Hamstring Avulsion (complete tear from pelvis)

[dccoffman]

Hi Everyone! I've taken a little break on here due to a family emergency- dear cousin diagnosed w/bone cancer. She's going to be getting some excellent care now and that feel wonderful.

Everyone's progress is so exciting, it's hard to believe how far some of you have come in such a short time!

Jackie and Paul, my doctor ordered my brace on Wed., but that's all I know. I'm frustrated because I don't even know if I see him again before surgery. I'm really going to push for answers on Monday. I email his assistant and she tells me that my questions are very good and that she'll forward them on the Doctor and that's the end of communication.

H2O, thanks for the encouraging words. I really enjoy your daily posts as my surgery is getting close. What did you mean by, " my hip brace came yesterday and my knee brace is off"? Doe a hip brace include a knee brace or do you just wear one and not the other? How is the pain? Are you on pain meds still? Are you still in the hospital? If not are you just lying in bed all day at this point? Can you sit up at all with the hip brace on?

Does anyone know the answer to this question? I have a lot of pain still on the back of my knee on the injured leg. On the good leg there is a tendon that I can easily feel on the outside back of the knee, on the injured leg there is no tendon. Does anyone know if that's normal, or could it be a separate injury. It's a good question for my surgeon, but I'm not sure I'll have contact w/him before Aug. 31.

Paul, which leg did you injure?

Dra, Paul recommended a good comfy chair for sitting a while back. He ordered it from Staples. Paul, do you still think that's chair to have? If so, I'm going to order it today.

Renee

[PWJJ]

Hi Renee,
So sorry about your cousin. My father had bone cancer and my brother is fighting cancer so I know what you are going thru, it is not easy. My brother goes for another CT scan today, this will be the first time I am not there with him in 7 years.

Keep after your doctor about your questions. Obviously you need to not alienate them, but you also have important issues you need answers to, so use very friendly persistance.

Sounds like your tendon question is simply a result of your avulsion. If the hamstrings are no longer connected at the pelvis and retracted there is obviously zero tension on them and you would not feel them very much behind your knee, while you will definitely feel them on your good leg. Think about when your Doctor examined you, I bet he felt behind both legs for comparison. I know for a fact I couldn't feel mine on my injured leg, which for me was the left. Now, after my surgery, I can. In fact my PT has me place my hand there to feel them and monitor whether or not I am activating them while doing exercises when he doesn't want them firing. You can clearly feel the increased tension. Likewise while bending my knee he has me monitor the increasing tension on them so as not to go too far. While rehabbing, so far most of my pain is from the patella and knee ligaments, but what is present from the hamstring is more in the area behind the knee as opposed to the surgical attachment point which one would have thought to be more likely, but actually isn't. All that said, that's just my particular case, you should definitely ask your Doctor about it.

Don't know that I would just order that office chair without trying it first, everyone is different. And in my case the chair I normally use was one of those ergonomic ones (Heman Miller Aeron) that has a hard front edge and a mesh bottom with no padding so it was a huge difference. Don't know how that differs from what you normally use. And it's only for at my desk and main computer, not particularly comfortable for just sitting, some of my LR chairs are better for that. I don't have one but many people have said that their recliners are the best for regular sitting comfort.

Hope everyone has a good weekend and continue haeling fast.
Paul

[h2oriding]

POD#3 Renee They did not have my hip brace on the day of my surgery (probably because I am in such a rural area that the rep isn't here very often) but the rep for the brace came and fitted me at home on POD#1. I woke up from the surgery with the knee brace on locked at a 90 drg angle. It was just to keep me from moving the leg too much imediately post-op and keeping tension off the hamstring. I do not have to wear the knee brace at all now that I have the hip brace on. Also if my surgery time had been earlier in the day I would not have had to stay overnight. It was scheduled for 430pm and actually was delayed until after 6pm because of another case. So I expect you will not have to stay overnight unless yours is more involved which I think you said you may need a cadaver tendon which would be more involved so I am not sure what will happen in your case.My surgery lasted about 2 hours. As far as meds go I am now up to going 6 hours between my doses of oxycodone (I started at every 3 hours the first day) and I took just one valium before sleepinng last night and none so far today but I haven't done much activity either. I am going to attempt to shower later so I will probably need one after that. Sleeping with the brace on is not easy and no I can not sit with the brace. it keeps the hip from flexing. So I am pretty much in bed except when I get up to go to the bathroom. That is a challage too and I have no advise for that you just have to find the most comfortable position for you. Also get yourself one of those grippers so you can reach things if you drop them and also helps to scratch you lower legs and dress yourself. They are only about 15 bucks and well worth it. Overall my leg still feels better now even though I am not usung it much yet. Just having that lump off the back of my leg from the muscle being colapsed feels so much bettter. I can move my foot all around witout pain. oh and I am on an aspirin a day to prevent DVT they also gave me one shot of Lovenox (blood thinner) before I left the hospital. I am sorry to hear about your cousin. But hopefully this info will take some stress off you for your upcoming surgery.

[h2oriding]

POD#4 Managed to shower last night. did ok; the hardest part was getting out of the tub (had to grab hold of the curtain bar and jump over the side.) Also wraped my dressing with saran wrap to keep it semi dry per my MD.Today I decided to venture downstairs and that was exhausting. There was no comfortable way to sit even though i have a pub style dinning room table and could put my one good cheek on that easily it got uncomfortable pretty quicly. I think a tall padded stool might be good.I was wiped out by the time I got back to bed. Think I spent all of 15-20mins down there. Not really painfull just very tiring. I have just had one oxy so far today so lessening those pain meds as much as I can. I don't really like the way they make me feel.It is going to be a long recovery I am already going stir crazy. I have watched way too many movies done too much Sudoku and I already have my exercise bands attached to the bed and working out as much as I can. i can only hope going downstairs will get easier soon. Anyway, hope everyone is doing and you all had a good weekend.

[1crankygirl]

Hi All, name is Kim, new to the forum and absolutely thrilled I have found you. I completely tore the hamstring off the pelvc bone by not paying attention and slipping down my front steps. First thought it was a simple strain, got up and continued to feed livestock. When i tried to get out of bed the next day and couldn't, I knew i was in trouble. After a quick trip to the ER and several doses of happy drugs later, x-ray showed bleeding (bruising) and possible internal tear. A couple days later the wonderful words "pelvic avulsion (evulsion) made their first appearance. I will be visiting my first orthopod this Thurs and after reading everything on this site, pretty much expect surgery of some sort. What I really need to know is, are there specific questions besides how many of these have you done before? That i need to ask. I am 42 years old semi active female (meaning no super X motocross riding for me) and recently moved to MT from CA. Any and all help y'all can give me will be greatly appreciated. Also, even though the ER doc gave me crutches, it does not hurt to do small amounts of walking, even with out the pain meds. The pain kicks in when i am sitting, standing or lying in a position that hits that softball size knot right at the juncture of my thigh, pelvic region and buttocks.

[PWJJ]

Kim,
Go read my post #1969 on page 197 for some questions to ask. You should bring a written list and someone else with you to help remember all that you hear. Make sure you speak to someone who has experience with this injury.
Paul

[dccoffman]

Hi Paul,

How did your brother's CT scan go?

I'm sure you are right about the "lack of a tendon" issue. It's just hanging out until it gets reattached!!

I thought you just ordered your chair, so I'll go try some out at Staples this week.

Question- are you able to do any house work? You are almost a month out now right? I'm trying to judge how much I'll be able to do to help my family at your stage, is the reason I ask.

Only 8 days until my surgery.

Hope you had a nice weekend!
Renee

[dccoffman]

Hi H2O,

I love hearing of your progress, it's so interesting and encouraging for me as my surgery is coming up very soon. I can't believe that you got to have a bath so soon! At least that's what I think I read, but I cannot find it now.

Regarding my doctor's prediction of a 3-4 day stay, I'm hoping that's his "worst case scenario" but it also could be because I live about 3 hours away from the hospital where he will do surgery. On his website he says that he check all of his patients 3 days post surgery and I"m guessing he may just want me there to check me. Other wise I'd have to spend 6 hours in the car, could be wrong about this too. He seems like a very conservative doctor. Am fairly concerned about our lack of communication. Am going to try Paul's advice of friendly persistence. That's a wonderful term and I like the idea, so I'll let everyone know how it works for me!

Your posts have taken a lot of the stress on me! Thanks so much and have a great day!

Renee

[dccoffman]

Jackie, would love to hear how you're dong?

Kim, I'm just amazed at your lack of pain! You are very lucky. The softball sized knot is probably your muscle. Mine was large like that for weeks, but now it is a much smaller lump back there. Just to let you know I fell on July 9 and at this point I have very little pain and can walk around short distances just fine. Sitting is pretty good, provided I have the correct chair. Walking any distance over 6-7 years or walking on inclines or uneven ground is very difficult. My leg just no longer works right. It is also numb in a lot of places. I'm 48 and semi-active and but I just feel too young to never hike with my kids again or walk in a mall or go camping. All my kids are still at home and I even have a preschooler to keep up with, so I really want to get back to my old level of activity. I'm also tired out when I try and do much of anything. I really think it's from trying having my leg to contend with all the time.

Good luck w/your ortho and I hope he's seen this injury before. My experience was that 4 doctors (one was a highly recognized ortoho) all told me NOT to have surgery. They all said it was too risky and that PT would be fine for me. The PT and members of this group felt otherwise. So I saw as fifth doctor and he told me that if I wanted to avoid significant pain and disability for the remainder of my life, then I needed to bit the bullet and have the surgery. He was adamant about the need for surgery. He did not mince words whatsoever. It's so hard to volunteer for the amount of short term disability I'm going to have from the surgery, but as Paul said, don't sacrifice the rest of your life for some short term inconvenience (or something close to that). And that's just the way to look at it as far as I'm concerned. I'm having my surgery in 8 days and as far as I'm concerned, it cannot get here fast enough. I'm ready to face this and start my recovery.

Good luck to you and let us know how it goes at your appointment!

Renee

[PWJJ]

Hi Renee,
You sound great and have a great attitude, I love it. You will do fine, albeit there will be some low points-but you will do fine.
My brother went for the scan on Saturday which is easy, but we don't hear the results till Wednesday which is the usual pattern. That is the appointment that is most important for me to be with him just in case it is not good news. Unfortunately I will miss that for the first time in 7 years also, as my wife is having surgery (gallbladder removal) the same day. Couldn't reschedule either of them. I am praying that he gets an all clear, and I think that will be the case-but you really never know.

As far as daily routine, I am at 3 1/2 weeks today, but from the get go I was getting around on crutches, although just to the bathroom and back, and to get icepacks from the freezer the first couple days as there is discomfort and you tire very quickly. From day 5 post surgery I was alone all day and it was fine. Made my own lunch etc.. Helped that I have a wide wingspan and could move dishes from the fridge to the counter and microwave and counter to counter pretty easily. Alot will depend on your kitchen layout too. Even able to use the stove. But you're not going to be carrying any dishes around, I slide them from counter to counter and stand midway between obstacles and lean the crutches against the counter and pass things from hand to hand to get past the stove and cabinets to the next counter. And EVERYTHING takes a HUGE amount of time. What took 2 minutes and was done without thinking, now tales 10 minutes and careful planning. Was able to open sliding doors and let the dog out. I washed dishes in the sink and unloaded and loaded the dishwasher. By lifting the bad leg up behind me I could even reach down and pick up things from the floor. Can carry most things in a plastic bag or tote-but very carefully. You'll figure stuff out.

However-I only have the knee brace. With a hip brace you will not be able to to bend down to the dishwasher for example and certainly not pick up something from the floor. I have to believe you will be severely limited in what you can do in comparison, and will need someone there. (Now that I think of it, with a hip brace I wouldn't have been able to even get icepacks from the bottom freezer drawer). And with all your kids, as opposed to it being just me, you will have a much more difficult situation. I would think you will need to arrange for daily help as much as possible, especially timed to your kids schedules, you can always cut back if you are more able. Get your support system in place. I have no doubt your regular daily routine makes mine look like a vacation.

One thing that I really don't know how to figure in, is that you are far far more mobile and advanced after your injury than I was. After my injury there was no chance I could move anywhere at all without full use of the crutches. I could barely get out of bed. So maybe that bodes well for you after surgery, as I was much more comfortable and mobile after the surgery with the brace on and maybe you will be even more so since you were ahead of my curve before the surgery. But the surgery might just equalize everything out. And again, I only have the knee brace. If at all possible you need to get your brace to try. That will answer all your questions as you can try it yourself in real situations. If you can't, simulate having it and really take note of how often you bend at the waist in all your daily tasks-it's a lot. All that said, I am hoping to the max that you don't need the cadaver graft and don't need the hip brace. But always plan for the worst and be prepared, and then you can be pleasantly surprised if it doesn't happen.

Sorry to bring up negatives, here is the positive: At 3.5 weeks, with permission from my PT, I can remove the brace in the house and really practice walking with a normal gait, it feels great. In fact I am almost fully wieght bearing on the bad leg. (OK, so the almost fully weight bearing I will have to confess to him today. Probably will be justifiably scolded.) Of course one must be very careful, but my mobility and comfort level is vastly improved. Of course I have removed every possible obstacle on the floor, all throw rugs and runners etc. and my pup can't understand why her toys are no longer scattered everywhere. Now if I can just eliminate the involuntary stretch issue that I think is setting me back every day. I need to talk to my PT seriously about it today as I had a bad episode yesterday morning.
But overall I am highly encouraged by the progress. And as I mentioned I was driving at day 13, not difficult with it being my left leg injured. It will be long haul but I can see a difference every day and every day gets easier with the daily tasks.

Again, you have the right attitude, spirit, and motivation and will get thru this well.

Best to all,
Paul