Education, rapport and convenience are key to participants’ perceptions of receiving physiotherapy or shockwave for proximal hamstring tendinopathy: a qualitative study

Background: Proximal hamstring tendinopathy (PHT) is a challenging musculoskeletal condition commonly affecting active populations, presenting as localised lower buttock pain. While various treatments have been investigated, including physiotherapy and extracorporeal shockwave therapy (ESWT), there is limited understanding of patient experiences with these interventions. Aim: This study aimed to explore patient perspectives and experiences of receiving physiotherapy and ESWT treatments for PHT to provide insights into their perceived effectiveness and acceptability. Methods: A qualitative design with semi-structured interviews and an interpretive description approach was applied. Participants were recruited from a randomised trial comparing individualised physiotherapy versus ESWT for PHT. Twenty-two participants (16 women, mean age 46 years), were interviewed after completing their allocated interventions. Data were analysed using thematic analysis to identify patterns and themes. Results: Participants reported improvements in symptoms and function with both interventions, attributed to education and strong rapport with physiotherapists. Differences between treatment groups emerged in their perceptions of ease of adherence and additional benefits. The physiotherapy intervention group participants reported that exercises were challenging to adhere to but perceived unique functional and strength improvements. Shockwave therapy group participants felt it was easier to comply with, offering pain relief and functional gains but lacked the physical conditioning benefits of physiotherapy. Conclusion: Both physiotherapy and ESWT were perceived as beneficial for PHT management, with important differences related to ease of treatment adherence and other benefits. These findings emphasise the importance of individualised care and consultation with the patient when choosing treatment for PHT.<p></p>