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Check out Lasse's website here: https://www.lasselempainen.fi/?lang=en
In this episode, Brodie sits down with world-leading orthopedic surgeon Dr. Lasse Lempainen, a specialist in complex hamstring injuries, to answer one of the most confusing and anxiety-provoking questions runners face:
“How do I know if I actually need surgery — or if rehab is still the right path?”
Drawing on decades of surgical experience and extensive research into hamstring avulsions and proximal hamstring tendinopathy (PHT), Dr. Lempainen walks through how he actually makes decisions in real clinical practice — not just what MRI scans show, but how symptoms, function, timelines, and rehab quality all fit together.
Together, Brodie and Lasse unpack the gray area that most runners live in: partial tears, chronic pain, mixed scan results, failed rehab attempts, and fear-based decision-making. The result is a balanced, evidence-informed discussion that helps runners understand where surgery fits — and where it doesn’t.
What You’ll Learn in This Episode:
How Surgeons Decide Who Actually Needs Surgery
Hamstring Avulsion vs Proximal Hamstring Tendinopathy (PHT)
Critical Timing Windows
“Failed Rehab” — What That Really Means
What Surgery for PHT Actually Involves
Common Pre- and Post-Op Mistakes
Key Takeaway
Most hamstring injuries — including many cases of PHT — can and should be treated conservatively.This episode helps you understand which group you fall into, without fear-based decisions or false hope.
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In this episode, Brodie breaks down a newly published review paper that takes a deep dive into what’s actually happening inside painful tendons — far beyond the usual “overuse” explanation. You’ll learn how healthy tendons are structured, what changes at a microscopic level when tendinopathy develops, and why pain severity often doesn’t match what shows up on scans. The episode explores how factors like load management, low-grade inflammation, oxidative stress, ageing tendon cells, and overall metabolic health all interact to influence tendon pain and recovery.
Brodie also discusses what this emerging science means for real-world rehab — including why rest alone doesn’t work, why exercises sometimes stall progress, and why a more holistic approach is often needed. The episode finishes by looking ahead at future treatment directions, from improved diagnostics to regenerative and molecular therapies, while grounding everything in practical takeaways runners can apply right now. If you’re dealing with persistent tendon pain — especially proximal hamstring or Achilles tendinopathy — this episode will help you understand why recovery can be slow and what actually gives you the best chance of long-term success.
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In this episode, we break down a brand-new randomized controlled trial comparing individualized physiotherapy with shockwave therapy for proximal hamstring tendinopathy. I walk through how the study was designed, what each treatment involved, and why the results showed no meaningful difference between the two approaches. We also explore the role of education, load management, and compressive tolerance, and what this means for your rehab decisions moving forward. If you’ve ever wondered whether shockwave is worth trying or how it stacks up against a structured strength program, this episode gives you a clear, evidence-based answer.
Paper 1: Physiotherapy Compared With Shockwave Therapy for the Treatment of Proximal Hamstring Tendinopathy: A Randomized Controlled Trial
Paper 2: Treatment of Proximal Hamstring Tendinopathy with Individualized Physiotherapy: A Clinical Commentary
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
Research Deep-Dive: Hamstring Strength & Running Biomechanics
This episode reviews the study: “Hamstring Strength and Architectural Properties Are Associated with Running Biomechanics”, including findings from ultrasound imaging, EMG analysis, and 3D running mechanics.
Key Study Questions
🔎 Main Findings From the Study
1. Stronger Hamstrings = Better Running Mechanics
Athletes with higher eccentric hamstring strength had:
2. Longer Hamstring Fascicles = Safer, More Efficient Loading
Runners with longer fascicle lengths showed:
3. A Two-Way Relationship Exists
Strength ↔ mechanics influence each other.
4. Over-Reliance on the Biceps Femoris = Red Flag
Runners with weak or short hamstrings tended to over-activate the biceps femoris long head — the most common site of PHT.
Stronger runners shared load better with the medial hamstrings, reducing tendon stress.
🏃 Practical Rehab Takeaways
1. Build Eccentric Strength
Eccentric strength is one of the strongest predictors of hamstring injury risk.
Examples Brodie recommends:
2. Improve Fascicle Length
Eccentric exercises at long muscle lengths help lengthen fascicles naturally — more so than stretching alone.
3. Strengthen the Medial Hamstrings
To prevent overload of the biceps femoris:
4. Slightly Increase Cadence (~5%)
A small increase in stride frequency may reduce late-swing strain and improve running economy.
5. Integrate Running Into Rehab
Before adding speed:
Final Thoughts
Hamstring strength, muscle architecture, and running technique are deeply interconnected. Improving one helps improve the others — creating a pathway toward better performance and long-term PHT resilience.
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Sign up for the FREE PHT 5-Day Course HERE
🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉
🗓️ Book a free 20-minute Injury Chat with Brodie 📞
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
Paper Title 1: Porcine Collagen Injection Therapy Affects Proximal Hamstring Tendinopathy in Athletes by Reducing Time to Return to Sport
Paper Title 2: Estrogen and progesterone exhibit distinct yet coordinated roles in the regulation of tendon extracellular matrix remodeling
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🗓️ Book a free 20-minute Injury Chat with Brodie 📞
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
In this episode, Brodie reviews brand new research exploring patients’ real-life experiences receiving physio-led rehab vs shockwave therapy for proximal hamstring tendinopathy (PHT). This qualitative study highlights what people found most helpful, frustrating, and effective during rehab—revealing valuable lessons for anyone currently recovering from PHT. Brodie also provides a personal update on his own hamstring rehab and HYROX training progress.
Check out the paper here: Education, rapport and convenience are key to participants’ perceptions of receiving physiotherapy or shockwave for proximal hamstring tendinopathy: a qualitative study
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Sign up for the FREE PHT 5-Day Course HERE
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉
Learn more about Brodie's PHT AI Assistant 📄🔍
Sign up for the FREE PHT 5-Day Course HERE
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉
Learn more about Brodie's PHT AI Assistant 📄🔍
Sign up for the FREE PHT 5-Day Course HERE
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
🎉🎉Sign up for the FREE PHT ROADMAP 🎉🎉
Learn more about Brodie's PHT AI Assistant 📄🔍
Sign up for the FREE PHT 5-Day Course HERE
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
In this episode of the Overcoming PHT Podcast, I dive into a valuable supplemental resource created by researchers at La Trobe University as part of their clinical trials on proximal hamstring tendinopathy (PHT). This patient education file breaks down everything from diagnosis to discharge advice—and I highlight the key takeaways that can help you better understand and manage your recovery.
What You’ll Learn in This Episode:
Why This Matters
Whether you’re new to PHT or have been struggling for years, this episode gives you a clear, research-backed framework for understanding your pain and making smarter rehab choices. It’s not just my perspective—it’s guidance from some of the leading tendon researchers in the world.
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Sign up for the FREE PHT 5-Day Course HERE
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
In this episode, Brodie reviews a brand-new 2025 clinical commentary on the treatment of proximal hamstring tendinopathy (PHT) with an individualised physiotherapy approach. The paper, authored by experts including Jill Cook and Aidan Rich, outlines a comprehensive, stage-based rehab protocol grounded in tendinopathy principles and adapted for the unique demands of the hamstring complex.
What you’ll learn in this episode:
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
🧠 Episode Summary
In this episode, Brodie dives into a newly published paper titled “Female Tendons are from Venus and Male Tendons are from Mars: But Does it Matter for Tendon Health?” by Gerard McMahon and Jill Cook. The paper explores how male and female tendons differ in structure, adaptation, healing, and injury risk—and what it means for those dealing with tendinopathy.
🔍 What You’ll Learn
📌 Key Takeaways
💡 For Runners With Tendinopathy
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
In this episode, Brodie explores the latest research on vitamin D and its role in tendon health, diving into a 2024 comprehensive review that examines both cell-based and animal studies. You’ll learn how vitamin D influences tendon healing, inflammation, and collagen production—and how low levels could delay your recovery. Plus, Brodie shares practical advice on vitamin D testing, optimal levels, sun exposure, supplementation, and the potential role of vitamin K2.
🧠 What You'll Learn:
🧪 Research Highlight:
Study: Exploring the Impact of Vitamin D on Tendon Health: A Comprehensive Review (2024)
🛠️ Practical Takeaways:
🎯 Ideal For:
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Sign up for the FREE PHT 5-Day Course HERE
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
Guest: Dr. Ian Seels | Specialist Musculoskeletal Physiotherapist
🧠 Episode Summary
In this thought-provoking episode, Brodie chats with Dr. Ian Seels, a private musculoskeletal physiotherapist with over 35 years of experience and a co-author of the paper The Relevance of Diet in Musculoskeletal Clinical Practice – A Narrative Review. Together, they explore the emerging science behind how diet influences inflammation, pain, and injury recovery—with a particular focus on what this means for recreational runners.
If you're battling persistent niggles, chronic tendon pain, or just want to run pain-free into your later years, this episode offers a fresh perspective you might not have considered: what you eat could be the missing link in your recovery journey.
🔍 What You’ll Learn
🧪 Practical Takeaways for Runners
🛠️ Resources Mentioned
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❓ Questions Answered in This Episode:
💡 Key Takeaways:
🧠 Brodie’s Insight:
“Consistency and experimentation are key. You're not just following a plan—you're learning how your tendon responds. The more data points you collect, the smarter your rehab becomes.”
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
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In Part 3 of this special series, Brodie tackles more insightful questions from listeners navigating their PHT recovery journey. With practical advice and personal stories, this episode is packed with actionable takeaways for anyone dealing with chronic hamstring pain.
🧠 Topics Covered:
🧰 Key Takeaways:
📚 Brodie Mentions:
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
Learn more about Brodie's PHT AI Assistant 📄🔍
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In this milestone Q&A episode, Brodie tackles your most pressing questions about proximal hamstring tendinopathy (PHT) — covering flare-ups, long-term pain, sleeping issues, training setbacks, and even how tight hip flexors fit into the picture.
Whether you're just starting your rehab journey or stuck in a plateau, these answers will help you adjust your plan and regain control.
🎧 What You'll Learn:
✅ Cycling & PHT — When cycling to work becomes part of the problem
✅ Long-Term Recovery Doubts — “Will I ever be pain free again?”
✅ Tight Hip Flexors — Do they relate to PHT or are they just noise?
✅ Flare-Up Triggers — Why some weeks you feel great… and others fall apart
✅ Running Strategy — When to stop, reduce, or push through
✅ Speed Work — The right time to reintroduce faster running
✅ Sleep Disruption — Why some flare-ups hit hardest at night
✅ Nervous System Involvement — How chronic PHT becomes more than just tendon pain
✅ Hot or Burning Sensations — What it means when your tendon feels “hot”
✅ Post-Rehab Maintenance — What to do after symptoms go away
🧠 Key Takeaways:
🛠️ Helpful Resources Mentioned:
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.
Learn more about Brodie's PHT AI Assistant 📄🔍
🎉🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉🎉
In this listener-driven episode, Brodie answers 10 of your most pressing questions about proximal hamstring tendinopathy (PHT). From isometric training to pain rules, sitting tolerance, and tendon healing potential—this Q&A is packed with practical insights to help you take control of your recovery.
🧠 What You’ll Learn in This Episode:
🛠️ Helpful Resources Mentioned:
🔁 Stay Tuned:
This is just part 1 of a multi-episode Q&A series—more listener questions and in-depth answers coming soon. If you’d like to submit a question for a future episode, sign up for the free email course and keep an eye on your inbox!
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In this episode, Brodie sits down with Moira, a dedicated endurance athlete and physical therapist, to discuss her long and challenging battle with chronic injury. What started as a suspected stress fracture turned into a frustrating cycle of pain, conflicting diagnoses, and psychological hurdles. Moira shares her journey of setbacks, self-reflection, and ultimately, breakthrough moments that led her back to running. Her story highlights the importance of understanding pain science, overcoming fear of movement, and following a structured, gradual return-to-running plan.
What You’ll Learn in This Episode:
Key Takeaways:
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
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Learn more about Brodie's PHT AI Assistant 📄🔍
Optimal Nutrition for Tendon Recovery with Jordi Sullivan
📍 Episode Summary:
In this episode, Brodie is joined by sports dietitian Jordi Sullivan, founder of The Fight Dietitian, to unpack one of the most overlooked aspects of injury rehab: nutrition. While the conversation begins with general performance nutrition, the focus soon shifts to actionable strategies for tendon recovery, particularly for those overcoming proximal hamstring tendinopathy (PHT).
Jordi shares his evidence-based, no-nonsense advice on calories, macronutrients, micronutrients, and supplements, while offering simple frameworks to help injured athletes support healing and stay on track with their rehab goals.
🧠 What You’ll Learn:
👤 Guest Bio:
Jordi Sullivan is a qualified dietitian with a Master's in Dietetics and a background in exercise and nutrition science. He works with a wide range of athletes including combat sport professionals, endurance runners, and team sport athletes. Through The Fight Dietitian, Jordi and his team specialize in helping athletes optimize performance, recovery, and injury resilience using practical, science-backed nutrition.
📌 Resources & Links:
💬 Key Quotes:
"If you’re under-fuelling long-term, your body starts shutting down systems it can’t afford to run. That includes your bones, immune system, and even your mood." – Jordi Sullivan"Supplements should supplement your diet—not replace a poor one. Start with food first." – Jordi Sullivan🎧 Tune In If:
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For ALL Other Resources, Visit the Website proximalhamstringtendinopathy.info
Run Smarter AI Assistant: Access personalized, research-based answers to your running and rehab questions. This tool integrates Brodie’s database of research papers and podcast episodes for tailored advice.