Complete avulsion of hamstring

I had surgery on a complete hamstring avulsion in September 2013. I was 32 and extremely active so surgery was my only option to be certain I could continue my intense activity. Surgery and rehab were extremely successful. I was able to train and run the NYC marathon in November 2014, almost exactly one year after I started walking again post surgery. I continue to run, play sports, and weight train. I get pain sometimes but am not limited at all. I hope this helps! If you work hard, follow your rehab plan and ease into it, you shouldn't be limited in your activity.

I feel for you.  I had a complete avulsion repair at the end of March and I can tell you that it will get easier to do the things that you normally do.  I say that because it has only been in the last few weeks that I've been able to sit on a toilet without leaning from  the affected side. For the first 6 weeks, I used alot of ice packs.  I'm still not able to put on my left sock and shoe, but I am seeing progress in being able to reach my foot.  I understand that this type of injury is one that can take a long time to heal and I will probably be limited in some of the things that I do.  I'm 51 and from the first consult with my surgeon, it was a given that I would need surgical intervention.  But I was surprised when he told me that I would not need therapy.  I still have constant pain and am rarely comfortable unless I lay on my stomach.  I want to begin building my muscles in that leg but I am so wary.  I can't afford to miss any more work and was forced to go back earlier that I should have.  I wish you the best and want you to remember that it will get easier, I promise.

                                                                 

Hi: thanks for the encouraging words. However, it sounds like you are not all that happy, if after more than 2 1/2 months you still can't sit on a toilet, and have to lay on your stomach to be comfy. That actually does not sound all that encouraging. But, I will see how I am recovering. Weired that you still dont have any therapy...

Anyway, hope you improve soon! I will share my recovery as well.

Not sure who you mean by you all? The recovery is very slow research shows that greater recovery and return to sports after surgery than without. But recovery can take 6-12 months patience is the key a tendon takes much longer than a muscle of bone

Also we are all in pt just at different rates since the protocols vary so widely

For me, I had a raised toilet seat at home that helped a great deal!  it sort of sits on top of you toilet seat and is raised so that you are not having to bend so far over - plus, with bandages and your incision, it can get tough to use a bathroom initially (at least it was for me, as a female!) It's dealing with public bathrooms that was difficult!  I never appreciated handicap accessibility so much!  I was in a leg brace and crutches for almost 8 weeks with no weight bearing so I spent a lot of time sitting and in a recliner when home.  I was not allowed to remove the brace at all - i put a chair in the shower and got a removable shower head to help and showered the best i could!  the mobile shower head helped a lot!   Be sure to keep moving though!  Getting up and moving around helps reduce post surgery complications!  

     I'm actually alot happier than I was just a month ago.  And eventhough sitting on the toilet is still very uncomfortable, I do feel improvments in my overall condition.  It's more frustrating than anything else. 

     In just the last few weeks, I've noticed big strides in my recovery.  I'm not taking anymore pain meds, although there are times when I've wished that I still had them. 

     My surgeon told me that he didn't believe that I would need therapy and to me, that sounded odd.  So I've taken it upon myself to do some therapy on my own.  I have a friend who is going to get me some therapy bands and then I'll try my eliptical machine.  

     I want you to feel encouraged, knowing that even though this is a process that requires patience, you will be fine.  I'm still working on my patience.

Larry

 

get a 2nd opinion about therapy it's very important and you can really hurt yourself without the proper guidance

Hi, my PA suggested that I get some egg carton foam and cut it to put on the toilet seat. It really helps and when your done you throw it away! She also suggested I get some memory foam pillows for sitting on. I did get the memory foam but it's still rather uncomfortable top sit. I had surgery one week ago today. I hope your surgery went well!

Hello! You are about a week and a half ahead of me. I had surgery a week ago today for the same injury. I'm not wearing a brace either and have been directed to walk using only small steps, then at 6 weeks, I'll be able to walk with a normal stride and then at 12 weeks I begin PT. I'm off pain meds and have been laying around too. I had hoped to be able to return to work soon but reading all the posts, it doesn't sound realistic. Good luck in your recovery. Ill be watching the posts so please check-in if you learn anything interesting.

Hi! Thanks to all who posted re the avulsion. Are you walking with small steps without crutches? I am walking now with 50% weight bearing with crutches, and just a slightly smaller stride than usual. However, at 2.5 weeks out I am able to sit comfortably with just a standard chair cushion. This makes me very hopeful that I can return to work in 1.5 weeks. I will need someone to help me with carrying charts and things as I cannot carry anything of substance with crutches, but most of my job involves sitting. Let's keep each other posted!!!

Hi Teri, I am not using crutches. The surgeon said I would feel like I needed them right after the surgery but that I would probably find them more of a bother after a couple of days - which is exactly what occurred. My injury, from water skiing, may not have been as bad as yours. I had more than an 80 percent tear from the ischial tuberosity with a 4 cm retraction. My restrictions are small strides and no bending at the waist with legs straight. Sitting is definitely an issue. Upon suggestion of my surgeon, I bought some memory foam to sit on, which helps a little but is certainly not comfortable! A concern since my job is primarily sitting.

I have my first post-op on the 16th so I look forward to learning more details of the surgery and recovery. I'm not allowed to drive at this time. I look forward to reading about your progress!

Hi! Have faith re sitting. The difference for me between 1.5 weeks and 2.5 weeks with sitting was incredible. There was no way I could sit at 1.5 weeks, but now sitting comfortably. The incision healed quite a bit during that time as well. I am now just using a pillow or chair cushion and it is fine, even for hours at a time. You sound like you are doing really well, I am sure you will be fine!! Best, Teri

So happy I finally found something about what has happened!! I'm a firefighter/ paramedic who has been training for an Ironman. I was running when I fell 8 days ago and completely tore all 3 of my hamstring muscles off. I am very physically active. Run, cycle and swim daily! I am devastated by this! I am scheduled for surgery July 6. I'm in crutches but have a hard to getting around due to the pain and still van not straighten my leg. Does this sound familiar? I am unable to ait on my right side due to the avulsion. This is all a nightmare. Any idea how long I will be out of work?

I'm 10 weeks post op 57, was in great shape skating 10 miles a day at 5 min mile pace, and started saber fencing this week I'm walking 6 mil at 16 min pace without cane; still no hoping, jumping, stretching, running, linging lifting anything more than 20 lbs can't engage hamstring yet, no loading or suden bursts, can do all upper body work outs and floor exercises planks and puch-ups; free weight but again not heavy enough to engage hamstring. this is a devestating, and heartbreaking  injury- this too shall pass but not as quickly as any of us want it to and you can undo your surgery if you try too much too sooon!!!! You may need to be on leave from work longer than you'd like (

I had a feeling it would be a very long recovery. I can be on light duty teaching paramedic school which is a good thing. It just disappoints me that I ruined my chances of competing in the Ironman

How has your recovery gone? 

​I am 7 weeks post op tomorrow.

​Michelle

Hi Teri, I hope you are doing well and that your surgery and PT has been successful.

I salute all the brave women and men that have taken the time to share their stories and build a community while helping other sufferers of tendon tears and avulsions.

My story is almost identical to yours.  I was standing on an old unmaintained tennis court and stepped one foot forward to toss a frisbee to my dog , and the foot kept sliding and I fell down into a "perfect split."

I am 58, very active with bike riding , volunteer work, water sports ( windsurfing and wakeboarding   and occasional water skiing .

Nearly  identical 3.3cm  avulsion of common tendon off the ischial tuberosity .   All muscles sprained, and semimembranosis tendon also stressed.

Edema of 16 x 6 x 5 cm contacting sciatic nerve - you all know it hurts.

Thanks to everyones' comments I immediately asked for MRI and got it quickly.

I am less than 2 weeks post injury.

I am considering surgery and weighing + / - of getting surgery vs letting it heal, and living with the issues that may likely cause.

Here's the Questions.

Asking the folks who did not do surgery :  

What issues are worst for you now , and how was your recovery?

How long did it take for the awful sit-bone pain and hematoma throbbing to diminish ?

What are your top ten tips to get through this ordeal ?

Asking  those who got the repair surgery:

What are the preparations my wife and I need to make to make the recovery manageable?

When could you go up / down one flight of stairs?

When did t

Before the surgery, Should I get someone to install an overhead bar, or large rings to grab while getting up and down from bed?

How hard is it to be immobilized with both a hip flexion brace and a knee flexion brace for 6-8 weeks?

How tough is it to rebuild muscles after the immobilization atrophy?

What tips for  using the potty (#2)?   Overhead grab bar?  Elevated booster seat?  

How close are your incusion(s) to the BM zone and what tips have you learned?

Does it make sense to Buy an add-on fanny sprayer for the toilet, and get it installed pre-surgery?  (The sprayer we use is controllable   And keeps the water centered over the mid-line.   

I have No clue how close the incision dressings are to the BM zone.

When were your surgery dressings removed ?

How do you sleep with braces on?

Did anyone have 2 braces ?

Was your surgeon able to relieve the hematoma as a normal course of the surgery?

How was your wound care and maintenance ?   

What type of incision did you have ?   

What are best dressings for wound care?

What lessons were learned with PT?

I bet it us easy to gain weight.  What are people's tips on weight gain avoidance (portion limits and no sweets?)

I hope that our kind community can contribute to my upfront learning, and that together we can build a great list of

must-haves and suggestions for everyone.

We all feel bad about our injuries  , but our ability to support one another and share lessons- learned is truly a god send.

Many thanks , blessings, and best wishes to all.

WallyWhoops

Sylphs,  How are you doing ?

I posted my story and am deciding whether or not to do the avulsion repair surgery, but am Leaning in that direction.

Uh oh, on crutches...., I shouldn't be "leaning ."

Can you please look at my post and pass along your hard-earned wisdom?

I am  trying to build a list of pre-surgery home prep and also learn any other tips that may help myself and others 

thank you for your kind contribution to our recovery community !

Wally 🍌 Whoops 

Hi FFMaka,

How has your tendon repair surgery gone?

I hope you can briefly share the lessons you have learned  as a result of your surgery and recovery so I may put together a list of suggestions .  

These suggestions may include: changes to make to your sleeping and bathroom areas to make life easier ,  Things you learned in PT,  things to ask your doc before and after surgery , or any  topic.

I've put a list out on our site in the hopes of collecting people's "lessons learned: how to prep for and succeed with your tendon repair surgery"

This activity is only to attempt to contribute to the group, and also help me prepare

Thanks in advance for your input!

Wally🍌Whoops

Walt, 

​I am going to respond to your questions for the Post Op group. I will do it in pieces as my session keeps timing out and I keep losing everything I typed. 

​1st my history: 46 yr old complete avulsion of all hamstring. 5 cm retracted. Post op 4 months , was treated as bad tear riginally. Learned month 3 it was not attached. Had reattachment at 4 !/2 months. My detachment occur running after a ball. My hamstring was very degraded from previous injury and a lot of strain from and undiagnosed hip issue ( had that repaired 6/2016)

I was in compression stocking for 21 days. Had brace for 6 weeks. Slept in it but had no trouble . It was 1 piece. It attached at waist and leg restricting movement to 30 degrees 

I was also on crutches post op day one ( which I did not know would be the case) 

I remained on crutches about 8 weeks worked down to 1 crutch and eventually cane. 

 

Things you must have:

Elevated cut away toilet seat

Sock slip

​Flushable toilet wipes

​a good grabber

slippers or grippy socks ( you can not slip or fall!)

​I also had a wedge that my husband picked up at a medical supply place. I used it under my head and shoulders to give my neck a break and allowed for slightly different positioning. 

​Gatorade for day of surgery and post op day 1 to replace electrolytes

Incision: Will be vertical or horizontal depending on the extent of repair.

?mine was vertical. They preach keeping it clean and dry. This is where flushable wipes come in handy. 

?I had a clear surgical covering on my incision area. it was replaced with a new one  day 10 when they removed my staples. They don't want you to fiddle with it .

My bleeding absorbed . My leg was concord grape colored

​Sitting is very unpleasant and nearly impossible in the beginning. When I got out of brace at week 6 I was able to start driving. It is less than comfortable to drive in the beginning.  

An interesting point my surgeon shared with me was that at 4- 6 months post detachment the amount of function you have gained back is about the amount of function you will have going forward . For me at month 4 post injury hearing this made surgery a must have.

PT:

​I was evaluated month 3 for PT. I was not cleared for it. It is a case by case basis. It takes 6-7 weeks for hamstring to be semi secure

# months to be fully scarred in to place. The scar tissue is what ultimately holds it in place

I was allowed at 3 1/2 months to start using my elliptical NO resistance. ( or stationary bike, or walk, no resistance)

​At month 4 , which I am entering now, I will start water therapy.

​At 5 months post op I can add resistance to my elliptical use. 

​My post op appts were at roughly 2 weeks post op, 6 weeks, 3 months and 6 months.

Other pointers 

​I stayed in a pull out bed in my livingroom to avoid using stairs. They wanted me to avoid stairs as much as I could so my pullout bed was a great advantage mas my bedroom is upstairs. 

​As for rehabilitation I have been told over and over again it is a slow process. My hamstring was unused 6 full months. Tendon is slow at healing. The forward moment is there though an just about as I reach my boiling point with frustration I turn another corner.  

 

Walt, If you have any other questions I forgot to cover please ask. This is a difficult recovery in that is not a common injury. We need to support one another as you spoke about. I have had a tremendous support network around me which was really helpful and has got me through. At this point I have been living with this injury and surgery repair combined 8 months. Each day I am one step closer to where I want to be and I am happy to help with information any way I can

Hi Michelle,

How wonderfully kind  and supportive for you to share so much information! I sincerely thank you. 

Your recovery sounds daunting.

I wish you the best and Want you to know you will have another person in your corner pulling for you.

 The information you have provided is great.      I have a similar house configuration, but fortunately have a small guestroom in the downstairs bathroom and agree with you about the stairs. 

Relaxation "meditations" help with attitude and getting centered:

My wife turned me on to listening to YouTube relaxation meditations.   By listening to these before I go to bed and whenever I feel a little down I am able to reset myself to a good place.

There are many different topics from relaxation, to stress relief, to positive reinforcement healing..... and the Aussie accents are nice to hear.

It is so easy to go to sleep by, and our brains still take in as we sleep.

I wonder if other folks on the group have similar methods.

PT and kinesiotape :

 One of my daughters is the physical therapist, but she lives 150 miles away. 

 It is amazing that many doctors do not appreciate how doctors of physical therapy (DPT) today have vast  anatomy and body mechanic training far beyond that of  orthopedists. 

 The tricky part is finding a good physical therapist. 

 My daughter told us that we could relieve pain and perhaps speed the hematoma resolution by finding a DPT  Who is experiencing in the usage of elasticized 

Kinesiotape.

 I did some experimentation that may be useful to others after my DPT daughter explained the goals and overall method of using this technique.

 I experimented by gently pulling on all different areas of my thigh and hamstring , from the  crotch all the way down to the knee .

Anywhere that I felt some pain relief, I marked it on a crude diagram outlining the specific area, and in which direction I was pulling.

 My daughter said you can also use a pen directly on your skin and indicate the direction that you're pulling  once you find an area that provide some pain relief. 

I found a good PT locally, and Asked them to  please tape me up with kinesiotape after they did a full Eval.

I  shared the diagram, and she applied Kinesio tape which she pre-tensioned at various force levels along areas I had identified.    

 I asked her to explain the anatomy of the tendons and muscles and asked her if there may be other areas she could try to use the tape  to stabilize the structure. 

 She taught my wife and I a lot, and let us videotape her as she explained the tensioning of the tape, cutting of it and the geographic landmarks that she was applying it at. 

 So far, I have gotten really good pain relief and a much more stable feeling after the work that PT did with the tape. 

 Best of all, you can buy the tape yourself from Amazon and you can find YouTube clips about the usage of this kinesio tape .

 So far I have seen four doctors, and none of them thought it would be significant. 

I guess we all use the tools of our trade which is why the docs do not think much of it.

It is relatively inexpensive and it is very unlikely someone can hurt themselves by using it.

Have other people on our group found this to be useful?

I love that we have tools that we do not need the docs for, so that our mental outlook is not tied to someone else..... we are not helpless.

Then again, I am just beginning this unplanned journey .

Thanks again for the kindness you have shown to this Newbie!

" Wally 🍌 whoops "

did you have surgery? is there anyone here who did not have surgery for total avulsion??? i am 51 fairly active running (light) after several hiccups yesterday in preop i actually got scared x cancelled surgery! my dr said i seem to be scarring and have no nerve involvement so with pT shod gain full functin but w leg weakness

so its uo to me. help!!!! im scared either way

so would love to hear from someone who has Not operated with conplete tear greater than 3cmm

find the Facebook group Proximal Hamstring and Avulsion. It has wealth of info for surgery or Non surgery route.

we have a couple doctors in that group too and it is world wide

what is your retraction? is it all 3 tendons?

thanks for reply yes all 3 with 3.5cm bufemoral and 1.5 semimembranous what was yours? did you operate? i found fb it helps too all info welcome

yes, I did have surgery. all 3 tendons avulsed , 6-7 cm retraction.

A bit of background, I chased a diagnosis for 4 1/2 yrs for a hip issue and PHT( proximal hamstring tendinopathy)along w a previous partial tear.

My 1st surgery was to repair my hip. I did not understand at the time how truly damaged my hamstring was. a year into the hip recovery I detached my hamstring. So my situation was not from an accident. I had the previous tear, pht and later in my hip recovery I was having a lot of pain in hammie when exercise walking. Dr later explained my hammie had been slowly tearing more and more.