Hamstring Avulsion (complete tear from pelvis)

[mals]

My son is 14 and he just had surgery yesterday to repair a hamstring avulsion. We're now struggling with the braces. What have others done post-op to immoblize the hamstring - braces? bedrest? Thanks in advance!

[pedro99]

Hi.

It has now been 6-months post surgery to the day since I had my right hamstring repaired. I have returned to playing ice hockey again - and almost at the level I was at prior to my injury (I am at better than 90%). I expect to be at or close to 100% within the next month or 2.

I have been very pleased with the rehab and can't say enough positive things about working closely with my surgeon and physical therapist. I started skating but with restrictions about mid-Feb (2008); I was under strict guidelines not to push-off hard and absolutely no burst accelerations. No slapshots or to try and do difficult shots or manuveurs.

Over the next 2 months I have continued to skate and play ice hockey approximately 4 times per week. I also continued work in the gym/rehab center to strengthen my repaired hamstring. I have yet to experience any significant pain or discomfort from the repaired hamstring. I have been very pleased with the level of intensity of exercising and skating that I have been able to perform.

The only thing I have yet to do is to shoot a hard slapshot; although I feel that I would have no problem doing it - I just have no real desire to. I skate with full confidence and do not think about my injury when I skate; I am very comfortable skating and playing again and have no problems with skating/turning in any direction - fowards or backwards.

My final stages (the next month) of rehab is for incorporating harder skating and burst acceleration, and sustaining higher speeds. I have been able to achieve burst acceleration and harder skating with no problem; and have successfully skated after and beat other players for the puck and skated on breakaways.

I hope this helps keep others feeling positive about working hard on their rehab for a hamstring avulsion. I have also heard that Luke Swan (football injury) has done well with his rehab too. I was told that my recovery-rehab would be 4-to-6 months back on the ice and playing again; and that is what it has been.

[Rod]

Pedro99 and others,

I had my (partial) rupture of April 3rd. It was very painful. I was alone and out of town, and all I managed to do was climb into bed and collapse for the night. Next day I was able to browse for answers on the Net, and I was afriad that it was a rupture based on what I saw. I decided to visit with an ortopedist in Aventura Hospital in FL (that is where I was), who was really no good and misdiagnosed it as not a rupture. He asl owanted to start PT right away, a bad move as i understand now. Back home, I visited a specialist in Sports Medicine, M. Krauss, who did a superb job at examining the injury and correctly diagnosing it. The MRI later confirmed: two gone, one still attached.

He referred me to to P. Sallay, a surgeon in Indy who is one of the experts in this type of surgery. I was operated exactly two weeks after the injury happened. It was done with Titanium anchors and sutures to the muscle, which is pulled toward the anchors. Up to now, am extremely happy with the treatment. I am trying to stay in bed as much as possilble. When up, I use crutches and a harness. I do feel considerable stiffness in the lower part of the hamstring. It is hard to be confined to bed, but I am afraid of damaging the repair or hamstring by moving too much. It would be great if Pedro99 could offer some specific advice on the first week to 10 days after surgery. Did you feel some stiffness of the hamstring as well? How long were you immobilized?

My sports are yoga, tennis and running. In the future, I will comment on my performance here so people can have another view from a patient. Pedro's has been helpful to me. For those academically inclined, there are papers describing the surgery and its results. It was reassuring to see that my doctor had published his experience with surgery in academic journals.

[aspenjohnson]

I just spent 45 minutes with a reply and got logged out and lost it - "dohhh"

I'm a 39 year old male and I had a near complete avulsion of the semitendinosus hamstring while waterskiing on June 9th, 2008. It was reattached on July 3rd - 24 days post injury. It was 11cm avulsed, so a second incision down the leg was needed (a few inches long), in addition to the typical higher incision following the buttocks.

The post surgical pain has been minimal - especially compaired to the initial injury. I only needed 3 pain pills and I am 8 days post surgery. Discomfort is more in numbness and limitaions, and the brace itself. Knee brace set at 60 degress.

The one thing that I wish I was better prepared to deal with, is the thing that no one wants to talk about: evacuation procedures. First of all, the incision along the crease of the buttocks is very close and vulberable to the evacuation area - know what I mean? Fecal matter in a wound could be awful! Trying not to extend the injured leg or put any pressure on it, while trying to sit on the toilet, is next to impossible, and the pain is nearly unbearable. The entire process is awkward, messy, painful, and unavoidable.

I got a raised toilet seat from physical therapy before I had surgery, but realized that it was going to be even less stable and didn't allow me to sit and evacuate on just the one cheek, so I never used it. Best suggestion I have is - just do it! Don't wait until you are constipated (pain pills will constipate, so get some mild laxatives). Also, wiping and cleaning up is easier once you are standing - have plenty of anti bacterial baby wipes on hand, and plan your showers for afterward.

I am completely off my feet until Monday - staples and sutures removed 11 days post op, and we'll see what the doc says then. No weight bearing for a couple of more weeks at least, I am expecting. Six weeks post op until I can start physical thereapy is what he said before. I would love to have the brace off as soon as possible, but wonder what the risk is to injuring the repair.

Quick recovery everyone,

Vince from Colorado

[Randy]

I just had surgery on Thursday July 31st. I'm in a brace and have been restricted not to put any weight on my leg. I?m spending most of my time trying to get comfortable in bed. Today, I took my bandages off and have about a 12 inch scar. I didn't think that it would be quite that long. Post op pain as been moderate to severe, controlled by about 8 500mg vicodin a day. I have been eating extremely light because with the pain and the brace I don't really care to tackle the toilet. Purchased a rubber ring and hope that it will help when the need arises. I retracted one of the hamstrings 4 months ago and finally, after seeing 8 physicians, one felt he was up to the task at hand. The pain I experience prior to the surgery was disabling. I fortunately have my own business, but could only work about 5 hours with a few Vicodins on board. I know what you all have been through and wish you all the best. Still not sure why I have such a long scar.

[aspenjohnson]

Hey Randy,

Sorry to hear about the injury/surgery. I am now 1 month post surgery. This has been a trying experience. I suspect that the length of your incision is due to the further avulsion of the muscle. I had a second incision that I wasn't expecting, and that is because they couldn't retrieve the little bugger. They also couldn't re-attach it at the ischial spot, so re-attached it to another muscle half way up the leg. If your incisions are anything like mine, the bathroom ring won't do you any good. The ring would have just gotten in the way. Like I said in my post, the best thing to do is just get it over with. If you have your brace on, you're not going to hurt anything, but expect some pain! BTW, at about 2 weeks I could tolerate the pain and well, going number 2 feels like I've been doing it my whole life - lol.

I was told orignally that I wouldn't be able to start P/T for 6 weeks, but got the go ahead after 3. The first session was painful but fine, and felt good just to be out of the brace. I had a lot of knee pain which surprised me, but that was because the knee doesn't like to be imobile that long. My second P/T session was a bit intense and they really stretched things out. I had some bruising and swelling from it and checked with the doc who said it was some micro tears, and to just back off a bit on pushing myself. I also tried full weight bearing/walking after getting it stretched out, and caused some more microtears and bruising. After one week of P/T, I am laid up again with little activity - mostly fearful of further injury, although they say that I am past the point of easily doing that - bar a fall and full extension. Lesson learned - don't push recovery too fast!

Keep us posted at your recovery Randy and good luck. Hollar back with any questions.

Cheers,

Vince from Aspen

[aspenjohnson]

In case you didn't know Randy, those Vicodin will stop you up really bad - make sure and take some laxatives before things get out of control!!!!!!

Vince

[Randy]

thanks vince, I've been on them for months now, and take an overcounter med that works fine. I'm looking forward to the next few days, when in theory, I'll be completely off all pain medications, except ibuprofen.
did you have this procedure, and if so how long was the incision? I didn't think it would be 12 inches.

[Randy]

Vince:
Just saw your other post, and now know that you did have the procedure. thanks for the advise. I have read that the Drs, usually try to use 3 anchors to attach the tendon to the tuberosity. My dr was able to use one anchor, and told my wife that there wasn't room for any others.

I've already put the blow up ring in the box and will have my wife return it this week. I will try to keep everyone posted on a daily bases on my progress. I hope it will be helpful since it is a rare procedure. My Dr. even said, we will both learn as we go.

[aspenjohnson]

I'm not exactly sure why, but my Doc also had me stop the ibuprofen after 7 days - he said it was important to let the natural swelling/healing occur - just might want to check with your doc on that. I can take tylenol extra strength, but haven't taken anything except a couple of aspirins since 10 days out. Lot's of water though (and I hate drinking water) to help hydrate the muscles. Also after initial healing of the incisions (once they take the stitches and staples out), you want to keep the incisions moist, but don't start putting a bunch of stuff on them. Don't be scared to get them wet, and a little bit of baby oil is alright, or something with no perfumes, etc., but watch out for a bunch of the miracle scar creams and what not. Staying hydrated will probablly help that as well.

Cheers,

Vince