Understanding Chronic Hamstring Tendinopathy
with Scott Tomkinson, Kernow Physio, Cornwall
In this week’s video, Scott Tomkinson of Kernow Physio discusses chronic hamstring tendinopathy, focusing on the long head of the hamstring — what causes it, how to manage it, and why the right diagnosis and rehabilitation plan make all the difference.
Getting the Right Diagnosis
Scott begins by stressing an important point: only qualified health professionals such as physiotherapists are trained and licensed to diagnose injuries like hamstring tendinopathy.
Unfortunately, more patients are arriving at his clinic after receiving “diagnoses” from unqualified practitioners such as massage therapists or acupuncturists – which can delay proper treatment and increase risk.
“Make sure whoever you’re seeing is professionally trained and allowed to give you a diagnosis,” Scott says.
Accurate diagnosis is essential for safe, effective recovery — and often doesn’t require MRI imaging when performed by an experienced physiotherapist.”
The Role of Environment and Load
Hamstring tendinopathy is rarely caused by one single event. Scott explains that it’s usually the result of environmental and load-related factors – things like prolonged sitting, poor posture, instability, or a sudden increase in training intensity.
He recalls a recent case where a postal worker developed a chronic hamstring issue after spending long hours seated on a hard chair. The constant pressure on the tendon’s insertion point aggravated the problem before any exercise even began.
The first step in this patient’s recovery was changing the environment: standing more often and using a gym ball instead of a hard chair to reduce compression and improve circulation to the area.
Smarter Rehab, Not Harder Training
Scott emphasises that rehabilitation must be specific and progressive – not rushed or overly intense.
Jumping straight into heavy exercises like Romanian deadlifts, for example, is a common mistake. Those movements belong at the end of rehab, not the start.
The key is to begin with controlled exercises in hip neutral or hip extension positions (not hip flexion), as these are safer and more effective for early tendon healing. Gradual progression in load and movement quality is essential for lasting recovery.
Why Shockwave Alone Isn’t the Answer
Many patients ask about shockwave therapy, hoping for a quick fix. While Scott agrees it can be a useful tool, he’s clear that it’s not a standalone solution.
“Shockwave doesn’t fix anything by itself,” he explains. “You have to put in the work and follow a proper rehab plan. Only then can shockwave support the healing process.”
It’s a reminder that recovery from chronic tendinopathy requires commitment, consistency, and guidance from a qualified professional.
Struggling with a Long-Term Hamstring Issue?
If you’re dealing with hamstring pain or a long-term tendinopathy, don’t push through it – get it assessed properly.
Contact Scott Tomkinson at Kernow Physio to arrange an appointment or to discuss your symptoms.
Scott provides evidence-based rehabilitation across Cornwall, helping patients recover safely, rebuild strength, and get back to doing what they love.