Hamstring Surgery…My Journey, One Year Later
This post has been a long time in the making…one year in fact. And it’s been quite the journey. I’ve had many ups and many downs too. Sitting here writing this I’d thought I’d be in a different place now than where I actually am today. If you had told me I’d still not be able to train, I’d still be dealing with post surgery complications I’d have been pretty bummed.
And after the past two years, bummed might be an understatement. But this post isn’t philosophical, it’s not spiritual, it’s not inspirational and it’s not depressing (at least I hope not). My goal of writing this is very similar to why I started this blog. The blog has taken on some different turns, and manifested into something new, however when I started it, it was to share this surgery experience. And that is why I write this today. From more of a “I’ve been through it, here’s what happens.” It’s my story, and yours might be different. However when I started this, I couldn’t find anything on it. And my hope and goal is that if you are going through this, you’ve found this and it can help. In addition, I had a chronic issue. If your issue is acute, or you don’t have a complete repair, your recovery timeline might look different. Heck, every doctor is different and I know Dr. Wolff is conservative. But this was my timeline and if yours is shorter, at least you were prepared for the worst!
My absolutely amazing physiatrist Dr. Victor Ibrahim encouraged me to start this. He could tell how anxious, scared and depressed I was. No one could figure out what was wrong, and he was the first doctor to give me hope and insight into what turned out to be Proximal Hamstring Syndrome. A condition which many doctors don’t believe in, although I’m not sure why. It is extremely challenging to diagnose, and most of us with it go for several years without a diagnosis. In short Hamstring Syndrome is (British Medical Journal):
A gluteal sciatic pain, in which posttraumatic or congenital hard fibrotic bands irritate sciatic nerve at the insertion site of hamstring muscles to ischial tuberosity. Traction, mechanical compression and impingement of the sciatic nerve may occur in certain anatomopathological situations at the origin of the hamstrings on the ischial tuberosity. The symptoms include local pain at the ischial tuberosity irradiating to the posterior thigh which appears with the cyclic stress of running, after physical exercise, and typically during sitting. Hamstring syndrome diagnosis is basically done according to typical symptoms and finding. Differential diagnosis is required from piriformis syndrome, ischiogluteal bursitis, posterior femoral muscle compartment pain, scars in hamstring muscles and back originated symptoms. MRI is the best examination to detect abnormality at the ischial tuberosity area. The majority of the athletes with hamstring syndrome respond positively to conservative therapy but in the refractory cases the hamstring syndrome can be treated surgically by dividing the compressing band and by performing the sciatic neurolysis.
This is what I had, in addition to a torn hamstring. So not only did I need to have the hamstring re-attached, I had to have the nerve surgically removed from the hamstring. So whether you are going through Hamstring Syndrome, or have torn your Hamstring and need surgery, the same or similar progression will occur. Now this is my story and everyone’s will be different. But this is my timeline, so you have a better understanding. (If you’re not interested in the gory details, stop reading now). Dr. Wolff said initially the surgery recovery was 6-9 months. As you now know, mine took longer. In his defense, I was his first surgery of this kind and while that might seem a bit crazy, not very many doctors will perform it. And he is one of the best surgeons in the country. In addition, I had the nerve component. If you don’t, yours shouldn’t take as long.
Day 1 surgery– 4 hours in surgery, a few hours in recovery, and back home
*You’ll be high, on crutches and not able to help yourself. Brett and my next door neighbor had to carry me upstairs. For the next 3 days you’ll lay in bed, getting up to use the bathroom, taking pain meds, anti inflammatories and using your ice machine. You won’t have much of an appetite, but must you must eat. Going to the bathroom will be very challenging as your leg is strapped into a large leg brace, and you will be in immense pain. You won’t be able to sit on the toilet, but will have to hover-this is very hard.
*You’ll slowly start to get used to the crutches and having to hover over the toilet. You won’t have the ability to sit on the toilet for 3 weeks, and you won’t have a bowel movement for at least the first 2 weeks (at least I didn’t, and I eat a lot of veggies). Even with the correct meds. The pain will be almost unbearable. As an athlete, you’re used to pain. This is a different pain, and pain meds did not help. The only thing that helped was my ice machine. It said not to sleep with it, but I did. At least I didn’t have to take too many pain narcotics, since they didn’t help.
*In addition, you will need help. I would try to find a family member or friend who works from home, is retired or doesn’t work. You will need a lot of help from getting out of bed, going to the bathroom, showering, eating, getting dressed, moving around the house, pretty much anything you can think of. I thought, I’m an athlete, I can do it, but no I couldn’t. And thankfully for me, my mom is retired and since Brett was in school, I stayed with my parents during this time.
*Get ready to sleep and lay with 4-5 pillows. You’ll need them to put under your leg, and the entire side of your body. Be prepared to wear clothes are that very easy to put on, and get around in. Think elastic waist shorts and tank tops. The leg brace is very hot, and you will sweat. It is not a straight brace, so for weeks your leg will be bent. It’s not horrible, but you’ll wonder what it’s like to have a straight leg.
*I was off the pain meds by now, and started to wean off the ice machine. I held on because I was still in a lot of pain. But by now you’re moving around.
*Buy a squishy cushion/seat to sit on. You won’t be able to sit well, and you’ll want to lay down the whole time. But this will get you prepped for when you have to sit in a chair. And yes you’ll feel stupid, but you’ll need it.
*Around week 6 you’ll go to the PT. Don’t get excited, they will just be taking measurements. For example, they will measure your quads to see how much they atrophy. The brace should still be bent, and you won’t be able to stretch out your leg.
*You’ll be getting around fine on crutches, but you’ll work hard. Don’t be tempted to use your leg. They might have you start to put weight down, but don’t push it.
*PT really starts, and you’ll begin with stretches and manual massage to the surgery site. You might start to re-strengthen your hips, and even do some basic quad exercises.
*The brace will be slowly straitened, but you’ll still be on crutches. You can put a bit more weight down, but not a lot.
*I didn’t wear the brace in the house, just used the crutches. Outside you’ll need it to minimize the risk if you fall.
*You’ll start to feel like you’re going crazy, and finally you’ll be cleared to drive (yes, with the brace on).
*Back to work around the 3 month mark. I thought I’d be back at the 2 month mark, but I’m glad I had the medical leave with work (Thanks PowerBar) as I wouldn’t have been able to work.
*I started to drive at the 3 month mark, and even though still on crutches, I could do the grocery shopping, etc.
*You’ll start by switching to one crutch. You’ll do this for a few weeks. Then you’ll wean off the one crutch, and you’ll start to walk. It won’t look or feel like a walk. You’ll be in pain with each step, and it felt like my hamstring was going to rip off. Don’t push it. I was walking 25-30min miles. I started at 1 min, then 5, then 7, then 10. Each day going a bit further. I could walk 1 mile with rest.
*At PT you’ll start using bands and very light weights. If you have an awesome PT with an Alter G, you can walk on this. It’s awesome as it takes your body weight away, and it supports you=less pain.
*This is also where I started nerve glides and tensioners. Google or youtube these. Even if you don’t start with nerve pain, having hamstring surgery can cause nerve issues. So please start these to prevent nerve issues down the road.
*You’re walking without crutches or a brace and you’re able to walk normal for short distances. I would start off very slow, but could make it 2 miles. Towards the end you might limp a bit, but try not to.
*At PT you’ll be using weights and doing body weight exercises. You’ll start to feel like an athlete again.
*This is the time that I could start back to the pool. I wasn’t kicking much, but did push lightly off the wall.
*The hard part of this phase is that you’ll look normal, but your body won’t feel normal. So people will ask what your season is looking like, or why aren’t you racing. It’s very frustrating, challenging, depressing, anger inducing and just about every other emotion. You’ll want to scream out, or wear a large sign that says, “I look fine, but my body is healing.” It’s nice they care enough to ask, but it can make things worse. Be prepared for the mental toll.
*This will be very personal. Some of you might be able to start riding a bike, jogging, swimming, etc. In fact, I hope this is where you can. I couldn’t, I still had too much inflammation and nerve issues.
*This is also the time where my positivity from the surgery started to wane. How could surgery still be successful when I was still in this much pain? Well, it can, and I hope you don’t have to go through it.
Where I am, 1 year later-
*I progressed on the Alter G, and my PT said it was time to start to run. This was the 9mon mark. I tried for :30 of jogging, but the pain was terrible. I know that there would be pain, but this wasn’t a good pain. So I went back to Dr. Victor.
*Dr. Victor said I had too much scar tissue built up around the surgery site. So while I did everything I was supposed to, a bit of scaring is normal. But unfortunately it was causing inflammation and pain. So he took a large needle and stabbed at the scar tissue, breaking it up. He also extracted some scar tissue and injected an anti-inflammatory. He said to wait a few weeks and try to run.
*So I waited and went for a run. And while the ischial tuberosity pain was gone, I had this terrible internal, adductor pain. So, back to Dr. Victor for another ultrasound. This time he said that I had inflammation of the Adductor Enthesis: Enthesis is the tendon/ligament insertion into the bone. So he did another round of injections. He said to wait and we’ll do a re-eval in 2 weeks.
*So here we are, another 2 weeks after. I’m going in for another injection. And while I feel 75% better, I still have sciatic pain. I’ve been doing an anti-inflammatory compound cream, and nerve glides several times a day. I feel confident that Dr. Victor will be able to heal me, so next Wednesday I go back.
I am hoping to close the door on this journey, and to be able to start to get to train again. But one thing I really want to emphasize, is that everyone is different and you have to be patient. You can’t will your body to get better faster, and while you might keep pushing to get back, if you just slow down and realize your body will heal at its own rate, you will save yourself a lot of stress and heart-break. This is a long, long, long journey. Very few people will actually understand the mental and physical pain you go through. I wouldn’t wish this on my worst enemy (thankfully I don’t have too many I don’t think) and it will take a lot to get through this. When people try to tell you how they had to take 8-12 weeks off for a fracture, or this, or that, listen politely and nod. They mean well, but they don’t understand it will just make you feel worse. Or at least it did me. 2-3 months off is nothing and you’ll wish that was you. But don’t go down that road as it only leads to you feeling sorry for yourself. You don’t want to do that. You must stay positive the best you can. If you need to, just say you don’t really want to talk about it, and suggest a different topic.
I don’t have any great pearls of wisdom like do this, and magically you’ll be healed, you’ll have a great outlook, you’ll know how to react to people, etc. I don’t. All I can say is trust your body, take care of yourself, go very slowly back-be conservative and don’t listen to others. This is your body, and do what you think is best. You and your doctor that is. Good luck and I hope you all have speedy recoveries.