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Hamstring Avulsion (complete tear from pelvis)

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  • About to schedule surgery

    Hello All:

    Thank you all for the insights that have been posted on this "rare" injury. I was water skiing 26 months ago when I felt the "pop", followed the next day with a bruise from my butt to the bottom of my foot. After 6 weeks on crutches and 13 weeks of PT, I started to run again. I ran my first half marathon in April of last year and thought my slower time was a result of another year of age (I'm now 52). I trained more and ran the NY Marathon last November very slowly with a bunch of pain and tightness. This year after my 4th half marathon I was close to immobile so I went to another sports injury specialist who recommended surgery for my 10cm of scar tissue. I had a 2nd opinion by a Dr who also recommended surgery. I was on the fence until yesterday when I went to my chiropractor (who had been treating me with ultra-sound all along) who also said I should have it repaired. Now my decision is made and I will be scheduling the surgery tomorrow morning hopefully for sometime in December. I've taken note of all the comments posted thus far, but will welcome insights to living with a hip brace and 90 degree knee brace. How do you sleep? Use the toilet? Sit? Etc.? I know you all can offer some practical advice. Thanks in advance!

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    • One week post op and I feel great and pain free but just can't do much with the braces and crutches. The bathroom adventure is well a pain in the a$$. Doctor on Fridayand PT next week. My plan as posted above seens similar to yours. I can't wait to get started.

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      • Ventued Sorry to hear that it took so long to get a proper diagnosis. I have a different brace than most seem to have Mine is around my waist with a rod running down the leg and attached to a piece wrapped around my leg above the knee. Hip is locked at 15 degrees but from the knee down is free. Sleeping isn't too bad with this set up. The bathroom is another story. After reading here I got a portable commode that sits above the toilet. It has hand rails to help sitting down and getting up. A raised seat wouldn't be as useful. Have plenty of wipes handy. I found paper towels more useful to start than tissue.

        Heal well

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        • hi \ventued

          What type of hamstring injury did u have? A complete Avulsion?

          This is why i pushed for surgery from the start with my injury as it is not uncommon for people years down the line to have to end up having surgery in the end.

          It depends if they put you in a hip or leg brace (both do the same job) but leg brace is more comfortable. For the first two weeks it is very uncomfortable. I tended to sleep on my side with a pillow between my legs but after a few weeks you may feel bruises from lying in the same position. Because you cannot get the stitches wet, i tended to lean forwards over the bath and just put one leg into the bath and used the detachable showerhead over my bath to wash (but if you dont have one of these over your bath i would get yourself one of those hoses that attaches onto the taps as you wont be able to have a bath or get in a shower cubicle) but this may only be manageable a week or so after surgery depending on how sore the stitches are when you move.



          Originally posted by ventued View Post
          Hello All:

          Thank you all for the insights that have been posted on this "rare" injury. I was water skiing 26 months ago when I felt the "pop", followed the next day with a bruise from my butt to the bottom of my foot. After 6 weeks on crutches and 13 weeks of PT, I started to run again. I ran my first half marathon in April of last year and thought my slower time was a result of another year of age (I'm now 52). I trained more and ran the NY Marathon last November very slowly with a bunch of pain and tightness. This year after my 4th half marathon I was close to immobile so I went to another sports injury specialist who recommended surgery for my 10cm of scar tissue. I had a 2nd opinion by a Dr who also recommended surgery. I was on the fence until yesterday when I went to my chiropractor (who had been treating me with ultra-sound all along) who also said I should have it repaired. Now my decision is made and I will be scheduling the surgery tomorrow morning hopefully for sometime in December. I've taken note of all the comments posted thus far, but will welcome insights to living with a hip brace and 90 degree knee brace. How do you sleep? Use the toilet? Sit? Etc.? I know you all can offer some practical advice. Thanks in advance!

          Comment


          • Hi Greggo, thanks for info on p/t. Can i just ask what type of injury did u have? You seem to be weight bearing very quickly, was it a complete avulsion of all 3?. I think this forum is quite confusing for people who read up on it as there is a vast difference in rehabilitation for detachment of just one on the 3 hamstrings. For anybody reading this forum, there are different methods/recovery timescales for a complete avulsion (pulling all 3 hamstrings off the iscial tuberosity) to maybe just pulling one or two. I have detached all 3 of them but no bone fragment has come away with them, so i have 3 anchors in my bone and they have been reattached onto that.

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            • Ventued Sorry to hear that it took so long to get a proper diagnosis. I have a different brace than most seem to have Mine is around my waist with a rod running down the leg and attached to a piece wrapped around my leg above the knee. Hip is locked at 15 degrees but from the knee down is free. Sleeping isn't too bad with this set up. The bathroom is another story. After reading here I got a portable commode that sits above the toilet. It has hand rails to help sitting down and getting up. A raised seat wouldn't be as useful. Have plenty of wipes handy. I found paper towels more useful to start than tissue.

              Comment


              • To ventued--and Leggybird et al:

                Hi ventued, I was at the point you are at approx 5 wks ago, when I had the option to continue with PT, and have no surgery, ---or schedule surgery and get this thing fixed. I am also a runner, and ironically I was considering runnng the Austin Marathon next spring (would have been my first marathon) when the waterskiing injury ended that!! During my initial evaluation with PT they told me that I could have some type of non-descript pain at a later date, and they could not give me a good idea of what my functioning would be without surgery--but it would not be the same again, ever. Best estimate was perhaps 70% of pre-injury strength. So... I opted for the surgery and am now 5 wks post OR. I think you are making the right decision. I had the affected leg tied up behind me at a 90 deg angle for 2 wks, which was a challenge...but doable. If you have read the posts you know some of my history here. I too usually slept with a pillow between my legs, and sometimes felt like I would flip myself back and forth from side to side all night like a pancake. I had a shower stool that I propped my injured leg on while standing on the good leg when I was in the shower.
                Leggybird: I had a complete avulsion, but not a bony avulsion--the bone was intact. I have 5 stainless anchors in the ischeal tuberosity where the tendons are attached. I will get some more info from my surgeon, but I was under impression that two of the muscles have a common insertion point, and one of them is just lateral to that. In any regards, I tore the whole complex off!! At PT today, I was on a stationary recumbent bicycle for 10 minutes! Did that ever feel good--then I did a series of 11 exercises. These are just very gentle with no weight or strain, just trying to get the hamstrings to "fire" a little. I am weight bearing as tolerated (which is pretty much), and it is recommended I use one crutch only now, with no crutches starting next week (wk 6). I have to watch I DO NOT slip or fall, which could be catastrophic at this point. But so far so good. Talk to you all later,
                Greg

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                • Thanks

                  Hi All:

                  Thanks for the practical suggestions and your comments. My list now has on it a portable toilet and a shower stool - and with Christmas coming I'm all set. My surgery is set for 12/15 so if any other thoughts/suggestions, etc. come up, please post them. I'll be getting my brace fitted a couple of weeks beforehand and pass on any suggestions they may have as well.

                  For those who asked, I have a complete avulsion that has about 10cm of retraction. A bunch of scar tissue is there and it seems it's continuing to grow (or so says my naturalist chiropractor who has been treating it with ultra sound and still recommended I go through surgery). My surgeon said he may need to graft a tendon if my muscle isn't elastic enough. No matter how you look at it, I'll still be better off than the donor. (yikes!)

                  Greg: I'm optimistic that this is all going to work out for me, so I'll be applying to run the NY marathon in November of 2009. I'm figuring that my 20 week training program will need to begin the end of June. I'll have the 6 weeks in a brace bringing me to the start of February. From February until June I'll have PT going and should be able to log at least a couple of miles a week, so I'm set. I'm also told recovery is quicker if you have something to focus on, so would you care to join me and run a couple of miles at a marathon in solidarity? (If you're focused on Austin being your first one, I'll apply to that for February 2010.)

                  Chevyman - sorry that you're now one of us. Good luck with your surgery and quick healing! (Don't regret going to parents' weekend -the years go by too fast - just as they do while the kids are growing up. I have one in college and one in law school - I used to let them come in before me at half marathons, now at mile 3 they say "see ya".)

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                  • Glad to hear everyone is recovering well. This website/forum has been a big help to me, not only in giving wonderful advice about what to have handy to ease the complications that arise from one leg bounded, but also to know that others are going through the same thing and coming out alive and well on the other end. The long recovery process is rather dark when just beginning.

                    To All: I have a complete avulsion of the semimembranosus muscle from the ischium. My muscle was retracted 8 1/2 cm and started to attatch itself to my sciatic nerve with scar tissue. I now have 2 titanium anchors in my ischium. The anchors were tied to my tendon holding it in place on the bone. I was told no weight bearing/no sitting up for 6 weeks. I hope this gives a clear answer to folks.

                    I am getting so anxious to move around more! I feel myself spending more and more time outside, using my crutches out of bed. It is really too bad I am not allowed to sit up, as I would love to get back to work, even if sitting at a desk would be my fortune. Good luck to all!

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                    • Hey Everybody,

                      I'm getting really excited now. I just got my brace! Wo hoo! It is basically a knee brace, one like you see after acl surgery. They told me the doctor is going to put it at a 45* angle for three weeks, then reduce the angle and see how I feel. They did say that I can take it off when I take a shower and from what I've read on here a shower chair sounds like a good idea!

                      I have a qestion for those of you that have already had the surgery. Is the incision site below the butt cheek? This brace rides high on my leg so I am scared it is going to hit the incision.

                      Ventued, thanks for the encouragement! Good luck to you as well. I'm really looking forward to parents' weekend next week but am nervous about the surgery two days later! I will let you know how it goes.

                      Greg, sorry you did not get to run the Austin marathon. Austin was the last marathon I ran-- back in 1998! From what I've heard the course went back to the harder, hilly one! Hope you get to do it in 2010. I have retired to just running 10'ks and might do a half again after I heal.

                      Thanks to all of you for sharing your stories so us newbies can see what lies ahead! Heal quick everybody!

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                      • Chevyman,
                        My incision is in the crease just below the butt cheek. I have a different type brace that attaches above the knee and then around the waist connected by a rod that keeps the hip at a 15 degree angle. I can bend my leg at the knee.

                        My surgery took 2 hours and I have not had any pain. My doctor had me stay overnight in the hospital but reading here it appears some go right home. It is interesting to see the different treatments for the same injury.

                        I am glad that I had the operation. Now it's just a matter of time to return to normal. You'll be just fine.

                        Heal well.

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                        • Vollmer,

                          This forum has been a great help to me also. I was lucky in that I had an MRI right away and decided on the operation before I had a lot of scar tissue form. I can at least sit up in my brace.

                          I had my first post op visit and the incision has healed nicely with no signs of infection. I was told that I could go from Toe Touch Weight Bearing on my crutches to 25%. Doctor said use a bathroom scale to get an idea of what that feels like. 40 lbs in my case.

                          I had no pain when he moved my leg without the brace. I start therapy on Monday.

                          I will be spending more time outside next week. The internet is a great diversion.

                          Heal Well

                          Comment


                          • I fell,
                            I had my MRI about 3 weeks post op, and my surgery 4 weeks. I didn't really take any consideration to my injury before I met with the specialist and definitely didn't take it easy after it had occured (until of course I was told I would be having surgery). I'm not sure if that had anything to do with the scaring or not. I have touched my leg to the ground a couple of times, and put slight pressure on my toes, but I can still feel it through the entire leg so I always quickly stop!

                            My leg doesn't have much pain when I move it, unless I try and straighten it completely. I can then really feel it in the tendons behind my knee.

                            I HAVE to get outside at least a couple times a day. I walk around the yard and stay up for 10-15 min. before laying back down. Standing on one leg gets quite tiring.....quickly...lol.



                            Chevyman,
                            My scar is about 8-9 inches long. 3 inches of it or so are on my butt cheek. My brace is just a knee brace which starts about 3 inches above my ankle and continues about half way up my thigh. It sits about 3 inches south of my scar. The brace is actually causing most of my problems right now..the straps seem to push into my leg if I lay in the wrong position, and the general rubbing of the skin. My surgery lasted about 2 1/2 hours (this was longer than expected because of my muscle binding to my sciatic nerve) and I was released a couple hours after that. My surgery was scheduled for 7 am and I was out around 12:30 pm. The only complication I had was going to the bathroom for the first time following surgery. They put about a liter and half of fluid in me during the surgery, then I had 2 cans of sprite while in recovery, then drank probably another liter of water in the afternoon. I ALMOST went to the ER because my bladder was hurting so bad, but I managed to push a little out before really going about an hour or two later than evening. Kinda scary at first, and I'm sorry if that's a bit too graphic for some. Good luck!

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                            • PT progress

                              I had PT on Wed 15 Oct, with 10 min on stationary semi-recumbent bicycle--Just to "get the blood flowing" per PT. No resistance, just gently motion that mainly works the quads anyway. After warming up, I do a series of 11 exercises (first week it was 6, then 11, and now 14) where I tighten my quads (which locks knee) and lift the affected leg 8-12 inches. First I lay on back, lift it up, then lay on side, lift it up, then on my stomach, lift it up, etc. I do some gluteal sets and adductor sets to strengthen accessory muscles too, and some calf exercises which don't have anything to do with the hamstring really but part of the whole picture that works together. Various configurations, various ways of stretching. Vollmer, since you asked I will email you the exact protocol for a look--I have not sent yet because it keeps changing every week!.

                              Each time I see the PT (I go 3 x a week) he adds a few more things to do. For instance, today I "march in place" ...very slowly, for about 20 repetitions, bringing my knee up as far as I can. The last few times I did the same thing but was lying on my back. I even do a few "mini squats" where I stand on floor and squat down JUST A LITTLE. So you see, very slowly progressing where I ask the hamstrings to do just a little more. Right now, he says I am ONLY gently stretching the muscle, "waking it up", getting it to fire again. As this progresses, he will start to slowly add weight to my ankle, for example, to actually start the strengthening. That won't happen until after week 6. The unaffected leg is so used to taking the load that I still transfer most of the load to it, and the PT could see that right away--so now I must try to transfer just a LITTLE back to the affected leg. I know what you guys mean about getting up and going on the crutches. It was killing me staying home 2 wks on them, in the knee sling. Only so much "Jerry Springer" shows I could tolerate......When I finally felt well enuf, I put on a pair of padded-gel bicycle gloves, grabbed a water bottle, and went outside for "crutch walks" around the neighborhood! I probably went a few miles, people must have thought I was crazy, but at least I got the heart going a little and broke a sweat. I did this 2-3 times. They told me that blood flow to the area is crucial to healing. Make sure you have ok from your doc before you do this! My advice was "just don't over do it!". With the leg in a sling it was all on the unaffected leg. With time my upper body strength got much better.

                              Ventued, I think that is a fantastic idea, do you really think we could run a marathon after this?? That would be a great goal to set. Perhaps we can find out if anybody else with this injury has recovered to do it. If we can't do that, at least a 10 K somewhere in conjunction with one. Austin will be too early for me, so perhaps the NYC marathon Nov 09 is just about right. I am learning its all about goals and attitude to get thru this--I find now I look forward to going to the rec center to do the PT, etc. My early goal is to do a 5 K about March/April (?).

                              By the way, my incision was right where the "cheek line" is....right in or just below the crease. Stitches removed, and only steri-strips now. Its like clear duct tape. When the strips fall off, they won't replace them. I still have some numbness, and pain when I sit on a chair a certain way (just about any way)--not really acute shooting pain, but just an uneasiness sensation of pressure, that I am sitting on something (which of course I am). That will take a LONG time to go away, and the PT said its because this injury is problematic because we are constantly sitting on it, moving around, etc. I am so used to it, it has become more annoying than really painful. I work I set on a pillow, and use only 1 crutch now. At week six (this thurs) I think they will tell me to toss the crutches...maybe. The exchange here is a great support and I have learned so much
                              till later,
                              Greg

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                              • Wow! This forum is great. Thanks everbody for answering my question. Hope everybody's recovery is going well. I am ready to get mine started, only about a week to go!

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