A Hamstring Rehabilitation Chronicle

After the X-rays have been taken and reviewed, the physio's side-kick (internist) has come in and given me a questionnaire, finally the Big Chief walked in and has me lie on me back while push-kicking into his palms. He does some more feeling around and looks up and says “ Man, your hamstrings are tight!” Its obviously a solemn occasion as the room grows quite . “And....”, I think to myself. We ponder the moment for a bit longer as I wait expectantly for the punch line, which surely must be arriving at any moment. “They both are”.

A well – respected sports medicine facility staffed with the Best Doctors list of Orthopedic surgeons surely must have run into tight hamstrings at some point. They must be really tight, then. I felt almost honoured to have hamstrings declared “really tight” by a renowned speciality in his field. They must be as tight as a violin string wound 10 octaves too high.

I hadn't felt too honourable weeks earlier while I limped to our car in the dark of a nearly deserted park after one of those hamstrings finally had enough and snapped during a high-speed sprint. One of the most intense pains I've ever felt – I worried it a blood-clot initially – leaving me unable to walk or even sit properly, let alone attend boxing class, play with my kids and all the myriad things I'd taken for granted. A careless step back would drive a shank of agony into the back of my leg.

My present condition is probably due to a number of factors, not the least being a long addiction to stair-case lunges and jumping split squats, a monstrously unbalanced quad-strength relative to hamstring strength, improper stretching, and a total lack of any eccentric hamstring strengthening exercises in my routines to name a few.

The stage had been set for a good bit. As Seiken Steve pointed out not too long ago, “Sprinting while in quadvile [sic] is a recipe for disaster unless you sort your business out stat” I warn't just passing through Quad-ville, I'd rented a flat there and settled in for good.

But, I am not the only one, by far, to have this. Its a very common ailment, but can be very debilitating and discouraging. The attributes and predispositions towards weak hamstrings also make one susceptible to an even more serious injury of the ACL.

There are specific things one should and should not do in order to recover fully and that is what this will be – A Hamstring Rehabilitation and Rectification Chronicle as merely rehabbing my hammies back to their original condition will not suffice, the long-term conditions that existed before the actual injury must be corrected for the long term as well.

I'd like to thank Herr Van Zandt and Seiken Steve for their helpful suggestions, warnings and insider info which allowed me to enter my first formal day of physical therapy at the medical facility “well ahead of the game” - according to the Therapist with whom I did the 1 and one-quarter hour session with.

I'll be posting my therapy sessions as well as my home sessions. Those wishing to add their expertise and experiences are most welcome.

 

It's great you're approaching this with a sense of humour. Sounds like you're in good hands (literally ). Increases in range of motion are greatest when lifting weights through as big a range as possible, and things like deadlifts and squats are best for this. The only "downside" though is you're going to be an absolute beast.

 

No dynamics here...all static. This is marked as "healing phase", so I hope they move on to better things in a bit.

 

Being the lazy sod that I am, I decided that since the medical facility was kind enough to print off my rehabilitation routine, it would save time and postage to scan it as an image and upload it directly to MAP.

Obviously a simple routine to start off with. I did not think of it at the time of my routine, but looking at it later I recalled reading something regarding #8 – Forward Bend, Elevated, as its referred to by the physio's office - I call it simply a elevated hamstring stretch – something regarding the need to keep a straight lower back to be effective.

It should be common sense that one does not overdo these, particularly at the outset and while in the healing phase, but I am so used to maximal-point-reached or maximal-effort-expended in my own exercise routines, the therapist had to correct me several times; “... you're not trying to kick the ceiling..., you're doing a hamstring stretch, not a glute stretch”, “...slow down...”.

Maybe I was just going out of my way to show that I wasn't old and decrepit. I'm quite certain I impressed no one by letting my ego take charge.

You can be certain, the next day I wasn't feeling too good and consequently will go into my next session in worse condition than I had gone into the first.

Morale ? Just do the stretches, nothing more.

​

 

When I tore my MCL in high school I got set up through a physical therapy program a couple weeks later. I got the same reaction about tightness but for my quads. It really is kind of weird isn't it? It's like you're getting an award for sucking at flexibility, like you should be in a museum or something.


As far as the stretching goes, try to take some time to work on your mind-muscle connection and the mechanics of your body. It's developed by just focusing on the muscle you're working on and how you've moving other parts of your body. Focus on any contraction, and really focus on what body positioning gives you the best kind of stretch for a specific area. You would be amazed at how much a slight wiggle of the hips changes a stretch from hitting your glutes to really working on the hammies, or angling the non stretched leg can give you a better stretch, or what paying attention to your backs posture can do for a specific area in a stretch (especially the hams). Always good to be in tune with your body, it's always helped me not overdue things in stretching or weight lifting and I've had to set myself back a week in pursuit of a goal multiple times just to reconnect with myself.

And go slow! You're old. :zzz: ban

 

In.

 

:happy: Ya, very weird! Everyone in the office looking at you as if you've been chosen to be shot from a canon at the next Cirque de Soliel.

I'm gonna show you who's old, smart-arsed kid,

 

I'm going through a hamstring pull right now as well...I know your pain...literally. A demonstration gone bad, side kick and snap! ended the demo right away, thing is I felt the tightness in the hammy earlier and after standing around all day judging at a tournament with little time for warm ups...well you know the rest of the story. Anyway I'll be following along your journey.

 

Ha I thought 'bairn' was a Geordie term.

 

Are you getting any formal treatment for it, or just healing it on your own?

This was a bad grade 2...I'd not want to know what the next level up would be like.

 

Alreet, I've to fix that.

Better?

 

You a closet Geordie BT?


There was a video I found infinitely helpful when warming up my soccer players who where all post hamstring injury at various levels. I've been looking high and low for it and I can't find it, I'll keep looking though.

 

:cry: Ever since we were booted out of tyne n wear -

Lol, dontcha know we get Premier League here in the Midwest?

Meant to add: Thanks for keepin me in mind for the vid!

 

O lucky man, that I am, the place we went for Christmas holiday had a first-rate exercise facility with a number of machines that I've not had access to heretofore.

I was able to take some advantage of it and, had it not been for developing a miserable, nasty cold at the outset of the trip, would have availed it even more.

I'll make a log of it and post tomorrow hopefully. Fever and head-spinning 'round's putting me to bed soon.

 

Having had access to machines while on Christmas holiday, I thought it a good time to up the ante on rehabbing my shot hamstrings.

25.12

Using the treadmill as a warm – up for 3.5km at a 8km/hr pace after which I did the usual Physical Therapy approved routine that I'd posted earlier but skipping the 15min ICE part.

As I was beginning to feel the first chills of what would eventually become a fever – one that I'm still battling – I thought it a good idea to not let the 'warmth' of my treadmill warm-up die down with the relatively light PT routines that I had completed; I jumped on one of the ellipticals and worked up quite a good sweat doing high-speed/low-speed intervals – nice not having to worry about the inevitable stiletto in the back of the thigh – I was able to give my leg muscles all they needed for a good warm-up; something I'd never been able to really do since the injury and restrictions on hard-surface running and jumping.

With a sufficient warm-up, it was on to the seated hamstring curl with weights. I know it was recommended NOT to do the seated by lying curl, but alas, that one wasn't available.

I alternated each 15 rep set with either pull-ups and military-presses or curls with the barbell there. I don't know if this is the right 'rest' procedure after a set when rehabbing hamstrings – I 've come to fear 'growing-cold' more than anything and decided to make the 'rest' a bit longer and utilize it for upper-body purposes.

4 sets 15 rep seated hamstring curl – at 90lbs (US) X 2; 70lbs X 2

Had to admit, the feeling in the back of my legs was odd – not bad, just a sensation that I've not felt in quite a while – warm.

From there I did a few simple lying hamstring stretches – slowly, methodically and then on to the Seated Leg Press with Weight Machine. Used to doing presses the old-fashioned way, I had neglected to check beforehand what the weight had been set at. Of course, a Sumo-squat master had been the last to use the thing and the weight was probably set well over 230kg!

5 sets 15 rep seated leg press. Again alternating each set with upper-body routines – this time various dumbbell exercises. There were plenty of machines available but I prefer free weights.

Forgot to add: Finished with another slow round of hamstring stretches and elevated hamstring stretches.

The odd thing with fevers being, they either knock one out completely or they warm and invigorate – this was the latter. I buzzed right along with the warmth – like standing in front of a great snapping fire on a chill evening.

Pretty light fare, but its the most I've managed in the weeks since my hamstring snapped. I thought I'd be sore and limping the next day but was surprised to find my legs felt better than they had in a long while. Only the respiratory infection to put a damper on things.

26.12

Essentially a repeat of Christmas day - except now the respiratory infection was not taking prisoners and the hacking cough was enough to break the flow of progress, not to mention hasting other members an early workout finish.

 

No formal treatment, mine was a level one, I guess, it didn't get black and blue I just had a hard time walking and now I can stretch it again. A level 2 is not good that must have really hurt. As we get older our mind says yes, but our body... I see you're doing better.

 

No...gone on with it..."...but our body..." WHAT?!? What does our body do? LOL.

It was doing better... I've developed a very bad 'hammer toe' and its thrown a monkey wrench into things ... can't believe such a trifling thing so aggravating.

Anyroads, therapy tomorrow

 

Progress with healing/rehabbing the hamstrings has been an on/off affair. After initial healing and PT, I had managed to bring things into line from re-injuring them twice a day down to 0 and much of the discomfort and some of the stiffness had subsided greatly.

Christmas holidays found me in a nicely outfitted gym and I took things a step-up on my own by getting on machines and not minding myself to set the weights to minimum before gradually scaling up.

Mistake...the first day or so had me to think that I'd done a good job scaling the therapists timetable, which I thought too conservative, to rehab up significantly as I felt great but I think the upper respiratory infection medication I was taking at the time masked the reality which set in a few days later.

The combination of strain from overworking my injured leg with crippling pain from a badly deformed hammer-toe on the other limb has resulted in an unnecessary setback in the healing/rehab timetable.

After a dress-down by the therapist regarding taking matters into my own hands, we preceded on with the routines that will occupy my home PT for the next 10 days...

Active hamstring stretch from back 5 X 2 sets, 2 sessions per day

Elevated hamstring stretch 5 X 2 sets, 2 sessions per day

Bridging 10 X 3 sets, 2 sessions per day

Prone Leg Raise 10 X 3 sets, 1 session per day

Prone Leg Raise (with knee bent 45 deg.) 10 X 3 sets, 1 session

*Standing Resisted Knee flexion with 5 pound weight 10 X 3 Sets, 1 Session*

Sitting knee extension with 5 lb ankle weight 10 X 3 sets, 1 Session/day

The only adjustment I made was doing the routines on both legs – which the therapist agreed would be a good idea to prevent the same injury to the other leg.

*Standing Resisted Knee flexion with 5 pound weight 10 X 3 Sets, 1 Session* - this was a new one added from the previous PT session and I can say its Ground Zero for my hamstring injury. I felt exactly where I had first injured the hamstring while doing this – the exactly location. I didn't feel it would snap again, but I could tell this must have been the postion I was in when the tear first occurred.

Yes, for those like meself, who are decidedly bereft of any knowledge of exercise physiology whatsoever, its a good idea to have the supporting structures up and running before dealing with the epicentre of the injury.

 

I'd been consistently doing the above routines for the last couple of weeks with no problems. Had another therapy session a couple of days ago - another session, like the last one* that left me somewhat bewildered when I inquired as to progressing beyond the static stretches - I believe I was dismissed as when I attempted to set a new appt., it was basically don't call us, we'll call you.

The therapy sessions themselves went well, therapist was encouraging, always said I made good progress but any sign whatsoever that you are anything but an utterly helpless patient who doesn't have one iota of interest in progressing beyond the capability of a 90year old stroke victim, their faces darken - literally as if one had uttered a vile curse for no apparent reason...

Has anyone else had this experience?

* http://www.martialartsplanet.com/forums/showpost.php?p=1074822937&postcount=3

 

What's that saying? "The job of a healthcare professional isn't to heal, it's to not get sued."