Tendinopathy occurs when there has been excessive loading of a tendon; generally for a prolonged period of time in runners.

With Biceps Femoris Tendinopathy at the distal (knee end) of the muscle-  this injury generally develops due to an excessive increase in long run distance. This is particularly common in people who have also increased their hill climbing activity.  Biceps Femoris Tendinopathy may take more load in people who externally rotate their feet as they land as they may take more load through the outside part of the leg in the running pattern.

Management of this injury requires initial reduction in loading of the tendon which means reduced amount of running however, I stress that people need to continue to do some kind of activity to ensure there’s not a subsequent weakness of the hamstring.

There needs to be a structured and progressive strengthening program of the tendon in different ranges of movement of the knee and hip as it is a muscle that crosses both joints. There also needs to be an assessment of the biomechanical factors, that allowed this tendon to become overloaded.

The long-term results for this injury are very good as most people who rest appropriately and then build up their loading afterwards do very well and are able to return to normal running, usually within a few months.