Possible hamstring tear - anyone have any experience with it?

[Dr_Doolittle]

Last Tuesday I went to the beach with my daughter for a vacation (first one in 6 years for me!), and we went swimming in the ocean shortly after getting there.

Everything was going fine, there were a few bigger waves but we were able to easily bob/swim over them, then a rogue MerFer came up seemingly out of nowhere - BIG, high! crest!, and because I didn’t want to be slammed in the face and shoved backwards, I turned slightly to the side hoping to ride it in.

(We weren’t out all that far, but not close to shore.)

Instead, it grabbed me, turned me, took me and slammed me, and I went down into the shallows by the shore, landing at an angle on my knees and pelvis - felt something “give way” in what I first* thought was my hip/thigh/pelvis - and luckily somehow my daughter was right there beside me, I found her hand and arm. She had been taken and slammed as well, but was uninjured.

She was able to help me to my feet (sort of), but I was unable to bear weight on my left leg.

Backstory: My right hip was replaced a couple of years ago (left one has much less arthritis for some odd reason), and I’ve had two injuries “in that area” - both on the right side - once before and once after the THR - and over the past 6 years. Both (weirdly) from riding; neither from falling off. The first one happened in the air over a cross country cabin; I felt something “pop” in my right upper hamstring, but like all (stupid) eventers I continued riding and popped over a few more x-country jumps then galloped on the track.

When I got back to the trailer I told my DH (who was concerned, because I had a Horse Trial the following weekend), but I said “let’s play it by ear, I will ice it and rest it and see how I feel.”

Fast forward to the HT, I finished on my dressage score - though my mare’s epic leap off the high downbank sort of “put paid” to the damn thing, and I was hopping on one leg after dismounting. But hey, I wound up 3rd! (Yes, stupid, stupid.) Also, this was November, so a great time to have a season ending injury if you’re going to have one.

Anyway, after a clearing x-ray and an MRI it was discovered that I had partially torn 3 hamstring tendons off of my pelvis. Because they were partially and not completely torn, the Ortho doc said surgery wasn’t necessary but that I would have to do months of PT and that is would “scar in” - so I would be able to get back into riding gradually.

Done and done.

(Amusingly, all Ortho docs ASSume that we are “thrown” off “rank horses”, so mine asked me: “can you find anything calmer to ride?!?” My mare is my homebred who I have done ALL of the training on, and she is a lazy WB who I know like the back of my hand. Also, I did NOT plan to just “mount back up and take my chances”, but instead start back with groundwork and longeing; she is ALWAYS totally fine. Silly doctors…)

I am a PT monster and was incredibly dutiful, and it eventually healed up completely - back to riding and jumping, etc.

The second injury was about 15 months ago. My saddle fitter had screwed up the fit of my jump saddle by putting a narrower gullet plate in it for some reason (this was rectified after the fact), so the saddle would slip to the right and I would have to loosen the girth, move the saddle to the left, and re-tighten the girth. (I kept calling to complain about this, and had them out 3? times before they finally figured out the problem!, and it’s been fine since), but during a jump school when I tried to “shift the saddle over” by moving it with my right thigh, YIKES!, OUCH! another strain - this one to my right adductor muscle. X-rays were negative, and they didn’t think an MRI was necessary in this case - so back to (ouchy) PT I went! My pelvis became cattywompus as a result of my walking in an assymetrical way, but one amazing PT did some minor adjustments and Voila!, I was immediately much better! After that it was just the usual: strengthening all the muscles around it, glutes, hips, quads, core - and I do a LOT of this already (work on my core daily) so pretty much breezed through it, going 2-3 times a week. That one healed more quickly and I was finally back on he horse.

FTR, I am 68 so things heal more slowly - and older tissues are just not as strong - but I’m pretty fit and work at it daily - and because my muscles/fascia are naturally tight, I do a SHIT TON of stretching, hamstings included; I stretch them 3 times a day - and this also helps my low back. I’m actually pretty flexible and strong, and do Pilates.

(I can put my palms on the floor when bending down, FWIW.)

Back to my mishap! Luckily there were several VERY kind people (a couple and another guy) who saw my DD dragging me out of the water and ran up immediately to help me, offering their shoulders, finding a chair and putting me in it - and one of the guys wound up carrying me (as in over the threshold) all the way to the parking lot so that my daughter could come in the car and take me to the nearby hospital about half an hour away.

Angels, they were We both thanked them profusely! And funny - the wife had a yellow Lab puppy with her (a darling thing), and since I’m a dog trainer I was able to give them some training tips and reassure them that they were doing a great job. A meager compensation, but something.

They did x-rays and an US at the Hospital in Rehoboth (DE), both were “negative” (I didn’t think anything was broken because I would have been in more pain), and the US didn’t show any ligament or tendon tears (no diffuse fluid, etc.), so we drove home (got home at 2 AM!) and I was lucky to get an appt. with an Ortho PA the following afternoon. He examined me (gently), and said that it’s probably a tear - probably NOT a rupture (thank God!) because the swelling wasn’t too bad and there was no bruising.

So apparently (according to Doc Google) there are 3 “grades”: 1 is a strain, 2 is a partial tear, and 3 is a complete tear, requiring surgery.

I’m thinking it’s 2. MRI is scheduled for this upcoming Wednesday, after which I will have a F/U appt.

Pain is controlled by my Tramadol and Meloxicam; I do take Ibuprofen (and did the night of the injury), and I popped an OxyCodone the morning after. I also do medical marijuana for my pain issues (prescribed by a Dr. I have a card) so that helped a little.

I am ambulatory, but can’t really bend down much without YIPES!!!, and I’m using a cane (and a walker) just to make sure I remain stable. It doesn’t hurt when my knee is bent and supported (which is how I sleep anyway to take pressure off my low back; I sleep on my back), and I’ve been on and off icing it. I also have a Pemf unit (it’s pretty wimpy), but have been putting that on the pain setting during the day.

The pain is minimal when my leg is up and supported (I “live” at a 3, so), but on the occasions that I have bent down or YE GODS!!! tried to put on socks or shoes!! EGAD!!! DH helps me (and has been incredibly doting) but sometimes I just want to do a little by myself. Stupidly. I get impatient, though I am being “a good patient” and trying my best to take it easy. It’s remarkable how many things are hamstring intensive.

You horse chicks know how difficult it is to just SIT…(But I am LUCKY that I have help!)

Sorry for the novelette. I like to put ALL the possibly relevant info into post #1 so there will be no questions that haven’t been answered.

So has anyone else dealt with this? I DID do a search, there was one somewhat helpful post.

It’s killing me to have to wait to find out the extent of the damage while re-scheduling dog classes and horse lessons (and of course giving my mare an unplanned vacation) - but if anyone else has experience with this specific injury, I would love to hear about it - TIA!

[Jackie_Cochran]

I am so sorry you are going through this.

I’ve never had such an injury. Get yourself to a good leg doctor, insist that you will NEED physical therapy and do what your doctor tells you to (for right now.) Be sure to tell them you will end up back on a horse so they will get you to work the right muscles.

You will have to get this leg strong again. It will probably take time before you can ride at your current level again. Do not rush this, some things just take a lot longer to heal.

[S1969]

Not me, but my running partner had a hamstring tear last fall after slipping during a slushy Turkey Trot run. This was her 2nd injury in the same leg, just like you. Which might have contributed, because the scar tissue in that area made her less flexible and possibly more prone.

She ended up in PT and healed on her own in 6-8 weeks, but toyed with the possibility of PRP, which she had previously had with success with the previous injury.

If it’s not a rupture, surgery wouldn’t be helpful, but that is likely to depend on your MRI findings. Even if you do go the PRP route, I’m not sure when the ideal timing for that is, as it doesn’t do anything extra, just helps you heal faster. So, it’s not necessarily bad to have to wait for it, because if you’re healing well it may be overkill.

My friend had a lot of discomfort for about 2 weeks and did use crutches from time to time to help. I think she also found compression to help a lot, but be careful not to overdo that or it will be more painful. I’m not sure she took any specific pain meds, but that’s probably more her stubbornness than need. The only other recommendation would be a PT that can apply some laser therapy to speed up the healing.

She did not resume running for several months, and it is still a work in progress. She still has tightness in that area, and I think she probably should go to see a specialized PT for some myofascial release work because she has multiple injuries to the same place. I’ve had graston technique for other issues and while it hurts like a mother trucker…it did help. Obviously that’s down the road for you, but something to consider after you have healed.

Editing to add – so sorry for your injury! Nothing is worse than being hurt, except being hurt without a really good backstory. I had a mild calf tear once from the exact same thing - fun little holiday at the beach between hurricanes so some very active surf. Was fun until it wasn’t. Not being from a coastal area, I think we sometimes underestimate the power of tides; they look harmless until you get tossed around like a toy.

[Simkie]

Yeah, I did this last year. It was a bear, and hurt for a long time. I got some relief with PRP, but really should’ve pursued some shock wave too.

It took about a year to stop being an issue. Probably two months or so post injury to ramp down to a “nagging” level of pain.

Give it time. PRP and or shockwave are probably worth exploring.

[Dr_Doolittle]

Thanks, Jackie!

All the Ortho docs in the practice(s) are experienced with all “body parts” (and you can’t swing a stick here without hitting an excellent, board certified highly rated Dr. in general - and there are a lot of orthopedists!) We live in a county with over a million people and it’s filled with well-heeled professionals of all stripes - so the medical care is generally excellent. I do have a “hand doctor” who is a specialty orthopedist; not my first rodeo so have been to a good number of physicians in this specially.

I always tell them that my desire is to get back on the horse! I already do a LOT of specialized strengthening and stretching and mobilizations (Rider’s Pilates, Feldenkrais and Yoga for riders), so specific PT for the injured body part is very much in line with what I already do, and targets the same body parts: hips, glutes, quads, hammies, CORE!, along with upper body to stabilize (goes along with a strong core, good posture, and good body mechanics )

I am well aware of the time it takes; and always listen to the docs (within reason), the Ortho PA I saw said “I read the room” when dealing with injuries to athletes (even old ones, LOL!), as did the Ortho Doc who did my hip replacement. They were able to evaluate me from a fitness and flexibility standpoint, and also take into account that despite my impatience to get back in the saddle, I will be religiously dutiful about PT! I am always judicious; taking care NOT to push myself too hard because I do not want to re-injure it. They were also easily able to assess my level of determination.

(An aside: I have observed many older people in PT who did not want to do the work; complained about all of the exercises, quit early, wimped out, etc. All of my PTs have been amazed by my dedication, work ethic, and commitment to improving - one of them said: “Can you be a motivational speaker for all of my other clients here?” ) Anyway, I always pace myself and am careful, but DO really work at it!)

My main concern right now is losing fitness and flexibility, but I plan to e-mail my Rider’s Pilates trainer and see whether she has any suggestions as to how to carefully utilize the lessons while sparing the injured body part. She might have some suggestions as to how to work on my core without stressing my leg(s)

After a certain age, it becomes so much more difficult to get back in shape after one is “on stall rest”!

[Dr_Doolittle]

Ouch! Yeah, icy conditions can be treacherous.

It’s actually the opposite leg! All the issues (mentioned above) have been with my right leg (a pattern?), so no scar tissue there. Yet.

6-8 weeks would be wonderful!, but of course I will NOT jump ahead and ASSume that my timeline will be that short - it will of course depend on the extent of the tear, and I will no doubt have to wait until the end of this upcoming week to find out. The MRI is on Wednesday night, so likely won’t be read until Friday. I had to do a lot of calling around to find the “first available” - and that was it! So now we wait. SIGH

Yes, unlikely to be a rupture - but yeah - I guess we’ll see!

I had PRP done on my horse about 15-16 years ago (check ligament tear, a pasture injury), and after 8-9 months of healing, my vet looked at the leg and said: "Eh, I think it would have healed fine without PRP.

Since she had been the one to recommend it, maybe she could have kept that opinion to herself. It was 5 K!! Ugh. Mare was insured, but they don’t cover everything and obviously there’s a cap - so we wound up paying out of pocket for a lot of the therapies.

We have really good insurance that covers a lot (phew!), but not sure what therapies will be covered for this. I have someone local who has a Bemer, she also recommended cold laser. I went to a chiro for about 6 months prior to (and shortly after) my THR - he helped with my assymetries (you wind up all crooked as a result of compensating for the pain), and he did offer cold laser.

Again, wondering what is covered, but I guess I’ll cross that bridge, etc.

I am using a cane (DH keeps shoving the walker in front of me because he is overprotective), and I am able to lurch from room to room, carefully - but the cane comes in handy when negotiating stairs. We live in a 3 level TH which ALSO has a total of 13 stairs from the street to the main level (UGH!, and we have been looking for a single family house for years now, but DH won’t consider a rancher and wants his big brick Colonial with 2 stories and a basement. This is an ongoing “discussion”, during which I remind him of how old we both are and how easy it is to “fall down the stairs” once really elderly. He retorts with “I’ll get you an Acorn Stair lift, and we can put your bedroom on the main floor” )

I have tried a bit of compression - it helps a little, but even wrapped NOT tightly it’s a bit uncomfortable.

I have someone who does DEEP tissue bodywork and works into my fascia. It is SO painful that I need to take an extra Robaxin along with some Oxycodone in order to bear it - but it’s very therapeutic. I have gotten myfascial release in the past; again, excruciating!

NOT for sissies, LOL! I have a foam roller, a physio ball, TENs unit, Theracane, inversion table, etc.

Obviously (as you say) this is not appropriate yet!!, but once the inflammation is down and healing is well underway, I will “submit” to the torture. (As mentioned, I already do a lot of stretching and self manipulations to stay flexible. This sitting in a chair crap is for the birds…)

Oy!! Well, the backstory is at least NOT horse-related this time, Ha! Agree about the forces of nature - they are indeed awesome (and not in a good way); and it ruined our vacation since we had just gotten there!

How long did it take for your calf to heal?

[Dr_Doolittle]

How did you injure it? (Inquiring minds want to know, and solidarity!), the Bemer/cold laser person said shockwave would not be helpful (huh), but obviously she’s not a doctor. I will have to limit how much we spend “out of pocket” - but whatever might/will actually HELP will be prioritized!

What was your pain level, and how mobile were you? (pre-healing?)

A YEAR, just shoot me. I have recovered from several other “insults” (covered in my OP), and they did take awhile - the new hip was the quickest timeline because that tends to be the case (with a good surgeon), and I am insanely motivated to get better. Plus I was past the bone-on-bone stage, the surgeon said the hip was in awful shape when he replaced it, so I was in terrible pain for a while beforehand.

Because of my existing “pain issues” the initial recovery period was no walk in the park, but I was teaching lessons 2-3 weeks after surgery (even went to a Smokey Robinson concert 10 days post-surgery - on my cane - LOTS of walking but I did fine!), and was back on the horse 5 1/2 weeks post-surgery.

Obviously this damn soft tissue stuff takes longer.

I hate the “wait and see”, but obviously I don’t have a choice in the matter! Unfortunately I can’t take Reserpine, but I do have medical marijuana to help chill me out a bit…

[Simkie]

I was chainsawing a big log at about waist height, with my left leg behind me and bracing, and the saw jerked me forward suddenly. I heard & felt a pop and was immediately non weight bearing for idk like five minutes? Then just limping and painful.

I ignored it for maybe a few months? Used mobic and tylenol and robaxin as needed to get through the day. Sitting in the car, or on the tractor, or walking uphill were tough.

I did PRP maybe…4? 6? Months after I injured it. Should’ve done shockwave after that but that was about the time I had surgery for my elbow so wasn’t really driving. Definitely don’t shockwave it when it’s really pissed, but once you’re through this really acute period, it might be worth a try.

I probably had the most improvement over the shortest period of time when I was rehabbing the elbow, sitting around and doing nothing (I guess not nothing…I watched a lot of horse racing ) So be nice to yourself. Give it time and space to heal. Put yourself on stall rest and controlled hand walking!

Of all the weird shit I’ve done to myself this one really took some time to resolve.

[Dr_Doolittle]

Yikes!

Yeah, that sounds familiar in terms of the suddenness of the injury from being “jerked” - though I was able to hobble around a little after the worst of the pain had gone away - though it was still painful as hell (it’s better than it was, and this is day 5.)

Car rides are “okay” (had to sit in the car for 2 1/2-3 hours that night because we decided to check out of the hotel and just drive home so I could sleep in my more comfortable bed), and that was uncomfortable…Smoked some weed and had ibuprofen and Tylenol on board, along with 2 WEEEEE Oxy pills that were the size of those tiny little Arnica pellets! MUST NOT CREATE ADDICTS by offering one time pain relief. And of course most people don’t have chronic pain issues, so NSAIDS actually work.

I can’t imagine walking uphill any time in the foreseeable future! I am taking it SO easy, other than caning around the house (and negotiating stairs), and spending some time in the stall with my one horse (cane at the ready) doing a few neck rocks and belly lifts, applying fly stuff, and putting fly spray and SWAT on the other field boarded mare. Slowly, very slowly. I had DH do their feet and brush them - had to “coach” him through the hoof picking which was WAY harder than he anticipated! He was puffing at the end The hardest part was getting him to stand close enough to them when picking up their legs and also getting him to DIG into the clefts of the frogs!

He has handled them a lot and is very good, but this specific thing was very difficult for him; he also can’t help me put in studs. My poor wretched low back

Our smaller SUV has a broken running board on the passenger’s side, so I have to lift myself up onto the seat and “pivot” myself into place. Same with my broken recliner (which is stuck in the open position; it’s electric, and we bought it for my hip replacement recovery), and also my bed which is on the high side.

So you didn’t get any diagnostics? You are one tough lady!

I guess the question will be “when will I be through the most acute period”, at which point I can start these therapies? I do worry about scar tissue building up if I don’t stretch it (I am already feeling stiff because I normally do SO much stretching that I just can’t do right now - though I can stand on the bad leg and stretch my right Hammie - no straddle stretches though - EEEK!)

Did you insurance cover the PRP? I looked into that about 15-20 years ago for my back issues, but insurance (at the time) refused to cover it despite the doc recommending it.

Ugh and ugh. I need to be patient, but yeah - it’s tough for horse people. “Controlled hand walking”, LOL!

As my dear late father used to say: “This too shall pass.” This saying got him through WW2, so anything else is a comparative piece of cake.

[Simkie]

I’m glad you’re taking it easy! Remember that you WANT scar tissue here. Worry about strength and stretching once it’s more through the healing process. Stick to gentle movement that doesn’t take your breath away. Do you have your MRI report? What exactly does it say about the tendons, their attachment, and any retraction? I have a great physiatrist in NYC if you’re nearby and would like a second opinion on the imaging. Would be happy to hook you up with her deets, just lmk.

I had an MRI a few months later, really only because the elbow imaging was ugly & the hamstring hurt more…so yikes, what does that look like? Thankfully the elbow was still worse, so no hamstring surgery. Just a long road, though.

Nah, insurance still doesn’t cover PRP. Or shockwave, it’s all out of pocket.

Your dad is spot on! You’ll get through this. But be kind to yourself!

[RMJacobs]

@Dr_Doolittle

He retorts with “I’ll get you an Acorn Stair lift, and we can put your bedroom on the main floor”

I have a stair lift in my condo, and I could not live without it. All our living area is on the second floor; downstairs is only the front entry and door to the garage. If I ever want to leave my house, I need the stair lift.

[Dr_Doolittle]

Yes, just like horse injuries healing – that I’ve had experience with, along with my own!

You just don’t want the scar tissue to wind up shortening the muscle fibers so that they lose stretch and elasticity – I stretch my hamstrings constantly, otherwise I wouldn’t be able to function and my low back would be even tighter than it is.

MRI is this upcoming Wednesday night.

I live in Northern Virginia by the way – but we have a shit ton of great doctors in a fairly small radius because of how affluent our area is – it’s 20-30 miles outside of DC.

[Dr_Doolittle]

I see - yes, that makes sense.

I’m kind of not “there yet” though, as active and physical as I am I don’t feel like I really need it right now - I’m just very much NOT appreciating stairs anymore

[RMJacobs]

I lived in a townhouse back in the mid 1980s and was constantly dislocating my knee from an injury from when I was 15 years old. I got very tired of the dislocations and arthroscopic surgery had been invented, so I decided to get my knee fixed. After the surgery, going up and down those stairs was miserable on crutches, and this was when I was 30 and in very good shape. The bedrooms were on the second floor, and the garage was below the first floor, with the washer and dryer in the garage (no worries about freezing as it was in Pasadena, CA). A couple of times I got so frustrated that I went up or down on my butt.

The good news is that it’s been nearly 40 years since the surgery, and my knee hasn’t dislocated since then.

[Simkie]

@Dr_Doolittle

MRI is this upcoming Wednesday night.

Ohhhh I didn’t realize you haven’t had this imaging yet. Yeah, definitely take it easy until you get a peek at what’s up. Respect that pain. You don’t want to accidentally turn a partial tear into a full thickness one.

[Dr_Doolittle]

Yes, that’s definitely what I’ve been thinking!

Trying not to do any “big moves” and when I bend down (just a little, it’s all I can do), I engage the quad and hamstring of my good leg - and my core - so that I don’t “engage” that left hamstring by accident. I still “twinge” it sometimes when I’m doing stuff that I normally do and “forget” that it doesn’t work, but I’m moving carefully like an old granny with my cane, and being very careful when I get up and down to first engage my core, and do everything very slowly.

My QL’s are very tight in general, and I have been carefully getting on the inversion table and the Physio ball to try to decompress my back, but I have a feeling I’ll be hitting the heat and the TENS unit tonight.

Right now, we are at the barn, and I’m giving my husband a tutorial on how to pick out feet!

[Dr_Doolittle]

Ugh, that sounds just awful – you poor thing!

[RMJacobs]

It was all practice for when I became disabled!

[Dr_Doolittle]

[S1969]

@Dr_Doolittle

We have really good insurance that covers a lot (phew!), but not sure what therapies will be covered for this.

I have great insurance and PRP is not covered as it is experimental. It was about $1K for my hip; I think it was probably about that for my friend’s hamstring.

@Dr_Doolittle

Obviously (as you say) this is not appropriate yet !!, but once the inflammation is down and healing is well underway, I will “submit” to the torture. (As mentioned, I already do a lot of stretching and self manipulations to stay flexible. This sitting in a chair crap is for the birds…)

Oy!! Well, the backstory is at least NOT horse-related this time, Ha! Agree about the forces of nature - they are indeed awesome (and not in a good way); and it ruined our vacation since we had just gotten there!

How long did it take for your calf to heal?

Yes definitely wait until your MRI and a conversation with the ortho about alternative treatments. I can’t imagine myofascial release in that area would be a good idea for at least 6-8 weeks but laser treatments or shockwave might be ok.

I’ve torn my calf muscle several times; the beach experience wasn’t the worst, but did it about 2 summer ago while training for a half ironman and couldn’t run for more than 2 months; maybe closer to 3. It was a bad one, but from no real cause - was running, it cramped up, and I had to limp home. Iced and rested, tested it out a few days later and it was still sore. Took my puppy to a dog show a couple days after that and took two trot steps and heard it pop. Not a cool story at all.

But - I do think that if I had treated it like an injury, I would have been ok - so be careful now. I agree that you don’t want a mild tear to turn into a rupture while vacuuming or something.