Hamstring Avulsion (complete tear from pelvis)

[janemarie]

Dear I fell.

All went well with Dr Cohen. He is truly amazed on how well I have done. I walked in with some heels on and I said well if you can walk in them then all is well. I have no pain at all. I am still weak in the hamstring but I have such great flexibility it is incredible. I can put my knee to my chest on the affected side either standing or laying down.. I am less the 12 weeks post op. I will return in feb for my 6 month check up and then I am done. I am smart and dont do anything that might harm this. i really know my limitations and adhere to them. I can begin in the next month to jog on the treadmill and continue to strengthen the hamstring. I have never has one regret. I know that ball coach is trying to decide. I hope he feels comfortable with whatever his decision is. But I believe I would not be able to do much of anything that I am doing now had I not had this surgery.
I feel the same way that you do with helping other people with as much information as possible. This forum was so helpful for me. I cant thank the people on the site enough.

I noticed that the building was almost complete. How far to you live from Riddle. Maybe next time we could meet for a coffee.


take care
Janemarie

[BallCoach]

Thank you all so much for your continued responses to my questions. I went to see a Dr. in Denver this morning for a second opinion and now I'm more confused/frustrated than I was. He is a high profile doc and works with some professional sports teams in the Denver area. He basically told me I didn't need to do anything, should start PT and come back in 6 weeks. I'm totally baffled since my MRI shows I have a complete avulsion. He said he can tell it isn't completely torn by his physical exam (I had tightness with a straight leg raise) I'm not sure he looked at the film and said since I didn't have bruising (I'm 3 weeks out, but never did bruise) and am walking around, that I'll be fine. He said I wasn't presenting with the symptoms I should compared to the MRI report. Truthfully, I felt like he blew me off and wasn't well informed on the injury or treatment of it.

I've read the article you all suggested and it seems that either I fall into the completely avulsed (all 3 tendons) OR possibly still have part of one tendon attached. Now what? I've had one surgeon tell me either we do surgery next Tuesday OR go into a hip extension brace to let the torn tissue heal properly. And the other surgeon saying I'm fine and don't need to do anything. This whole thing has been extremely frustrating and I can now understand why it took so many of you all so long to get diagnosed/treated.

Any input you have for me would be greatly appreciated.

[BallCoach]

I thought I'd ask if anyone knows of an experienced MD in Colorado who they would recommend. I've made so many phone calls and still the most I've found that anyone has done is 5 repairs.

Thanks again!

Also, Janemarie...thank you for your input and yes, I'd actually love to talk to you about your experience, it seems very similar to mine. If you'd like, would you mind emailing me at coaching4him@comcast.net and I can contact you? Thanks!

Lisa

[Jay M]

Ballcoach,
Wow, you are getting a lot of conflicting reports. Well, I had one tendon partially attached and I chose surgery. I feel great and I'm 9-10 months post-op. I know that, I absolutely made the right choice. I'm pretty sure I would have chosen surgery even if I had two tendons attached. Keep in mind that without surgery the hamstring muscles will certainly not re-attach to the correct origin which is on the bottom of the hip. They will adhere to the surrounding tissue and fascia. With any luck, they will not surround the sciatic nerve, which is basically going to be in close proximity. At best, your hamstring will be only as strong or secure as the remaining tendon is. Also, if in the future the remaining hamstring tendon does rupture/avulse you may not have the option to have the hamstring repaired. Surgeons are MUCH less likey to want to do the surgery on a chronic avulsion than an acute one.
With surgery, you will have the tendons re-attached to the correct location. So, this means that as the tendons naturally adhere to their natural origin, your hamstring muscle will certainly be much more secure and stronger. The worst part of the surgery is (in my opinion) wearing the brace and it sounds like you're not going to escape this one way or the other. These are some things to keep in mind.

Hope this helps,

Jay

[I Fell]

Ball Coach,

I had the classic bruising with my avulsion but was walking pretty well and had good strength in my leg when tested. The pain was almost gone ewo weeks after I fell. I talked to on othopedits who was the non surgical doctor i the praxtice and he recommended a consult with the surgeon. he said either way I would be in a brace for 6 weeks and the PT would be the same. Only difference was an overnight stay in the hospital. From the stories here of those that were misdiagnosed or just tried to rehab it seems that surgery is the best bet. The sooner the better. I did all the reading I could find and made up my mind to have the surgery. When the doctor said "I can't tell you that you have to have surgery" I was thrown for a loop after having made up my mind to have it. He then went on to explain the things that could possibly happen without surgery. All things that have been expierenced by the people here that delayed treatment. Those stories weren't available a year ago. He went on to say that with with surgery I would at the minimum have most of my strength back. It was Friday afternoon and he said that if I decided on surgery he wanted to do it on Monday. As Jay said, the best results and easiest operation is as quick as possible. I don't know how old you are but at 61 I wasn't going to go around the rest of my life with a limp and less than maximum achievable strength in my hamstring. Maybe you can have the first doctor set up a consult with Dr. Cohen. I'm sure the MRI is probably on line. Might cost a little more but Dr Cohen has an interest in this injury and seems to be getting excellent results. Let me know if you need his number. Best of luck with your decision.

Heal well

[I Fell]

Janemarie,

So glad you are doing well. I am more flexible now in both sides of my hamstrings than I ever was.
I was done at 6 months also. Hard work but moderation is the key. Be careful in the snow and ice when it comes.

I live 15 minutes away from the hospital. When you go back in February let me know and maybe we can get together for a cup. Maybe the new facility will be open by then. I would like to stop by and see the new rehab center. Hopefully I won't ever need it by the people that work there are great. I usually stop by when I visit my doctor.

Heal well, Ned

[Jay M]

Ball Coach,
I think that I Fell's idea about a consult with Dr. Cohen is an excellent idea. If they are willing, you could send the MRI and just see what he thinks.

Good luck,

Jay

[BallCoach]

Thanks I Fell and Jay! I think your idea of a consult with Dr. Cohen is great. I would feel better knowing that my Dr. got some input from one of the experts in this area. If you have his phone number that would be helpful. I found him on the internet, but looks like he is at several clinics??

Thanks for your support, it has been invaluable through this process.

[thomasstuart]

Hello Friends.
I read your entire post it is good 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 water skiing injuries.

[CAF]

BallCoach,

I want to reiterate what everyone else has pretty much said - surgery is the best option, especially if you are even mildly active. I had a complete avulsion water skiing on July 6th, was mis-diagnosed from 2 Ortho's until I forced an MRI from 1 of them. The MRI confirmed what I had suspected (I had previously found this site). He had never seen it before and actually told me i should "Google it" to find out what to do...wow! From there I had a hard time finding an experienced doc in this injury until I found Dr. Joyce in Glastonbury, CT. He works with several pro athletes and teams as well as the UConn Huskies. He had done many of these and has developed a rather aggressive protocol for rehabilitation.

I had severe bruising and was walking a bit better w/little pain when I walked into the hospital for surgery on August 6th. I had no brace and started PT the day after surgery. PT being pretty basic at first working on quads, calf's, etc. I followed his protocol exactly and Tuesday night I actually played by first game of full court basketball, exactly 4 months after surgery. No pain at all. It is still somewhat weak and I was going easy but I did play for over an hour with no pain and I felt great the day after.

Bottom line, I wanted to encourage you or anyone who is contemplating surgery vs waiting it out that surgery is absolutely the best long term option. I will also reiterate the idea that maybe your doc could call Dr. Joyce and/or Dr. Cohen who both have a lot of experience in this surgery.

Good Luck!

Charlie