Complete avulsion of hamstring

Tania,

Did the surgeon you saw indicate how much of your ongoing symptoms are due to the long period that went by between the injury and the surgery ,versus the severity of the injury, or a combination of factors?   

Do you have nerve pains, and wee these worse initially after surgery.

(I have some  nerve pain, my retraction was only 4cm, and my surgery was only a week ago, 5 weeks after injury)

As an athlete, it is very sad and disturbing you were misdiagnosed.   What did they tell you after your injury?   (You've seen what they tell the older people : "unless you are an athlete it isn't worth fixing..."

Please tell us what the docs at Mayo Clinic are like.  I have heard they often work as a team and have a better standard of care than most settings.

Keep up the strong will and good attitude!

Wally 🍌 Whoooops

Hi Walt!

The surgeon did not indicate to me how much of my ongoing symptoms are related to the long period of wait time vs the severity of injury; however, the study that my surgeon did on these injuries indicated that the recovery is much better when seen acutely. If you would like to look up the study, just google Dr. Chris Larson "Management of Chronic Proximal Hamstring Ruptures." This seems to me that my symptoms are due to the long period before being correctly diagnosed. An achilles allograft was used because my tendon/muscle had atrophied so much that it would not stretch back up to the initial insertion point. This essentially lengthened my tendon as a whole. My muscle itself is now shorter, and I think that has a lot to do with my symptoms. If I had not waited, the allograft would not have been needed in the first place, as there would not have been any muscle atrophy. 

I think if I had gotten the proper care initially, my ongoing symptoms would be much less severe, given that most of my symptoms are from lack of strength/control. I do not get nerve pain; however I can no longer sit on a bike seat, as that is where the surgical screws are with some sensitive scar tissue. Sitting for long periods of time will also irritate my hamstring at the insertion point (2+ hours). The only real pain I get is from over-use/tendinitis in other areas of my hip. Sometimes I will feel a pinch or a tug from the site itself, but thats when I know I really need to take a step back from activities to stretch and re-strengthen the muscle, as the tendon is being over-worked at that point. The muscle itself weakens very quickly. 

It took me a long time to get over my anger and frustration with the MULTIPLE physicians I saw that dismissed me. Sometimes I wonder if it has to do with the fact that I am a minority female... but thats another issue entirely... I was told that it wasn't needed, that it was just a sprain, and that I would recover in a few months. 10 months later in PT, there was no improvement; however, my body did compensate well, as I could walk easily, climb up and down stairs (even though more difficult than usual), and walk up and down steep hills (again with more difficulty). When I was finally diagnosed, the docs said that they normally wouldn't do surgery, that they had never seen this injury before, and that I should continue doing PT. They said it was likely that I would not snowboard or figure skate again. I pushed back and they sent me to another doc where he sent me to Dr. Larson. 

The docs at mayo clinic were very helpful and responsive. I had both Dr. Larson, his PA, and his anesthesiologist taking good care of me, as well as multiple nurses and doctors prior and during care. I flew up there from VA. At the time, Dr. Larson was the only one that I could find that had actually done the chronic reconstruction surgeries (2014). Dr. Larson and his associates are accustomed to having patients from all over, and they knew very much what to do (the next pt he had was from Saudi Arabia). The nurse followed up with me regularly after surgery via phone. I was also given a local ortho to follow up with, who was updating Dr. Larson as I recovered. 

Thank you! Let me know if you have any other questions. Good luck in recovery, and stay positive! It's a long road, but I can't tell you how amazing it felt to do my first squat after 2.5 years of being inactive and then being able to get back on my snowboard (definitely had some tears in my eyes!!). 

Tania 

Hi Tania, I don't blame you for being upset , and you are really smart to figure out some way to let it go.

I am 58 and it took me at least until 55 to learn to let things go.

Since your surgery was more than 3 years ago, I'd love to know about when you didn't feel odd  nerve sensations.... 9 months after surgery?

That first squat at the 2.5 year mark must have been something!

I Wouldn't be surprised at all if the docs didn't listen to you because of being  a "two-fer".... a woman who is non-white, but also, you are young so technically you are a 3-fer.

Doctors get p***y with me because I am super curious and love to understand everything  I can.   Invariably, docs will say To me: "are you an engineer?   You guys make the worst patients, so

Many questions... argh."

I have a couple ideas you probably thought of.   You can make a custom seat cushion with custom cutouts for the sit bones.

This might provide significant comfort enhancements so you can get past the 2 hour sitting mark and even have less pain.

You can also make a custom bike seat that has the same properties.   I am thinking , if you know the space between the sit bones and create openings that are between 2-3" , have layered memory foams of different densities covering it, you will eliminate most of the point loading where those sutures attach.

I do not know how to PM in this interface but if you do, I'd be happy to share my "annoying-engineer" ideas.

I also want to tell you a couple of great stories about dr experiences but there is

No way I will put it out on the web.    My Mom was with me for one , and my wife for the other.

It has taken me so so long to realize that most docs are not that different than a car mechanic or a plumber.    The main difference is, if a tradesman messes something up the customer sometimes has recourse to get the problem resolved.    If a doctor screws something up , we patients seldom have recourse.

If some of the docs I have dealt with went to get their car serviced and received the same kind of care the doc provides to his patients the doc would have a fit!   "This wasn't diagnosed correctly!   That wasn't fixed!  This is unconscionable!"

When the doc does it, they duck, cover, and can snidely explain that what they do is "an

Art."       No wonder it is called "practicing medicine ."

I have had some good docs , but so many marginal ones.   My wife and I joke when we see another doc : "I think this one was getting Cs and Ds.   Low end of the bell curve."

Statistics dictate that we should not expect most docs to be the As and Bs of the class.  There are more Cs and Ds out there!

Best wishes,

Walt 🍌 Whoooops  🍌 

 Walt ... You are absolutely spot on with your defination of the differences between doctors and mechanics. I spent many years of coping with some misdiagnosed joint and tendon pain and ended up with a recalled hip implant because the mechanics in the design failed. This particular design was implemented to help with the ease the installation for the "Artsy Talented Surgeon". He would take less time and receive a huge donation $ from the Manufacturer for using their design.

Sorry to all the engineers out there but a bit of mechanical failure was in the design causing my hip replacement components to be subject inumerable problems / pain and led to another hip joint replacement and more complications. 

Maybe we can all get together and write a book on doc's with all "A" reports on their web sites. I once wrote a truthful negligent report on a orthopedic surgeon Yelp site grading the surgeon with -5 ??  on the review page. Wouldn't you know it the next hour I checked the site and my review was deleted. Surprise! 😱

I am very sorry you and Tania had to cope with so much of the muddied waters. Dismissal of patients who have serious issues are in my state catorgized as pain medication seekers. You know those opiates that help releive pain! Yet we are not given or ask for pain meds just want to have our lives back and find out why we are suffering??

I am very proud of you both for not giving up and becoming your own self advocate. Seems like we need to be detectives these days to find the long triad  to recovery.

hooe you both continue on the better side of recovery and back to life as usual?😃👍

Hi Walt! 

Yeah its really difficult, and I'd be lying if I said I have completely let it go. 

Could you be more specific about odd nerve sensations?

And that is actually really funny, because I studied biomedical engineering in college, I am also guilty of the tons of questions. Docs should be prepared for people to be asking questions... I think its only fair if they're going to be diagnosing and treating me. 

Yeah I've thought about that but I don't even know where to start with the custom seating for bikes! I would be super interested in some ideas from you! And if I'm being honest, it's kind of embarrassing to be around my fully able bodied 24 year old friends, and I'm walking around with a butt cushion... haha. So I've been kind of sucking it up with that one... stupid reason I know. 

And that is so very true, especially of ortho docs. I'm planning on going into medicine myself, and from my experience shadowing/my own patient experiences, some of them can be very careless, especially if the patient isn't interesting enough of a case. I have also had some really good docs, and some that are just plain dismissive. It gets hard to have to stick up for yourself so much with this kind of stuff. 

One of my family friends used to say "You know what they call the person graduating last in their medical class is? A doctor."

I see that you PM'd me, but I also wanted to respond here. 

Tania

Wow Tania,  I love what that family friend said.  It is so true.

I will start 2 new threads about:

Post-surgically , first 60 days:

Who has experienced any unusual nerve sensations?

Describe the pain and how it changed over time .

Post-surgically , middle time frame 2 month - 1 year:

Same question as above.

Also,  do you have pressure point sensitivities and how big are they and where are they?   What do they feel like.

Post-surgically, more than a year:

Same questions as above

I want to be able to build some expectations .

The odd nerve sensation I am having which started at day 7 after surgery and is continuing @ day 10 is :

Numbness with an overlay of what feels like a really bad burn .

As the numb area slowly gets smaller the burning area gets bigger.

I am having some swelling which I try to address with men's compression underwear.

I am optimistic these pains will all abate as time passes.

Please let me know if you (or anyone) has better ideas .

Best wishes to one and all.

We are not all alone thanks to this great Community.

Wally 🍌Whoops

Walt,

I had one region that was totally numb after surgery but it was right away. That slowly cam e back over a couple of months ( I am post op 5 months)

The burning ,well I had my share. What I am wondering is how restricted are you? I was in a brace and needed to lay down most of time for 6 weeks .

Whenever I moved a little too much or "wrong" the burning increased. I was told the body is trying to build scar tissue. When you disrupt that it burns, the body then sends in fluid which causes more discomfort.

Wonder if you are trying to move around too much??? It takes cwry very little to p**s it off in the early days and weeks of recovery.

Thanks Michelle,  I really appreciate your note and insight.

I think you are right, maybe I am moving around too much.

I should ask everyone :

What limitations did your doctor put you on , and for what period of time?

What kinds of nerve pain have you experienced and how did it change over time?

My doc said I can 50% weight bare and that I can use a rollator walker on wheels.    I didn't want my wife to always have to wait on me so I have been shuffling around my house using the rollator.

Maybe this is too much activity.

Also, he has me in a knee brace that can move from 20-90 degrees, maybe that is too much.

I also sometimes sit on a padded recliner even though it hurts. Perhaps this is also irritating the repair area.

Thanks everyone for sharing what your doc told you , what your experiences are, and your opinion about where her I am overdoing it and being clueless while I overdo it!

Thanks,

Walt

I'm an not an athlete and 58. , but was told if I didn't do surgety that I would have problems with both hips, knees as I would always be compensating. A lot of us older folks have had the surgery.

Joy,

We are same age and other similarities:

My accident 2/13

My surgery 3/19

I tore 2 completely and semimembranosis partially .

Did doc tell you you could put any weight on the surgical side?

Did you have burning stinging pain and hamstring numbness?

Thanks,

Walt

Had My first PT appt today and am told to stand up (with walker ) and stand on good leg and then bad leg, back and forth with 40 % pressure. I need to do this 3 times a day for 10 times. I too have the brace and am only using toes for balance. I still have pain that comes and goes in both the incision and the sit bone.

Hi Walt, 

Injury: july 2013

Surgery: Jan 2015

Used an allograft to reconnect. 10 cm retracted. 

I was on bed rest for a few days after surgery with a brace placed at 90 degrees with no movement. After that, given crutches, stayed at 90 degrees for two weeks (non-weightbearing). Had a follow up to take out the stitches. I remember being incredibly sore, and had some numbness/stinging sensations. After two weeks at 90 degrees, brace moved to 60 degrees (again non-weightbearing with crutches). Two weeks after that, 30 degrees with movement allowed between 90 and 30 degrees, non weight-bearing with crutches. After two weeks at 30 degrees, I was allowed to take of the brace, and ween myself off the crutches. I would say I was full weight bearing at around 9 weeks after surgery. After that, I started physical therapy, which lasted for about a year.