Coming back from injury, pain returning (Read 85 times)

Hi all

Last spring I posted here because I was having pain in my upper hamstring. After a month of sports med docs, MRI's, and PT I came to the conclusion that no one knew what was going on, but self diagnosis was an upper hamstring tendonitis. I laid off all summer. No running what so ever for four months. I did once or twice weekly water aerobics with an overfriend in her pool while it was warm, but the workouts were not strenuous. I tried for about three or four weeks to ride a stationary bike in place of my morning runs but gave up because of lack of motivation.

I had previously been running almost every single day, forty to fifty miles per week. During this summer I started by doing the PT exercises, but quickly ran out of motivation for even doing that and just rested

Starting Labor Day I have been running again. two or three times a week only, starting very slowly (one mile) and working up to four mile runs, I still walk up hills and when I feel like I need a break. Things started okay, felt fine, was getting excited about running again. the pain was there in my leg but only immediately after a run and it faded quickly. but in the past two or three weeks the pain is sticking around, lasting the rest of the day, sometimes into the next day. I have been very careful about rest and only run every other day at the most. My log is open

Today the pain was bad enough that I had to stop frequently to walk during my run and I can tell it's going to need ice later today. It's becoming evident to me that whatever it was that was going on hasn't healed. But i'm not sure where to go next with this. MRI was clear. PT was an idiot and unfortunately I don't have a lot of options in my insurance network. Do i rest again, take another month or two off?? Thoughts from anyone?

Thanks!

It sounds like your problem is more of an imbalance/weakness/biomechanical issue rather than damaged soft tissue.  IF you had tendonitits/nosis, then it likely would have healed well enough during your down time to no longer give your trouble. It sounds like you were healed enough to have some good runs when you started training again.

However, IF you have an imbalance or weakness that is stressing the hammy tendon every single time you run, time off will not correct the weakness/imbalance.  Without knowing any more about your form, mileage, other activities, etc, I will venture a guess that your glutes are weak and your hamstrings are overcompensating.  Why are your glutes weak?  Could be a lot of things.  Just from sitting during the day, in which case more movement and some simple PT might be all you need (but GOOD, FOCUSED PT).  You glutes may not be firing well or at all, so they're not just weak, they just checked out of the equation all together.  Plyometrics and learning to squat properly could help remedy this. Why aren't your glutes firing?  Could be biomechanical.  A lot of runners with mysterious hammy/glute/groin pain are eventually diagnosed with hip labral tears.  The pain elsewhere is from the body trying to protect the damaged hip joint and keeping the surrounding muscles tight and spasming.

The point I'm driving towards is that I don't think additional time off will help in the long run because I think there is an underlying issue that is stressing your hammies in the first place, and one that will continue to manifest itself in high hammy pain.  I think your return to run program was conservative enough that you did not do "too much too soon."  Hopefully you can keep searching for a better PT and find one that can work through your issues, assess your form, find weaknesses, etc rather than just telling you to stretch and do clam shells.  I'm not a PT, but this is a passion of mine.

There are two things you don't want to do when recovering from injuries, especially injuries to connective tissue: 1. Total Rest. 2. Work thru the pain.

It's a balancing act (like everything else in life), you want to stay active, but don't cause pain, true pain, not the good pain; good pain is ok.

I've found this out both thru reading on injuries, but also from experience -- I know the pain from connective tissue injuries and some of them can take a very, very long time to heal, especially if you break rule # 1 or 2.

I'm very active in my lifestyle, everything from sports, cycling (my primary form of transportation), running, hiking... and with all that I include both simple aerobic training and anaerobic training. It's all important for me to stay healthy for life.

However, there is one exercise I do as my foundation, i.e. I do it as a way to keep healthy all those parts of me that are not worked too well in running/cycling and it keeps the body strong for the more impactful aspects of my activities, such as sprinting... And that's weightlifting. Luckily it does not take much time.

I would recommend starting a weight training regimen, this includes lower body weight training. Many people believe that just because you run you don't need to lift weights, that is dead wrong.

A few links:   http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-blog/seniors-beef-it-up-to-prevent-muscle-loss/bgp-20136508

And don't forget, the best aspect of weight training is to incorporate full range of motion, nothing else, including running incorporates full ROM  http://breakingmuscle.com/strength-conditioning/science-says-full-range-of-motion-is-best

Also, you don't need to start with weights (and some don't use weights at all, I prefer to...). You can simply start out by doing full squats with no weight. (If it's too painful to squat all the way down, then just go down far enough to where there is no pain, but work towards squatting all the way down.  http://bodyforlife.com/library/articles/training/five-exercises-for-strong-legs

http://breakingmuscle.com/running/why-runners-need-strength-training-and-how-to-get-started

http://breakingmuscle.com/womens-fitness/2-myths-about-women-and-weight-lifting-debunked