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Hi there,
Has anyone had an avulsion of the hamstring? I have been told by GP that is will need to be surgically repaired, but cannot get in to see the surgeon for 8 weeks. If anyone has experience with a hamstring repair, I would love to know about the op, how long after the injury and the rehab.
Look forward to hearing
Hi, sorry about your injury,
I just read an article in J Am Acad Orthop Surg, Vol 15, No 6, June 2007, 350-355. If you can get your hands on the article, it gives a great review of all of the pertinent literature about surgical repair of proximal hamstring avulsions (tearing the hamstring tendons off of the sit-bone). Here is the abstract:
Hamstring strain is common in athletes, and both diagnosis and surgical treatment of this injury are becoming more common. Nonsurgical treatment of complete ruptures has resulted in complications such as muscle weakness and sciatic neuralgia. Surgical treatment recently has been advocated to repair the complete rupture of the hamstring tendons from the ischial tuberosity. Surgical repair involves a transverse incision in the gluteal crease, protection of the sciatic nerve, mobilization of the ruptured tendons, and repair to the ischial tuberosity with the use of suture anchors. Reports in the literature of surgical treatment of proximal hamstring rupture are few, and most series have had a relatively small number of patients. Surgical repair results project 58% to 85% rate of return to function and sports activity, near normal strength, and decreased pain.
If you have a complete avulsion(tear) that has retracted 1 to 2 cm, then most of these are going to surgery. If the tear has not retracted more than that, conservative measures tend to be the better way. If I remember correctly, the sooner the tendon is repaired, the better but some of the cases were out months to years and still had good outcomes.
If you want a copy of the article, I could send it to you.
So, basically, it depends on the amount of retraction of the tendons (need to have an MRI to make that measurement.)
Good Luck!
Hi,
I have rehabed a rugby union player back from a surgical repair of a complete proximal avulsion and he returned after 6 months to play international rugby. Conservative management may not return the player to the pre-injury performance levels however. There are a few case studies in the literature, mostly waterskiing injuries. Considering the level of activity required post injury would nfluence which management plan.
Lise -- I suffered a complete hamstring avulsion (from the ischial tuberosity) on Sept. 9th and had surgery to repair the avulsion on Oct. 3rd. Surgeon said that the hamstring/tendons had retracted only about 1 cm in that time. (From what I read, more significant retraction occurs if repair surgery is delayed in terms of months.) Incision was in the line between the back of butt and top of back of leg, and only about 1 inch wide. He anchored the hamstring tendons back to the pelvic bone with 3 anchors. From what I read, the only option besides surgery for this injury is, essentially, to do nothing and hope that the scar tissue that builds up around the tendon can bridge and (sort of) re-anchor the muscle back to the hip bone. But a lot of complications can arise and scar tissue is notoriously unpredictable. In that case, you cannot ever expect a return to 100% strength in the muscle.
My doctor has prescribed -- 6 weeks on crutches post-surgery, then 3-5 months (perhaps more) of physical therapy to restrengthen the hamstring muscle. He said that, by Spring, I will be "rocking and rolling" and can return to skiing, hockey and all other sports. He said I should expect to return to 100% (or near 100%) strength and mobility.
Just wanted to let you know about my experience and what I've learned to date in dealing with this injury, as well as going through the repair surgery.
Best of luck with the recovery.
Hey, I suffered an avulsion 3 years ago and I still experience alot of pain when I play sports. I was in 8th grade when I had the injury and they decided to treat it conservatively, but after no progress was made I had the surgery about 10 months later. My surgeon reattached the bone via a screw and reattached the tendon to the bone with staples. The screw has since been removed, and apparently everything "has healed fine". The only problem being that tendon doesn't repair with tendon tissue, but instead scar tissue. My doctor informed me that this is probably as good as it is going to get for me. If you have this injury, I urge you to have the surgery done ASAP to prevent migration of the tendon and the bone, which will result in a less successful recovery. I still experience pain even when walking or sitting, especially after intense activity. I have extreme tightness in my injured leg, and it is painful to run. Because of this injury I haven't (and possibly never will) had a healthy day of high school sports.
This injury has been an extremely depressing experience for me, and I wish those of you that have also had it the best of luck.
Beau
I am posting my experience to date so that others may benefit. I completely tore my right hamstring on 9-26-07 [Wed nite around 9:30PM] while playing men's ice hockey. I am 50-yrs old. I ended up in an awkward position of going down into a full-splits position that I couldn't get out of ... my weight and momentum are what tore the hamstrings; I was not hit by another player - just a fluke accident. In fact, I remember thinking as it was happening - "I don't do these anymore" ... felt like a giant rubberband vibrating violently in the upper-back-part-of-my-thigh .... then it just gave way .... I heard no pop. But I went down in pain when it tore off ... I asked a few of the players to try and stand me up .... but I could not stand the pain. I had them slowly drag me off the ice .... so they could play as I waited for an ambulance. Went to ER .... got a heavy dose of pain meds, given crutches and sent home. I literally did not move [used a pee bottle] from my couch for 2 1/2 days [got off couch Sat. aft for 1st time] . Huge bruise - very purple and large show-up by Sat -- covered the back of my thigh. So injury happened on a Wed nite ... following Tues AM finally went to Doc. He said I a severe hamstring injury .... like what water-skiers often get .. and referred me to a Sports Doc-specialst. He did an Ultrasound -- but said injury was too deep ... but also felt it was severe. He took X-ray and ... showed no bone fragments. Had an MRI following Wed [now 2-weeks post op] then Docs eval of MRI by end of 2nd week-post-injury. He said it showed a complete avulsion of the hamstrings w/ about a 5 to 6 inch retraction of the muscle. He recomended that I talk to a surgeon to do repair. It should be noted that this was 2 weeks post-injury; I was actually feeling pretty good and no longer using crutches/walking up and down stairs like normal. When I was told it was a complete tear I was surprised, shocked and sad all at once. I asked how could that be .... I was feeling pretty good? Doc told me ... not unusual because there was actually no more significant healing going on because I had already been thru the trauma of the injury ... and since it was completely tore off ... there was no more healing to do. He set-up appt w/surgeon - Dr. Lee Kaplan - from Univ. of Madison UW-Hospital; who also specializes in these injuries and had just performed the same type of repair operation on UW Football team's #1 receiver - Luke Swan. Luke had his surgery 9 days [Oct. 10th] prior to mine. I am now 16 days post-op [surgery was 10-19]; I actually feel great - no pain from surgery and no pain post op for which I am very grateful . I have been told that my rehab to get back to ice hockey is approx. 6 months - but of course this is an individual thing and I have to realize that I am 50 and not 20. Tommie Harris of the Chicago Bears in the NFL had his surgery in Dec. 2006 and was playing again for them this year. I play recreational men's ice hockey at least 4+ times a week and remain positive about my recovery. I would be more than happy to answer questions about anything I can help you with.
Wanted to offer you something I've learned that might help you. I was told today that I need to get hamstring surgery to repair a torn hamstring and that the hamstring has also attached itself to the sciatic nerve which runs down the leg, and so they will seperate this attachment between the hamstring and the nerve. The pain you decribe is exactly what I feel. Maybe you can talk to another doctor about this - it doesn't sound like your pain will ever go away if the nerve is involved. If you want to do research, it's called "hamstring syndrome". All the studies I've read show very high success rates for people with hamstring surgeries returning to competetive sports, so it seems odd that you are still in pain. Good Luck!
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Originally Posted by beau_zo_brehm
I am now 8 weeks post op, feeling good and anxious. Meet with my surgeon and PT today [12-13-07]; both want to stay with a conservative course of rehab. I have been in the pool for almost 3-weeks doing warm-pool-hydro therapy for approx. 40-to-45 minutes up to 6 x per week [recommended 4x per week minimum] I have been on a bike for 1-week - PT is for 10-to-15 minutes 4 to 5 x per week on stationary bike. PT in both the pool and bike is not to push yourself to cause pain - it should be pain-free and for me it is. And, I have not experienced pain from the repair - however, I do have a "sense" of where it has been re-attached. I have additional leg, abdominal and lower back exercises that are part of my PT routine that I also need to do a minimum of 4x per week. I wore a brace for 5-weeks post op. I no longer wear the brace unless I have to shovel snow. I hope to return to skating and ice hockey sometime in Feb. 2008. At least at this point I get to exercise - for 3-weeks post op I did basically nothing except for a handful of isometric exercises.
Can anyone help me?
I was injured 2 years ago in a waterski accident. I was wrongly diagnosed and told that there was nothing to be done. I recently further injured the muscle. I had a new MRI and the specialist said that the elasticity was so far gone that surgery was impossible. I am undergoing rehabilitation for the new injury with almost no improvement. Is there any sort of replacement surgery available? I am really willing to try anything! Thank you
Quote:
Originally Posted by Lise
I am a new member and not very good with computers! I might be posting this twice! I had a complete avulsion of the hamstring 2 years ago. I was, unfortunately, misdiagnosed and was told nothing could be done. A few weeks ago I further injured my leg. A new MRI was done and the specialist said that the old injury had caused so much scar tissue and had so little elasticity that there was nothing to be done. I am undergoing rehab for the new injury with little success. I would love to know if there is any hope of a replacement or artificial transplant? Does anyone have advice? Thank you!