NOTE: There is some overlap with the Ischiatic Intersection Syndrome (IIS) described in the previous section.
Clinical features of the proximal hamstring syndrome:
(1) The patient often has a history of participation in competitive sports.
(2) The patient has ill-defined pain in the lower gluteal region with radiation of the pain down the posterior thigh into the popliteal fossa.
(3) Sitting, stretching, running or other actions that stretch the sciatic nerve may trigger pain.
(4) The patient may have a loss of strength in the hamstring muscles.
(5) Tenderness may be localized to the region of the ischial tuberosity (hence the overlap with the Ischiatic Intersection Syndrome).
(6) There is no neurological deficit.
A useful test is to evaluate the patient is to demonstrate both of the following:
(1) weakness of the hamstring muscles with the patient prone and the knee flexed to 30 degrees
(2) normal strength in the hamstring muscles with the patient prone and the knee flexed to 90 degrees
The usual cause is scarring about the proximal hamstring tendon and the sciatic nerve.
Most patients experience relief following surgery that releases any adhesions in the proximal hamstring muscles and/or about the sciatic nerve.
