Complete avulsion of hamstring

Hi Celia.

Sept 26th I slipped while in Mexico. Needless to say I tore a 9cm hole in the middle hamstring.

I returned home the following day and a day later I went to a walk in clinic. Had an ultrsound and xrays. Initially I was told a complete tear and a consultation with an orthopaedic surgeon said no surgery.

I was in so much pain they booked me with a sports medicine Dr who did another ultrasound and it was discovered that was was not a complete tear...but worse. There was no option for surgery. The ultrasound also showed a giant hole 9cm and my body had absorbed all the original blood that should have acted like a scab. Something to mend the hole.

I was offered PRP (platelet rich plasma) treatments. They draw a fair amount of blood. Separate the platelets by spinning it in a special machine and under tge guidance of the ultrasound, inject it back into the hamstring. It's not cheap. And it's not covered by OHIP in Ontario. $600 per injection. After having 2 we did another ultrasound 4 weeks in and found it had healed from 9 to 2.6cm. So I opted for a third injection. I have also been seeing on of the best physio therapists around. He used to be head physio therapist for the Toronto Maple Leafs and later the Coyotes. Both my Dr and Chris know the injuries well. I was told mine was on of the worst they've seen.

So greats Dr. And proper physio were key.

I never missed a day of work.

Last week I was given the clear to return to the gym.

I was told that 2.6 may never heal without the PRP

My advicell...find a sports medicine Dr and speak about PRP. I am wiling to spend anything for quality of life

Good Luck

Hi, sorry to hear you couldn't have the surgery, your injury mirrored mine but I was fortunate that

I was put in touch with a nerve specialist, a Mile Fox from Stanmore (lovely man) who agreed to debride the sciatic nerve

if Prof Haddad would reattach the hamstrings, luckily he agreed.

Sitting is a nightmare even with a memory foam cushion, I still get a stabbing pain in the buttock when I bend forward putting on shoes and socks,

as for walking, still odd and painful, after 25 sessions of physio, I have improved but there is still a long way to go. If I was treated appropriately at the time, things would have been different!

Wow Lynda Prof Haddad reattached your hamstrings? Brave time for you & even though you are still having issues sure you will get there. How much had your hamstrings detached? & how long after your injury did you see Prof Haddad. I saw him 5 mths after my fall. He said the physio I had from Sept 2014 to Dec 2014 didn't help as they were treating me without an MRI/XRAY (which I asked for at my very first apt as internally my leg felt so bad) But told you have a significant hamstring injury go home and do these excercises, walk go back to work. Think it aided my hamstrings to go further down than were probably at the start to be honest. It's very sad as was only 47 when I did it & it has basically stopped my active, both in work & home, life. Think local dr's/hosp should be more aware of listening to how the patient feels. What they say.

I hope you do get relief from your discomfort sure you will as do know that nerve endings etc take ages to settle down.

Hi, I had my injury July 2014, but it took months before I had an MRI which showed the unusual tear, 1st consultant I saw said I was too old (59) and didn't ski or play tennis so I didn't warrant an op, got a 2nd opinion Dec 2014 but after months of physio, injections, he decided to refer me to Mr Mike Fox (a friend of his) I saw him in Oct 2015 who agreed to operate, if Prof Haddad agreed. I didn't even see him at his clinic in Jan 2016, he agreed to do it without me seeing him, due to getting the two consultants available at the same time, took until June 2016, I was told it was retracted about 6inches and there was much scar tissue around the sciatic nerve, hence the large scar.I was in a right state, couldn't drive,walk, sit, sleep, had to cut work to two part time days, even now I can only manage two days. No one appreciated just how awful it was and still is. I complained about the initial diagnosis, a minor tissue injury, and got an apology from the hospital, but the damage was done, I just have to get on with it. I realise that I'll never be as fit as I was but I 'm doing my best and not give in. I'm only sorry that I didn't make more of a fuss at the time and that no one was really interested as it wasn't a typical injury and easy to fix .I dred to think what I would be like now if I didn't have the good fortune to see Mr Fox.

I do hope things improve for you.

Hi Lynda

I do feel for you. You feel exactly as I did. But I'm frustrated as never met anyone nice. Except prof Haddad who was so sorry. Pleased that you got hope re surgery etc.it was a year after you I saw him. He was appalled that local NHS didn'tt identify it. The London hosp pick up on it straight away apparently.

Your right I wish I made more of a fuss too. But at the time you trust who you speak too. Nice to get an apology. A&E I got as far as a triage nurse & sent home after 2 mins. The she went out for a cigarette. Just shows the flippancy. I wish u well and I find to deal on it on a daily basis. Not preempt this injury. As it can bring it's horrors with one hamstring not supporting the hip etc. So I hope another year goes by for you & you feel more comfortable. Take care.

Hi again,

Just out of interest, which hospital did you attend in the first instance? I went to Watford General via ambulance although Stoke Manderville is closer, mind you the outcome still may have been the same! Also how did you settle on seeing Prof Haddad as before I got to see Mr Fox I couldn't find anyone who specialized in hamstring avulsions.

Take care

Hi Lynda after my horrible fall in Aug 2014 my husband took me to the Conquest hosp A&E. Sadly got as far as a triage nurse. Sent home after seeing her for 2 mins. Told to see my Dr. My Dr had sadly retired. He would of taken me seriously. Next day my husband did take me and we saw a Dr in the practice which I didn't really want to see as had a bad reputation. But I was very desperate as in so much pain & inside my leg it didn't feel ok at all. She gave me very strong painkillers told to go home and rest and she'd refer me to local physio therapists. Following 2 weeks saw a physio therapist. Where I still couldn't get an MRI. Done what I was told. By Dec 2014 I was in a mess. Saw a endoscope practitioner who was very worried. Talked of DVT etc. Bowel and bladder problems. Said I needed an MRI. At last!! I was told my MRI would be Feb 2015. I had a right go!! As was beside myself by then. Got MRI Dec 2014. Got the bad news. It really frightened me. So I emailed all the orthopedic secretaries in London for some hope! I got an email recommending prof Haddad I asked my new Dr to refer me to him and she did as was & is very sympathetic. I saw him Jan/Feb 2015. Told it was too late. That's my story. Very frustrating, painful, stressful & life changing time really. As I'm sure you understand. Hope you getting there? I did have under prof Haddad & Rosie Tanseys recommendation 18 mths of physio here locally. My hamstrings have rolled down 11cm & connected themselves in my leg & I pray they don't atrophise anymore. On my right side of my knee I have partial detachment but hopefully trying to be active keeps them working to bend my knee and walk!! Bending down for things is terrible. But like you must do you improvise try to cope. Wish you well. Louise

Conquest hospital Hastings East Sussex I went to. It was bank holiday noone in A&E except my husband & I round 10am so the triage nurse could of given me time. Sad really. But it's happened. Can't go back. Wish I had gone in an ambulance like you.

Hi, All. I'm new to forums, so I probably posted this incorrectly.

I hope everyone is well. In comparison to others' struggles, mine is minimal, I know.

I guess I'm hoping someone has a brilliant idea.

I have been searching for others with similar situations--hamstring complete tear or avulsion that was not surgically repaired. After reading your posts, I realize that I've experienced a similar approach in the Eastern U.S.  I was a runner (jogger is more correct). Tripped and fell in March 2016. No MRI,  No xray. The Dr. decided it wasn't an avulsion or complete tear based on a clinical/observational exam. She prescribed conservative PT for 8 weeks. I came to find out later, complete tear of entire hamstring muscle group in the left leg with 6.5 cm. tendon retraction and inoperable and partial tear in the right leg...I think if I were younger or a professional athlete the outcome would have been different. I would have been sent for MRI and surgery would have been possible.

I'm nearing the 2 year mark---and I'm struggling to reclaim my identity and ANY level of fitness-- I'm wondering if anyone has ideas or hints- now that I'm closing in on 2 years,  I'm able just about able to walk at a typical pace for a 46 year old, though I have daily pain in both legs and I am prevented from regular and helpful exercise. There are things I cannot do and will not expect to do (pushing my father in a wheel chair, mowing the lawn, running to catch up with my 1.5 year old nephew, carrying things that need bending/lifting with the legs. Gained 40 pounds (sorry, US measurements) in less than 2 years due to inactivity.

Thanks,

Heather

Hello, I’m hoping I can help. I got reconstructive surgery 1.5 years after my injury. My function is much better than it was prior to surgery. I cannot run for long distances, but I also was never a runner. I was in a similar situation where I was only given an X-ray, no need for an MRI even though I was in significant pain, had a large amount of bleeding, and had a huge lack of function. Finally went to Mayo Clinic with Dr Chris Larson a year after my injury. Please look into surgery if you’re willing, and also stand your ground and advocate for yourself. If you’re not where you want to be, don’t let a doctor tell you that you shouldn’t have certain interventions because they don’t seem you active enough. 

Hi Heather,

Have you considered seeing docs that are associated with dr teaching programs?    I think they might be able to assess and help you decide risk/reward of surgery.

Thanks to this forum teaching me, I saw 5 docs and I also insisted on an MRI right after the accident .     If I did what 3 of the docs suggested it would be "do nothing."

Most sports ortho docs never see the kind of complete hamstring tendon avulsions we all have had , they are not trained in repairing them , and perhaps it represents a liability risk for them to do surgery ?   If that is correct, it is easier to say all the things we all have heard :

You don't need surgery .... only an athlete would get this surgery, etc etc, blah, blah.

In contrast , the docs that are part of a big teaching hospital (like Duke, in NC, or many other educational institutions) have a different mission than the sports ortho docs.   These teaching docs have more experience with injuries that the ortho docs don't treat, since those docs refer their cases to the teaching docs.

i liked what Tania said about Mayo Clinic, because they are excellent , but too far for me.

They are probably better than the teaching hospitals because I have heard their surgeons are not compensated based on the number of cases they do.   Also, I have heard the docs work as a team and do not have a competitive environment of churning out as many surgeries as possible.

It is sad that docs don't ever say things like: "I do not treat this kind of case but if you go to facility xyz they definitely do treat this."    It is easier to say the stuff about age, or athletic level as their method to side-step.

Why should they do this surgery and have liability risk when they can do a couple hip replacements in less time?

I hope you find someone within a distance you can travel to.

I guess we all have to be our own advocates and insist on MRI (or whatever) to try and define what is wrong with us rather than assume the doc we see will work in our best interest.

I think we were all raised to believe the docs want to help us, but they all will have their financial motivations , and liability risk is part of that.

I wish you the best and hope you can update us in your doc search.

The doc that is helping me is a hip doc that is under 40 but indicated he had done more than 25 of these avulsion  surgeries.

The only other doc I found that knew how to do them was older and had only done 5 cases.   He was in a sports ortho practice.

Blessings and best of luck to you,

Wally  🍌 Whooooops!

PS1- Yes, I make fun of myself for falling into a split tossing a frisbee on an old slick tennis court 

PS2- I am pretty confident in my assumptions about docs motivations.   I know I could be wrong becaus I have not lived in their shoes.   However, I have seen quite a bit that leads me to my conclusion.   My wife agrees and she is smarter than I about why people do the things they do, so I trust her judgement more than mine on these matters.

Lots of cudos to you Walt-whoops for your understanding explanations and humor of the institution of the medical field. Matches up with my many years of experience! 😳

Very impressed with your ability to fight for the correct diagnosis and never let anyone intimidate you ! And yeah I too had the three strikes against me plus the age thing and one extra issue the "Pain medication issue " ....which the medical community automatically adds on....if dibilitating crippling pain is involved. 

Thank you for sharing your story. I truly get it....👍

Sending you many healing blessings your way and hope that you receive all that you need to sustain you thru this journey.

 Hugs 

Hope4Cure 😊

I got hurt at my work on the job at Amazon they stated it was their fault I slipped on the floor because it was a brand new building with glossed a concrete and the reg that was there had polish that area when they pulled the rug up I was the first one on it did the split they sent me to there workers comp doctor which is Concentra the doctor said it was just a hamstring strain and put me immediately right from him over the physical therapy and for 2 weeks 3 times a week but my legs started bruising tell her the whole thigh was black and blue painted he said oh I think I want to get an MRI he didn't do any X-ray and first or an MRI he just made his determination of what it was after the MRI he seen that it was an avulsion the complete hamstring torn away from the tuberosity so no tendons attached to my bone centimeter is 3.5 away he said because of my age and I'm not an athlete I'm 54 that I don't need to have surgery or that he do it if I want but there's no need it seems like a really risky surgery so I said no he said well don't stay where they're at and scar to the surrounding tissues I said I'm okay with that he also stated that I'd be back to myself be able to lift 50 to 75 lb like I do it Amazon and be back to work in about maybe 2 months I workers comp lady said if you don't get the surgery then we're going to close your case and that got me scared so I was like okay I'll do surgery I can't be left where I'm at right now cuz I know I can't do my job where I stand now is I'm really mad I feel like my work doesn't really care

How many of these surgeries had this surgeon done?

I am concerned bc if he was very skilled st this surgery I don't think he would be saying the things he is to you.

I live in New Hampshire, USA and I had to go to Boston Massachusetts to find an experienced surgeon.

Your Dr is NOT correct in telling you you will be fine in 2 months. This can be a life changing injury that needs to be addressed

I am sorry you are under so much pressure.

Hi H4C!

It sounds like you have been through something none of us have- artificial hip implant, then problems , then removal/replacement.   Wow.   Sorry to hear that.

I can imagine docs getting $ incentives (and working within a legal conflict of interest ) installing prosthetics that they are involved in developing/promoting .

I really can't imagine a fix.   I can see the dr and companies point of view...... but, from the patient point of view I sometimes feel like we are glorified test subjects , being sold that joint replacement (or other challenging surgeries) are no big deal.... 

Was your situation within a major university health system?

I have much experience being a patient in a huge university health system.  

The health system promotes themselves vigorously with commercials to convey that their health care is "cutting edge."

Funny way to describe a caring healthcare system!

I've found that the docs main mission is to teach their students and improve the prosthetics which they may be developing. 

I really feel like the patients are a necessary complication for the docs to have to deal with since their mission is educating their student docs and Improving surgical methods and prosthetics under development. 

I can understand why these docs  only have limited patience to help their patients.     

It has to be easier to dismiss the patient who is in pain or has many questions since this could imply the doc could have done a better job during surgery or in clinic.     

Any doc in a teaching hospital has to have some amount of ego having a flock of "baby docs" in tow.

The easiest path for docs like this may be to act like the patient is the problem.

I do not know as much about sports medicine docs in private practice.    I am sure there are many good ones .

Best of much not being pigeon holed by your health card team and finding a way to get the docs to listen.

My wife taught me these methods to deal with the doc and get the best care from them .

I needed this input from her because she said it works  better to :

Act a little dumb when you see them because they get defensive if you act too educated

Believably Demonstrate that you value their input and guidance 

Appeal to their wisdom 

I have found it has helped me.

I want to share a quote from the tediously long voicemail loop within this health system on-hold greatest hits:

"Be sure to ask about our minimally invasive , cutting edge spine surgeries ...."

That is a really telling advertising slogan Indicative of the systems sensitivity !

Or..... maybe I am too sensitive?!