I was racing at Lake Placid last weekend. On the 2nd loop of the bike while riding on the bars on a slight uphill going out of town I felt a sharp pull/pain behind my knee. It stopped my pedal stroke for a second but then I continued. As I pedaled it felt more and more painful. I started pushing with my right leg more trying to ease the pain to the left hoping it would calm down. I made it to the end of the bike and headed out to run unsure if I would be able to. I did the run and as long as I was steady on my pace the pain was tolerable. But I was told I had a purple spot on my leg. I had a christmas tree shaped purple spot behind my knee at the end. The pain was quite bad. I iced it right away after finishing. Over the next day the bruising extended up my hamstring and slightly in to my calf.
I think its a hamstring tear. I have a doctors apt on Monday.
Anyone out there have any similar experience? Any ideas on recovery time? When can return to training?
I have an aggressive race schedule for the rest of the season.
by the way I ran a 3:46 marathon.
http://www.eatmoveimprove.com/2010/01/on-muscle-strains/
Based on your description, it sounds like you’ve strained your hamstring. I’ve dealt with a similar issue, but didn’t have the type of bruising you’re experiencing. The initial healing phase is probably the most critical, though many will argue otherwise. Stick to what works - rest, ice, compression, and elevation. The worse the strain, the longer you’ll need to stay off the initial injury. Ice for 20 minutes on/off for the first 48 hours, elevate the leg any time you’re able. After swelling has gone, consider starting some self-massage to keep blood moving to the area and to help break up scar tissue. Some people argue that the hamstring is one muscle where active recovery is pretty important to keep scar tissue down, but don’t push it.
Find a good PT in your area.
Interesting case… that may be more complex (not necessarily more serious) than a simple hamstring tear. First, distal hamstring strains are uncommon, especially among triathletes. Second, the bruising without trauma is uncommon as well. Third, a muscle tear that caused bleeding would have caused pain and impairment not compatible with your fine run.
My guess is that a small blood vessel behind your knee ruptured. If true, you might get purple bruising (ecchymosis) there. Gravity pulls the blood down into the calf. Not sure how it traveled up your hamstring unless you elevated your leg a lot. The only question regarding this hypothetical is why the rupture?
What your doc finds will be interesting.
Yes I elevated it and I used the boots. Maybe thats what made it travel up. Im still icing, elevating and resting. Im still icing a lot because it keeps swelling and the tendon is squeaking when it does. Pinpoint pain to the medial tendon area. Lets hope its not a tear then. Ive read that ultrasound can be used to diagnose otherwise MRI.
Update is. its a tear at the tendon/muscle junction per the doctor. he ordered an mri which currently my insurance is denying! I started PT on Tuesday. And an anti inflammatory. Not sure what this is going to mean for IMC. No one with any experience on this? Its a medial tear…guessing without an MRI. Is this how medicine works?
Update is. its a tear at the tendon/muscle junction per the doctor. he ordered an mri which currently my insurance is denying! I started PT on Tuesday. And an anti inflammatory. Not sure what this is going to mean for IMC. No one with any experience on this? Its a medial tear…guessing without an MRI. Is this how medicine works?
So, doc says this is a distal hamstring tear? Tears usually occur at the MT junction. Healing is faster at MTJ than mid-belly. Medial tears are more complicated because 2 of the 3 hamstrings are medial. He doesn’t want to order an MRI because he thinks it walks and talks like a duck, so it must be a duck. (But sometimes it turns out not to be a duck.)
What causes more pain: stretching or contracting the hamstrings? How much pain did you feel when the doc or PT tested your hamstring strength? Are there any regular daily activities you can’t do because of pain, other than training? If you lower the saddle, can you spin without pain? Re rehab: Focus on pain free strengthening (underscore pain free). Only very mild stretching.
The strength tests all had no pain at all, full strength. what hurts is contracting and it when the knee is almost all bent, straightening is fine. Walking downhill hurts and after walking for 10 minutes its a little achy and pulls up the medial tendon. Im still icing and using compression.
I swam yesterday and it was fine. I can spin on my bike on the trainer easy being very careful at the top of the pedal stroke just for 30 minutes yesterday.
The strength tests all had no pain at all, full strength. what hurts is contracting and it when the knee is almost all bent, straightening is fine. Walking downhill hurts and after walking for 10 minutes its a little achy and pulls up the medial tendon. Im still icing and using compression.
I swam yesterday and it was fine. I can spin on my bike on the trainer easy being very careful at the top of the pedal stroke just for 30 minutes yesterday.
Your injury still puzzles me because it has features not typical of a muscle tear, especially the “… no pain at all, full strength” part. Did they strength test other muscle groups that attach around the knee? To clarify, walking downhill is painful when the knee is straight on heel strike (that would stretch the tendon)?
Do you have any doubt that the pain, tenderness, and swelling (is it significant?) are located at the distal medial hamstring tendon attachment? Are you taking an anti-inflammatory?
It does me too thats why I was so interested in the MRI. He checked my knee and all the tendons were tight and good. It hurts downhill more I think from tighter bending. It does not hurt when the knee is straight only on bending. There is not any more swelling and the pain only comes when I bend it otherwise it does not hurt. Sometimes I feel a pulling feeling up the medial tendon (I think) and the other times it feels like someone is sticking a stick in to the area behind my leg ( behind my knee). Last week the tendon was squeaking but I think that was general swelling? I am taking an anti inflammatory that I just started a few days ago.
OK, I will go out on a limb of my cyber-armchair and guess that the tear is actually in the tendon of medial head of the gastrocnemius close to its insertion behind your knee. It’s unusual, but fits your symptoms better. Actually, I hope my guess is wrong because healing time would likely be longer than 2 weeks.
Try spinning with your foot remaining in neutral position (90 degrees) vs. foot pointed with toes down. Is there a difference in pain?
You can use PM, if you prefer.