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Knee Pain

How to Treat Hamstring Tendonitis

Minute Read


Posted 9 months ago


Last updated: 29/11/2022


by James McCormack

Hamstring Tendon Recovery Time

The healing time for a hamstring tendonitis will depend on the specific injury, the intensity of pain and duration of symptoms, as well as the treatment that is used to manage and heal the injury. For most tendonitis injuries, if addressed soon after onset of symptoms, improvement will occur in the first 6 weeks. However, a recovery time of 3-6 months for severe or chronic cases is common.

Physical Therapy

Physical therapy offers a broad range of treatments that are directed by a physical therapist who is a highly skilled medical practitioner, with experience in musculoskeletal and sports injuries. Education on the condition, massage, acupuncture and dry needling, exercise prescription and rehab protocols are a few of the treatment options available from physical therapy. You can read more about exercises for hamstring tendonitis in our related article, including common rehab exercises, such as the bridge and straight leg deadlift shown below. 


Photo of man doing a double leg bridge

Photo of man doing straight leg deadlift exercise

Heat or Ice

Ice can be an effective way to reduce pain for an acute tendonitis. However, the evidence for the effect of ice on inflammation and tissue healing is inconclusive.

Heat is an effective way for relaxing the muscle, by reducing the tone within the muscle. Therefore, application of heat to the main muscle and ice to the painful area can be an effective way to make the injury feel better, even if it does not have any physiological benefit to the healing process or improve recovery time.


Massage has been used for thousands of years as a treatment and for relaxation. It is commonly use for improving or claiming to speed up recovery with soft tissue injuries. The evidence is mixed on this, but there is good evidence to show that deep tissue massage can reduce the tone in muscle. A muscle with reduced tone will be more relaxed and apply less pull or tension to a tendon. If the tendon is in a tendinopathic state, this will be helpful as it will reduce the load on the tendon, in essence allowing it to have more rest and potentially enabling more efficient recovery. 

The use of massage guns, such as Theragun, has significantly increased in the past few years. With claims that the percussive application of force to the skin and underlying muscle has a similar effect and conventional massage. That is of relaxing the muscle and reducing pain. 

Friction Massage

Friction massage, also called deep transverse frictions, is a specific massage widely used on injured tendons. It involved applying pressure and rubbing the tendon across the fibres until pain reduces. Usually, it is done for 1-2 minutes, and as the pain reduces the pressure is increased, and the frictions are repeated for a further 1-2 minutes. Theories are that it provides stimulation for the tendon to repair, and has pain reducing effects. Diffuse noxious inhibitory control is the term used for a treatment that causes a different pain that reduces the original pain symptoms. This is causes by complex neurological processes, but in essence it distracts the nervous system.


Shockwave, or extracorporeal shockwave therapy (ESWT), is a relatively new treatment used for tendon recovery. ESWT uses sound energy waves to reduce the sensitivity of nerves and cause mirco-damage to the affected area. Micro-damage causes a bodily response of increased blood flow and metabolism, which can speed up healing. There is an increasing body of evidence to suggest the efficacy of ESWT for musculoskeletal injury recovery and pain reduction, at any phase of rehabilitation (Korakakis et al, 2018).

Acupuncture and Dry Needling

There is mixed evidence for dry needling and acupuncture treatments as to whether they improve tissue healing. There is some evidence that acupuncture can improve tendon blood flow and fibroblastic activity (Neal & Longbottom, 2012), and that it produces short term pain relief for musculoskeletal disorders (Wrigth & Sluka, 2001). As a treatment modality that is very safe with minimal side effects, it has been regularly recommended as an adjunctive treatment for tendonitis recovery.


Transcutaneous electrical nerve stimulation, also known as TENS, is a method of pain that uses a very low electrical current applied to the skin via adhesive patches. It works by producing a different stimulation to the nerves that can distract from the pain symptoms. It also stimulates the production of endorphins, which are naturally occurring pain reducing hormones. It is usually used as 2 or 4 patches. TENS placement, should be around the area of symptoms, so that the adhesive patches are either side of the painful area. 

Injections and Surgery

If conservative treatments such as physical therapy, including exercise rehab, massage, and shockwave, are not effective to resolve the tendonitis, and if pain is not managed well with these treatments, or with ice, acupuncture and TENS, then you might be offered medication in the form of non-steroidal anti-inflammatories or a locally administered cortisone injection. A hamstring tendon injection of cortisone is to reduce inflammation and pain. After the initial period of rest, and possible flair of pain in the first week or so after the injection, it is usually effective to reduce pain and allow you to progress with exercises and rehabilitation to strengthen and condition the tendon.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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