Heavy Slow Resistance Training for Proximal Hamstring Tendinopathy: A Case Report

A bstract Evidence suggests that not all tendinopathy patients respond solely to eccentric exercises. Systematic reviews on patellar and Achilles tendinopathies indicate positive outcomes with heavy slow resistance training (HSRT). This case report describes a 38-year-old active male with chronic left proximal hamstring tendinopathy (PHT), experiencing pain during squats, and prolonged sitting, running, and lifting objects. Familiar with loaded exercises, he followed an autoregulation progression method of training, using the rate of perceived exertion and repetitions-in-reserve to guide training. Within 3 weeks, his pain reduced from 8/10 to 0.5/10. Over 12 weeks, his performance surpassed pre-injury levels, achieving 100 kg back squats, 160 kg conventional deadlifts, 90 kg Romanian deadlifts, and 100 kg loaded barbell hip thrusts, and progressing from 60 kg back squats. At a 1-year follow-up, no recurrence was reported. Currently, no research exists on HSRT for PHT in India. Systematic reviews suggest that load intensity, rather than contraction type, maybe the key stimulus for muscle–tendon recruitment.