Hamstring slow healing

I injured my hamstring around 2 months ago, at the time I didn’t think much of it since i’d feel some tightness during the warmup but this would usually go and i’d be able to sprint 100% no problem with no pain. A month later my season was over so i’ve been resting it fully and also been receiving some massage work on it from my physio, who said i’d just tweaked it. Some very light stretching and heat have been applied also. I’m a little worried as after 4 and a half weeks of rest my hamstring feels the same as it did before i took time off :frowning: The pain only comes about when my knee is at a certain angle, for example if I were to lunge. I can feel it deep inside the thickest part of the hamstrings, not near the tendon insertions. As the symptoms match with a grade 1, shouldn’t I be healed by now?

How much massage work are you getting and is this person any good?

Once a week, he’s a chiro but also specialises in sport injuries. Some of it has been deep massage, not sure what its called but it was pretty uncomfortable lol.

Well, I don’t want to speak on issues I’m not sure of, but I think you’re going to need more massage then that. When my leg injury was giving me a problem I gave myself a massage for at least 30 min everyday for about 2 weeks.

Look up the info in the self-massage topic on this forum: http://www.charliefrancis.com/community/showthread.php?t=22624&highlight=massage+works

I had some tendonitis behind my knee and with a homemade foam roller and a baseball I was able to work out a spot in my upper left hamstring using no strict technique. The tendon pain is gone now.

Thanks for the info. I have a tennis ball that I could use for self massage, so 30 mins of rolling it under my hamstring each day would be beneficial? I’m just slightly worried that too much massage could be worse than better and could cause more damage, then again I dont know much on the subject of massage!

Just move your leg around with the ball under your hammie. If you feel a spot that’s tender/tight focus on that for a little bit, it’s likely scar tissue. See if you can find a position to just sit for a minute or so with pressure on that spot before rolling the ball around some more. 30mins would probably be plenty to do both hammies, glutes, back, whatever else you can come up with.

Ok, I shall give this a shot for a couple of weeks and i’ll update afterwards

Have someone else look at this
4 weeks is too long
something is not right
can not comment online as how could I know
one thing I know for sure
that is too long to have an injury
unless there is something else going on
have you had pictures taken?
ultra sound?

find a really good tissue therapy person in your area. ART or myofascial release person would be best, but good massage therapist would suffice. I agree with Ange, difficult to diagnose on line. Something is wrong if it isn’t quite a bit better by now. Just have them try to loosen it up and see how it feels. May take 2-3 times per week to breakdown the scarring.

Exactly my thoughts, I have made an appointment with my doc to see if I can get it scanned, the physio i’m receiving at the moment isnt on the nhs and I can’t afford to keep paying for it while its making little difference. Make that 5 weeks tomorrow by the way :frowning:

Again the problem is the cost of it, I can’t really afford to pay for it right now. Hopefully my doctor will send me for a scan so I can find out what exactly is going on.

A quick update…my hamstring isnt really a whole lot better. Interestingly though i have been doing some light stretches which do dramatically decrease the pain…temporarily :confused: I’ve been to see the doctor who says I have a leg length discrepancy of about 2cm, and has reffered me to a podiatrist. I’ve also noticed that my right hip, the oppsite side of the hamstring injury has started aching, a problem I had on and off throughout last season, I also told my doctor about this but he seems convinced its all due to this leg length problem. Im pretty sure the hip pain is from some sort of tendinitis, stretching my hip flexors out relieves the pain…

Is the referral with a view to fitting you with an orthotic?

I think so yes, he did mention it. I already wear insoles in my shoes due to collapsed arches, I used to have terrible trouble with shin splints. I dont understand why a leg length problem would manifest itself now though, ive been sprint training for almost 3 years and this is my first hamstring problem ever.

This is freakin’ ridiculous. No one should suffer through 5 weeks from a hamstring strain with no improvement. One of my favorite stories from Charlie is hearing how he was brought in by an NFL team to fix an athlete (very high profile receiver) who was suffering from a hamstring injury for almost a year. Charlie got in there and the receiver was good to go (i.e. playing and scoring touchdowns) after five days.

I wrote a few articles on a case study of the hamstring rehab process. One of my athletes, doing bobsleigh at the time, tore up his hammy pretty bad in pre-season testing. We had to get him back for the season which began four weeks later. This meant he had to be good to push at 100% on ice. There was no room for half-assed recovery. He had to be ready to push at 100% for numerous reps.

This particular progression took 3 weeks because we wanted to make sure we didn’t miss a step and he was absolutely ready to go once the season started. And we had four weeks - so why not take our time and make it For more minor strains, I’ve had great results (full recoveries) in 5-10 days. However, don’t artificially create a deadline. It may take as long as it needs to take.

The key point is that the muscle must be ready to do the work placed in front of the athlete. This means very progressive massage, a good understanding of running mechanics and good communication with the athlete on their status after each rep and set. You are not making them do something they are not ready to do. You are building on their successes and accumulating volume of work at a given intensity and distance.

If there is one thing you can learn from Charlie’s approach, it is you need to learn from what the athlete can has done in the previous rep/run and proceed from there. You constantly need to assess the status of the athlete from rep to rep. How did they look? Can they do more? Do not ask for more if they can’t maintain their technique. Do not change the intensity of the work too dramatically. If they look good running at 75% of top velocity, let them run a number of reps and sets at that velocity to accumulate competency at that velocity. Don’t get cute.

Needless to say, a whole book could be written on the subject of hamstring rehab. Hopefully these articles give a sense of progression and care.

When examining the video clips, notice the difference in foot placement and heel recovery as we progress through the rehab process (left side).

http://www.runningmechanics.com/hamstring-rehabilitation-and-running-mechanics-part-1/

http://www.runningmechanics.com/hamstring-rehabilitation-and-running-mechanics-part-2/

I will soon be posting some articles on managing muscle tone - which I believe is absolutely critical to the rehab process in all injuries.

I have long since corresponded with Number Two on the topic of rehab via massage techniques and his words should, in my view, be taken under the strongest advisement.

Of particular importance is something he touches on in the article he provided links to. Those of you, in particular, who work amidst the collegiate and professional sport ranks in CONUS must pay special attention to the following:

While many individuals will say that the prescription requires strengthening protocols, I would go much further to say that an appropriate coordination pattern must be restored. Obviously strengthening is part of the process, but it is a very specific form of strengthening (specificity of velocity, load and order of recruitment). This is why sprinting must be the primary source of work in a hamstring rehabilitation program. It is not a problem that can be adequately resolved in the weight room or physio clinic.

The hamstring rehab I perform on our players who sustain injuries in training camp and practices consists of a great deal of appropriately dosed power-speed drills and graduated sub-max accelerations

As Number Two infers, it is critical that the structures are appropriately ‘strengthened’ and this is not going to happen in the weight room. In fact, the only instance in which ‘strengthening’ via resistance training is needed, in the case of a hamstring pull, is in the event of a tear that causes substantial structural damage to the point that muscle function is inhibited enough to yield atrophy.

Most minor pulls, in which no structural defect or bruising appears, will not even cause a loss in tonic/low speed muscle lengthening strength in the athlete. They’ll only describe pain/inhibition during higher speed/force field based maneuvers. Thus it is the graduated re-introduction of many of the same field based movements that is critical to the rehabilitation.

What’s key here is whether the leg length discrepancy (lld) is structural (eg bone is actually longer) or an acquired compensation (possible through injury or trauma). Did your doctor discuss this? How was the lld assessed?

Edit: Have you had any falls, injurys, knocks, accidents in the last few months?

To build on what James has conveyed, for any of you who want to successfully work in collegiate or pro environment - where results are paramount - finding out the “right” way is absolutely critical. I will be honest - I do not work in a high pressure environment as James does - in terms of wins and losses - however, I do spend the entire week (10-12 hours per day) finding ways to give athletes a chance to play and contribute on Saturday. In some cases, your job depends on it. Those of us that have the passion and patience to find the “right” way will have success.

Charlie was adamant about the best way to learn how to massage and make a difference: don’t piss around, get in there and rub the muscles. I learn more about an athletes muscles by working them with my hands. You can feel the tonal variations throughout the muscle. You learn how to bring the tone down without beating the hell out of the muscle.

It is sad to hear these stories about individuals with injuries that have carried out over months and have not been addressed properly. James and I do not have the time to rely on the private sector to resolve the injury problems we are faced with. We just have to get it done.

For the past few weeks, massage has solved the following problems:

  • Back spasms
  • Muscle contusions
  • Hamstring strains
  • Shin-spints
  • Shoulder separations
  • Knee problems (MCL, alleged meniscus tear)
  • Patellar tendonitis/jumpers knee
  • And many more…

I would say we have cut recovery times by 50-80% - and I’m not exaggerating.

muscles compensation pattern…