Hey ergopower,
May not add much more to what has been said, but wish to emphasize a "Stop And Heal" approach. In 2010 I had my first Femoris issue, two physio sessions, needles seem to solve it. But it was an illusion as cycling does not expose the injury. I was not doing too much running due to knee surgeries. 2 summers I did 11000 kms cycling but tops 1000 running. All I felt, gradually, is slight tightness in my right leg. felt the need to stretch.
Last summer had a brief one week lower back discomfort, which passed away. Later I learned that was the SI joint..
This winter (Canada) I added more running, TM. Was pretty fast once I stretched. The hamstring tension was not an issue. Then, march this year, BLAM, I could not run one more step. Had to google anatomy, seek physio, and this is what I suddenly developped: SI joint dysfunction, piriformis sciatica, high hamstring tendenosis and loss of feel in my right hamstring. Had to add chiro (3 physio and 3 chiro sessions a week). Gradually, the SI unlocked, (each session relived many hamstring symptoms )swelling subsided. Piriformis began improving. Then we found the ischeal tuberosity tendon lumps after lots of effort, hiding below the tuberosity (you have to use a 2 inch hard rubber ball or drop on the ischeal tuberosity using a gym machine handle and break the lumps). Tennis ball is too big... The swell was so substantial that the whole thing felt natural and uniform. Yet when compared to the other leg, it seemed painful and bigger. In practical terms, I could not flex 5 lbs on the flex machine... Eventually, we found the ground zero: going down a painful sheath, mid length , the bicep femoris, from two years ago. As the BF lost functionality, tightened the muscle, dropped my strength and flexibility. Pulled the pelvis backwards, and locked my SI joint more and more till it froze this March. For 2 years did not feel much, but the chain effect caught on. To test would ART the BF, I could temporarily curl, that's how we knew. Other wise ROM or functional tests would not reveal much.
Was I going to need a Sciatic injection?
Was it an L4-5 disc?
Would I need a piriformis injection?
Is my sciatic trapped by the piriformis?
Turns out no. No more running. HAD TO STOP. A month now, no choice. Yesterday I did 1 hr cycling, first ride outside. I was weak, underpowered but the femoris was hardly felt. Lesson: cycling does not use the femoris nearly as much as running, but may still gradually wear it. I feel good: cycling circulated my cells, etc, speeds up recovery. But physio for the femoris and BF/ST tendon recovery must go on.
Am finally, clearly recovering. But the key lesson is, as far as you feel anything, and I mean, anything in your BF, do not run and must do the required physio to break down the scar tissue, and heal it. Then gradually resume. No choice.
The slowest healing part of my group is obviously, the tendon portion. 8 weeks median, 14-30 weeks numerous patients. It takes that long for collagen cells to become functional tendons.... A single run step at 80% would, guaranteed, set me back. Two runs and I would be fully reinjured again.
Even if my piriformis is 90% healed and I can run 100% (as I seem to do these past two years) I now know better and will heal it first, completely. Done it before on other muscles, this one is not different. I do not want an avulsion or permanently scarred hamstring group..
Medical articles, sports medicine all said the same thing: a hamstring injury must be treated as a chain thing, in parallel with hip and lower back evaluations and never in isolation. They were right, as my physio and chiro found a chain effect. You could heal an SI joint but a defective HS will lock it up again... Or you can heal a hamstring but a locked SI joint will not mov eand that hamstring will be overstretched from the get go.
Finally, remembering the injury history is critical at establishing a diagnostic, as well as healing roadmap. An understanding of anatomy also important.
Speedy recovery...
Oh I forgot... Anti inflammatories are good and bad. they help reduce inflammation or pain (say a sciatic type issue), and to get out of bed. Drop the swelling (for bigger tears, Grades 2-3 or 3) which you appear not have as you can still function). But BAD as they slow down the very inflammation that is designed to envelop and heal your tendons.. Key is I had maybe a Grade 1 to 2 strain, and no requirement for steroid or PRP injection. From my surgeries though, bottom line: never use NSAIDs unless in pain or as directed, otherwise, so say the specialists, they slow down the repair of torn tissue.
May not add much more to what has been said, but wish to emphasize a "Stop And Heal" approach. In 2010 I had my first Femoris issue, two physio sessions, needles seem to solve it. But it was an illusion as cycling does not expose the injury. I was not doing too much running due to knee surgeries. 2 summers I did 11000 kms cycling but tops 1000 running. All I felt, gradually, is slight tightness in my right leg. felt the need to stretch.
Last summer had a brief one week lower back discomfort, which passed away. Later I learned that was the SI joint..
This winter (Canada) I added more running, TM. Was pretty fast once I stretched. The hamstring tension was not an issue. Then, march this year, BLAM, I could not run one more step. Had to google anatomy, seek physio, and this is what I suddenly developped: SI joint dysfunction, piriformis sciatica, high hamstring tendenosis and loss of feel in my right hamstring. Had to add chiro (3 physio and 3 chiro sessions a week). Gradually, the SI unlocked, (each session relived many hamstring symptoms )swelling subsided. Piriformis began improving. Then we found the ischeal tuberosity tendon lumps after lots of effort, hiding below the tuberosity (you have to use a 2 inch hard rubber ball or drop on the ischeal tuberosity using a gym machine handle and break the lumps). Tennis ball is too big... The swell was so substantial that the whole thing felt natural and uniform. Yet when compared to the other leg, it seemed painful and bigger. In practical terms, I could not flex 5 lbs on the flex machine... Eventually, we found the ground zero: going down a painful sheath, mid length , the bicep femoris, from two years ago. As the BF lost functionality, tightened the muscle, dropped my strength and flexibility. Pulled the pelvis backwards, and locked my SI joint more and more till it froze this March. For 2 years did not feel much, but the chain effect caught on. To test would ART the BF, I could temporarily curl, that's how we knew. Other wise ROM or functional tests would not reveal much.
Was I going to need a Sciatic injection?
Was it an L4-5 disc?
Would I need a piriformis injection?
Is my sciatic trapped by the piriformis?
Turns out no. No more running. HAD TO STOP. A month now, no choice. Yesterday I did 1 hr cycling, first ride outside. I was weak, underpowered but the femoris was hardly felt. Lesson: cycling does not use the femoris nearly as much as running, but may still gradually wear it. I feel good: cycling circulated my cells, etc, speeds up recovery. But physio for the femoris and BF/ST tendon recovery must go on.
Am finally, clearly recovering. But the key lesson is, as far as you feel anything, and I mean, anything in your BF, do not run and must do the required physio to break down the scar tissue, and heal it. Then gradually resume. No choice.
The slowest healing part of my group is obviously, the tendon portion. 8 weeks median, 14-30 weeks numerous patients. It takes that long for collagen cells to become functional tendons.... A single run step at 80% would, guaranteed, set me back. Two runs and I would be fully reinjured again.
Even if my piriformis is 90% healed and I can run 100% (as I seem to do these past two years) I now know better and will heal it first, completely. Done it before on other muscles, this one is not different. I do not want an avulsion or permanently scarred hamstring group..
Medical articles, sports medicine all said the same thing: a hamstring injury must be treated as a chain thing, in parallel with hip and lower back evaluations and never in isolation. They were right, as my physio and chiro found a chain effect. You could heal an SI joint but a defective HS will lock it up again... Or you can heal a hamstring but a locked SI joint will not mov eand that hamstring will be overstretched from the get go.
Finally, remembering the injury history is critical at establishing a diagnostic, as well as healing roadmap. An understanding of anatomy also important.
Speedy recovery...
Oh I forgot... Anti inflammatories are good and bad. they help reduce inflammation or pain (say a sciatic type issue), and to get out of bed. Drop the swelling (for bigger tears, Grades 2-3 or 3) which you appear not have as you can still function). But BAD as they slow down the very inflammation that is designed to envelop and heal your tendons.. Key is I had maybe a Grade 1 to 2 strain, and no requirement for steroid or PRP injection. From my surgeries though, bottom line: never use NSAIDs unless in pain or as directed, otherwise, so say the specialists, they slow down the repair of torn tissue.
Last edited by:
Belisarius: Apr 18, 13 7:15