Category: Help by Location

High Hamstring Tendinopathy

High Hamstring Tendinopathy

It’s also known as proximal hamstring tendinopathy or high hamstring tendinitis and refers to inflammation of the common origin (ischial tuberosity) of the hamstring muscles. The origin is where the muscle attaches to the bone.
Having a quick internet search there seem to be 3 main causes or reasons associated with the onset

  1. Over use. This seems to be the most commonly written about on the internet. Specifically in relation to middle or long distance runners
  2. After back pain. This seems to be due to the pain irritating the sciatic nerve, The cause of the sciatica nerve irritation doesn’t appear to be indicated
  3. Traumatic or sudden onset. Possibly due to a slip or slide and sudden contraction of the biceps femoris pulling and irritating the tendon and where it attaches to the bone. There also seems to be where the fibrosis or sticking of the sciatic nerve to the muscle occurs.

Other causes are given below, but I think these are better thought of as maintaining factors.

  • Adhesions between the sciatic nerve and one of the  hamstring muscles.
  • The fascia covering the hamstrings is scared and bound to other structures and as a result may inhibit sciatic nerve function, and also shorten range of motion.
  • Gluteal weakness can cause overuse of the hamstring muscles. This can cause shortening and tightness in the hamstrings and potentially lead to high hamstring tendonopathy.


High Hamstring Tendinopathy gives you pain in the lower buttock on the part of the pelvic bone you should be sitting on. The pain in the buttock has been described as very sharp or like a tooth ache all the time. There doesn’t seem to be any inflammation in the ischial tuberosity although it’s painful to pressure, most notably sitting. When I had this I wasn’t able to sit comfortably for about 6 months. The pain I had when driving was almost unbearable.

Contraction of the hamstring muscles causes pain in the buttock as does a hamstring stretch . Standing does not cause pain buttock although a slight pull maybe noticed in back of the knee on the outside. Tightness may also be noticed  in the upper hamstrings.


  • 1st stop running/exercising if this is the cause.
  • Next, deal with any active inflammation. Ice around the insertion and tendon. Heat in the muscle belly feels good and may help release any tightness in the muscle itself.
  • In the early stages do not stretch the hamstring muscles, as this will pull on the tendon and further irritate it. I found rollering ineffective.
  • Get it examined so it can be diagnosed and treated as quickly as possible as this may shorten the duration of the condition.


Treatment by an osteopath is always based on the needs of each individual patient, because of that it is hard to give a definitive treatment guide.

To manage the potential link between low back pain and sciatica nerve, treatments I have  in the past have included soft tissue techniques to the Iliolumbar Ligament, Lumbar Erector Spinae, and Multifidus. Sometimes manipulation on the lumbar spine may be necessary although articulation can be used instead. Also soft tissue to the gluteal area and the deep hip rotators (piriformis and it’s relationship with the sciatic nerve deserve extra attention), but taking care to avoid the ischial tuberosity and the proximal part of the hamstrings.

When treating the hamstring a variety of soft tissue/massage techniques are used. The techniques chosen depend on the goals for that particular stage of treatment. I normally take care to not stress or tension the upper hamstring tendon until the later stages of treatment.


High hamstring Tendinopathy is a debilitating condition that can affect many aspect of your life. Simple things that we take for granted such as sitting down and eating a meal to leisure activities like running can become excruciating. I don’t want that to happen to you.

Not only have I treated high hamstring tendinopathy, I’ve  suffering from it as well. I understand the frustration that it can give, so aim to get you back to your normal activities as quickly as possible. I have the experience to diagnosis, treat and also advise on a rehabilitation program to try and stop it reoccurring.

Please note. I can’t give a diagnosis online, If you live or work in the Glasgow area it may be an idea to book an appointment.  Click to book an appointment now.

10 Causes Of Buttock Pain

We’ve probably all had buttock pain at some time, from a numb bum because you’ve been sitting too long, to the  sharp shooting pain of sciatica. Buttock related pain or hip pain as some people describe it because they feel it around the big hip or pelvic bone can range from mild to severe. In some cases, it can significantly affect a person’s quality of life and their ability to perform activities of daily living. Pain in the buttock area can be caused by buttock structures, or it can be referred  from other areas of the body, such as the lower back or thigh muscles.


This is not a diagnosis, it’s really a description of pain in the distribution of the sciatic nerve. The sciatic nerve is the longest nerve in your body. It starts in your low back, then runs from the back of your pelvis, through your buttocks, and all the way down both legs, ultimately parts of it end at your feet. When something compresses or irritates the sciatic nerve, it can cause a pain that radiates out from your lower back into your buttock and can travel down your leg to your calf.   Sciatic pain can range from being mild to very painful.

Sacroiliac Joint:

This is sometimes shortened to  SI joint, S/I joint or occasionally SIJ. This is the joint between the triangular sacral bone at the base of the spine and the iliac or pelvic bone. Pain here can be caused by too much or too little movement. Some  people term these as Sacroiliac joint dysfunction. Certain types of Arthritis can also cause inflammation and pain at this joint. Weight changes and ligamentous laxity during pregnancy can also lead to pain at this joint.


Osteoarthritis is often called arthritis or OA for short. OA is really ‘just’ wear and tear of one of the body’s joints. OA in the low back, S/I joint and possibly in the hip could cause buttock pain. The pain, when spreading from an arthritic joint, is often non specific, by this I mean there may be an ache in the area. This ache can become more centered when the joint is inflamed in which case it’s the inflamation causing the pain rather than the joint. The muscles can also become involved, this is then a muscle pain rather than arthritic or joint pain.


A bursa is a fatty sack. It’s purpose is to reduce friction where muscles pass across other muscles, ligaments or bones. Muscles that are overused or are too tight can rub and inflame a bursa which then causes pain. The two main bursa in the buttock area are the trocanteric bursa and the ischial bursa. One can can give you pain on sitting the other pain when laying on your side.


Sometimes written as coccyx/coccygeal pain. The coccyx is often described as the tailbone . If affected people complain of pain at the very base of the spine, just above their anus. The pain can sometimes be felt in the ligaments that help the coccyx maintain it’s position as these ligaments become strained  The sensation can vary from mild discomfort to extremely painful.

Iliolumbar ligament:

This is a really strong little ligament that holds the lumbar spine to the Ilium (part of the big “hip” bone). The iliolumbar ligament can be felt just around the dimples in the very low back.  This can get strained and stretched leading to inflammation. A common way of stretching this ligament is by sitting with your low back unsupported in a slumped position.  Pain can vary from a mild ache to a strong throb. Some sources say that a sciatic type pain can be caused by this ligament.

Piriformis muscle:

Piriformis is a small muscle that is located deep in the buttock region. The sciatic nerve  runs through this muscle. This muscle can become tense enough for it to squeeze the Sciatic nerve, producing symptoms including pain and numbness, that travel down the leg from the buttock region. When the nerve is trapped this way, it is called Piriformis Syndrome. Additionally, trigger points in the muscle may refer pain to other parts of the buttock and the hip joint region.

Trigger points:

Trigger points have been described as “a highly irritable localized spot of exquisite tenderness in a nodule in a nodule in a palpable taut band of muscle.” Another attribute of trigger points is they when the nodule is pressed or irritated it can trigger pain distant to the nodule. Trigger points in quadratus lumborum a back muscle and soleus a calf muscle can and do refer pain to the buttock.

Buttock Muscles:

The Gluteus maximus, medius and minimus are the three main buttock muscles. Gluteus maximus is biggest muscle in the body and some sources say it’s the strongest. All of these muscles may get tendon problems causing pain in the buttock. There are also a number of trigger points within these muscles that may give pain within the buttock. There are three trigger points commonly encountered in Gluteus max, another three in medius and 7 minimus.

High Hamstring Tendinopathy:

This gives you pain most noticeably when you sit and also a tight painful sensation in the hamstring. It’s also known as proximal hamstring tendonopathy or high hamstring tendonitis and refers to inflammation of the common origin (ischial tuberosity) of the hamstring muscles.This gives you pain in the lower buttock  on the part of the pelvic bone you should be sitting on. The pain in the buttock has been described as very sharp or like tooth ache all the time. More about High Hamstring Tendinopathy

Back Pain and Sciatica

Back Pain and Sciatica

Back pain and sciatica is common, but that doesn’t mean it’s normal for it to occur.

At my Glasgow osteopathy clinic I spend much of my time assessing and treating back pain due to it’s high incidence. There are many structures in the low back which may give pain to other parts of the body. The pain and stiffness can become worse if not identified and treated sooner rather than later.

Government statistics state that “Up to 70% of people will experience back pain in their life” and that “around one in three men and one in four of women in some age groups suffered for the whole year with back pain.”

Osteopathic treatment is often the most effective first line of treatment in correcting mechanical problems caused by back pain and preventing things from becoming persistent.

Back problems are often misunderstood.

Most cases of acute low back pain are classed as ‘simple low back pain’ or ‘non-specific low back pain’. Simple low back pain means that the pain is not due to any underlying disease that can be found. In some cases the cause may be a sprain or strain or maybe even spasm of a ligament or muscle.

In other cases the cause may be a minor problem with a disc between two vertebrae, or a minor problem with a small ‘facet’ joint between two vertebrae. However, the causes of the pain are impossible to prove by tests and so it may be impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.

The longer you put it off, the harder it will be to get going again.

Simple does not mean that the pain is mild – the pain can range from mild to very bad. Typically, the pain is in one area of the lower back, but sometimes it spreads to the buttock or thigh. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze. So, simple back pain is ‘mechanical’ in the sense that it varies with posture or activity.

Problems with your back can cause pain in areas you may not associate with coming from your back. Leg pain and buttock ache, groin pain or tingling in the toes can all come from the base of the spine. This is why a back strain can be mistaken for a hamstring strain.

Conversely, a problem elsewhere in the body may give you back pain. A problem with your hip or ankle, for example, may cause you to walk differently leading to a pain in your back.

Don’t be another back pain statistic.  As an osteopath I’m ideally suited to helping you.

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Frequently asked questions about osteopathy

Back Pain Self Help

Relief for back pain

Self help tips for back pain, muscle spasm/tightness and inflammationRelief from back pain

Some quick tips from me at Glasgow osteopath to help prevent and manage lower back pain. In preventing sports injuries, I wrote about the reasons for injuries. Over Christmas, these reasons are just as valid. Hopefully, if you follow this advice, you should stay pain-free. If for any reason you do have back pain I’ve also included some self-help tips.

If unfortunately, you do get problems; you may notice your back pain feels inflamed or bruised. Your muscles may feel stiff, or they could spasm. If this post doesn’t help I will be open between Christmas and New Year

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Sitting slumped on the sofa watching TV. With the advent of bingeing on box sets and the extended time we have over Christmas watching them I expect to see an increase in back pain patients in the new year. This increased sitting can make the muscles and ligaments at the base of the spine feel as if they’ve been stretched leading to the sensation of stiffness and pain.

There are a few ways to stop this happening in the short term.

  • Make sure you support your low back. Use a cushion to stop the unsupported curling and stretching at the bottom of your spine.
  • Shorten the time spent sitting. Sitting isn’t bad, but sitting in the same position for too long maybe. The answer for this is to take breaks from sitting. Get up and do something else. Make a cup of tea (it doesn’t have to be a long break).

I discuss longer-term prevention strategies to low back pain during treatment sessions and exercises that may help

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An example of misuse that appeared in a newspaper a few years ago was lifting the turkey out of the oven while bent over. (A quick note here. In 20 years of osteopathic practice, I hadn’t seen anyone who’d hurt themselves lifting a Turkey until Christmas 2016.)
Back pain from lifting is often more likely if you’re not used to lifting, or if you never lift with a bent back. The tip here is “Lift properly”. Bend your knees rather than your back and keep the weight as *close to your body as possible. It may also be a good idea to say, when lifting the turkey, don’t keep the oven tray too close. I find burns last a lot longer than back pain.

This type of pain often feels sharper, but it is vary rare that any damage occurs. Even though you may not feel like it, movement is often the best way to start getting pain back under control.

New use, Overuse and Abuse

I’m placing these three together and aiming this at people with games consoles. With the advent of Wii and Xbox Kinect, and now the Nintendo Switch people may find that they are doing movements they’re not used to (New use). Or a competitive nature might keep you playing on to beat your top score or get even with your partner (overuse and abuse). While the technology and the games may have advanced, the same conditions exist .

Advice here;

Take frequent breaks, and vary the task
Vary the type of game you’re playing (different actions)
Don’t play “winner stays on”.

I really do hope you have a great break and that you won’t need any help or advise from me, but if you do or you’re not sure that osteopathy can help, then try one of my free 15 minute assessments.

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Disclaimer: All the information contained within this post should never take the place of a qualified Medical Practioner. In the Scotland  NHS24 will be available over the Christmas period. I can also be contacted through E-mail or Twitter.