring
  • Progress hills and kicking volumes gradually

Australia snapshot

  • Common in running and kicking sports
  • Adductor tendinopathy is frequent in football codes
  • Proximal hamstring symptoms affect runners and sitters

Latest insights

  • Loading beats rest for tendons. Reduce compression while building strength and capacity.
  • Progress by criteria tied to pain response and next-morning status.

Frequently Asked Questions

Most improve over 8 to 16 weeks with structured loading. Long-standing cases can take longer.

Yes, keep easy running or cycling if pain is 3 out of 10 or less and the next morning is stable. Pause maximal sprints and long kicks early.

They improve control and Imaging helps when a tear is suspected or progress stalls after a thorough rehabilitation block.. The arch shape may change a little, but comfort and performance improve.

Heavy slow loading at progressive lengths, then plyometrics and sport-specific drills.

Use a seat wedge or stand more often. Avoid long sitting in early phases.

When next-morning pain is low, strength is within 90 percent, and sprint or kicking tests are passed.

Take breaks from prolonged sitting and avoid sudden lunges or heavy lifts during early rehab.