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In this episode of the Overcoming Proximal Hamstring Tendinopathy Podcast, Brodie dives into the most commented-on and most challenging questions from the PHT Facebook community over the past 90 days.

Rather than quick comment replies, this episode delivers long-form, evidence-based explanations to help you better understand your symptoms, your scans, and your rehab options—especially when things feel confusing or discouraging.

If you’ve ever been told “it’s severe,” “you’re too old,” or “it’ll never be the same,” this episode is for you.

🔍 What You’ll Learn in This Episode

1. Severe PHT, Tendon Tears & Bursitis — Is Recovery Still Possible?

• Why tendon tears on MRI are often part of the tendinopathy spectrum, not a reason to avoid loading
• How to interpret bursitis findings and when they’re clinically relevant vs incidental
• When ultrasound-guided corticosteroid injections may (or may not) help
• Why age and genetics slow recovery—but don’t prevent it
• Realistic timelines: why “2–3 years and never the same” is poor advice

Key takeaway: Even severe, chronic PHT can improve with the right loading strategy and recovery environment.

2. Load Management: The Missing Piece in Long-Term Recovery

• Why slow, progressive strength training is still the gold standard—even in older athletes
• How to find the “sweet spot” between challenge and flare-ups
• Why setbacks usually come from mismanagement, not irreversible damage
• The role of sleep, protein (especially leucine), collagen, hydration, and overall wellness in tendon healing

3. “Can I Start Walking Again—or Am I Making It Worse?”

• Why waiting for zero pain before returning to activity often delays recovery
• How to reintroduce meaningful activities (like dog walking) safely and progressively
• Why doing something—even 2–5 minutes—can be both physically and mentally therapeutic
• How graded exposure applies to walking, running, and all functional goals

4. Heel Pain & PHT — Are They Related?

• Why plantar fasciitis commonly appears alongside PHT
• How reduced sitting → increased standing can overload the plantar fascia
• Practical strategies for managing both conditions:
  • Footwear and gel insoles
  • Sitting vs standing vs kneeling rotations
  • Step counts, surfaces, and daily load awareness

5. Prone Hamstring Curls Flaring You Up? Here’s How to Modify Them

• How to confirm whether an exercise is actually the irritant
• Why double-leg > single-leg is often the right starting point
• Using reduced range of motion strategically
• How to progress:
  • Double-leg → single-leg
  • Load first vs range first
• Why small, systematic steps matter—especially for sensitive tendons

6. Sciatic-Type Pain With PHT — What’s Really Going On?

• How to tell when symptoms are no longer “pure PHT”
• Red flags for nerve involvement (pain past mid-hamstring or below the knee)
• Possible contributors:
  • Nerve sensitivity in chronic pain
  • Scar tissue or adhesions near the sciatic nerve
  • Compensation patterns (sitting, standing, movement changes)
• Why assessment matters—and what clinicians look for:
  • Piriformis testing
  • Neurodynamic tests
  • Nerve glide exercises and when to use them

🎯 Big Picture Takeaways

• Imaging findings don’t dictate outcomes—management does
• Severe or long-standing PHT does not mean you’re “too far gone”
• Recovery improves when load, recovery, and lifestyle align
• If symptoms spread or change character, don’t guess—get assessed
• Progress comes from doing the right things consistently, not perfectly

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MEDICAL & EDUCATIONAL DISCLAIMER

The information provided in the Overcoming Proximal Hamstring Tendinopathy (PHT) Podcast, YouTube channel, associated websites, social media, and other educational content produced by Brodie Sharpe is provided for general educational and informational purposes only. It is not intended to constitute, and should not be relied upon as, individual medical, physiotherapy, diagnostic or treatment advice.

Although Brodie Sharpe is a qualified physiotherapist, consuming this content does not establish a physiotherapist-patient or other healthcare professional-patient relationship. Any discussion of symptoms, diagnoses, rehabilitation strategies, exercises, loading programs, running modification, medications, supplements, injections, medical procedures or other treatment options is general in nature and may not be appropriate for your individual circumstances.

Musculoskeletal pain can have multiple causes, and symptoms that appear consistent with proximal hamstring tendinopathy or another tendon disorder may arise from other conditions. Appropriate assessment, diagnosis and treatment depend upon an individual's medical history, symptoms, examination findings, medications, health conditions, training history and other factors that cannot be adequately assessed through general online content.

Do not use this content as a substitute for assessment, diagnosis or treatment from an appropriately qualified healthcare professional. 

Before starting, stopping or substantially modifying an exercise or rehabilitation program, medication, supplement, injection, procedure or other treatment discussed in this content, seek advice from an appropriately qualified healthcare professional who can consider your individual circumstances.

Exercise, rehabilitation and medical treatments carry inherent risks. These may include increased pain, symptom flare-ups, aggravation of an existing condition, new injury, adverse reactions or other complications. Individual responses vary and no particular outcome, improvement, recovery timeframe or return to sport can be guaranteed. If an activity or intervention causes significant, unusual or worsening symptoms, stop and seek appropriate professional advice.

References to research, clinical studies, treatment approaches, products or opinions of guests are provided for educational purposes. Scientific evidence evolves over time, may be incomplete or conflicting, and findings from research populations may not apply to every individual. Discussion of a treatment or product does not necessarily constitute an endorsement or recommendation for its use. Views expressed by podcast guests or other contributors are their own and do not necessarily represent the views of Brodie Sharpe.

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