Hamstring Tendonitis

Summary

Hamstring tendonitis is a condition where the tendons at the back of your thigh get sore and swollen, usually from doing too much exercise or repeating the same movements too often. It can cause pain in the back of your leg, near your butt, or behind your knee (Figure 1) –especially when running, sitting, or going uphill. Doctors check for it by asking about your pain, doing a physical exam, and sometimes using an MRI or ultrasound. Most people get better with rest, ice, and physical therapy. Surgery is very rare. With the right treatment, most people recover fully and can go back to their normal activities.

Introduction

Hamstring tendonitis is a condition where the tendons that connect the hamstring muscles to the bones become irritated or inflamed. The hamstring muscles are located at the back of your thigh and help you bend your knee and control the movement of your leg during walking and running. When the tendons are overused or stressed too much, they can become painful and swollen. Hamstring tendonitis usually causes pain in the back of the thigh, near the buttock, or at the back of the knee depending on which of the hamstring tendons is affected by the tendonitis. Symptoms for hamstring tendonitis are typically most notable when running, walking uphill, or sitting for long periods. Hamstring tendonitis is most common in athletes, especially runners, soccer players, and dancers, but it can also happen to anyone who increases their activity level too quickly or uses poor stretching and strengthening habits.

How Doctors Diagnose Hamstring Tendonitis

To diagnose hamstring tendonitis, a doctor will ask about your symptoms, how the pain started, and what activities make it worse. They will also examine your leg by pressing on the back of the thigh and checking your strength and flexibility. Usually, the diagnosis of hamstring tendonitis can be establish based on the patient’s history and the physical exam findings. However, sometimes the doctor may order an MRI or ultrasound to look at the tendons and rule out other problems like a muscle tear or soft-tissue scarring. These imaging tests help confirm the diagnosis and make sure there isn’t a more serious injury.

Treating Hamstring Tendonitis

Most cases of hamstring tendonitis can be treated without surgery. The first step is to rest and avoid activities that make the pain worse. Using ice on the painful area and taking anti-inflammatory medications can help reduce swelling and discomfort. Once the pain improves, a physical therapy program is usually started. This includes stretching, strengthening, and improving posture or running form to prevent the problem from coming back. Recovery can take a few weeks to a few months, depending on how bad the injury is and how well the person follows their treatment plan.

When Is Surgery Needed?

Surgery is rarely needed for hamstring tendonitis. It is usually only considered if the pain is very severe and does not improve after months of non-surgical treatment. In rare cases, surgery may be done to remove damaged tissue or reattach a tendon that has pulled away from the bone. This type of surgery is more likely in chronic or long-lasting cases that have not responded to physical therapy or other treatments.

What to Expect Long-Term

Most people with hamstring tendonitis recover well, especially if they start treatment early and follow through with rehab. Once the pain goes away and strength is restored, people can return to sports and other activities. Some may need to make changes to their training routine, such as better warm-ups and stretching, to avoid future problems. With the right care, the long-term outlook is very good, and most people can return to their normal lifestyle without lasting pain.

Edited by Stephen Pinney MD, July 30th 2025.