Hamstring tear recovery: early isometrics and six rules

You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. Hey everyone, it's your host, co-host Sebastian with the Restoring Human Movement podcast. Thanks for joining the Movement Movement. If you have been listening recently, you realize that I tore my hamstring. I don't want to say again because it's a different one this time. It's the left one, but I did tear my right one about, there's like three, it was more months ago, probably about six months ago, seven months ago. So I was going to do a series of podcasts about some progress this time.

Last time I was, I was frustrated that I injured myself more so than I am this time. And I wanted to document and report some of the things I'm experiencing that I'm doing as well as I'm doing them, but you know, I didn't, I didn't want to. And I recorded a podcast yesterday for you guys that released a few weeks ago that you know, I don't want to, I want to do, I just want to loathe in my own problem. And I'm sure a lot of you probably felt the same way, but I am going to a better, do a better job this time of documenting for your guys' benefit. And also for my own, I realized I wrote a, I wrote a little back book a long time ago and did an audio version.

It's called, I will be back pain. And the last time I had back pain, it just happened to pop up on my, on my player, on my phone. Cause it was, uh, it was on there for editing purposes. And actually I, I, I was inspired by it. It was kind of nice to do. So this time through, I'm going to, I have a little bit of time at the office today and I'm going to record some videos of the exercises that I'm currently choosing based upon what I've learned about research with different types of early loading protocols, as well as how to offload from a lot of things that we've done in the past, uh, as well.

Now, since I'm driving to work, I'm going to take a couple, a couple of sips of coffee while this coffee is hot. So bear that in mind. So this morning I woke up and I did some isometrics yesterday. I did some, I did them very sparingly. I did about 10 seconds on and, and 50 seconds off. It was not super hard. 10 seconds passed very quickly. And if you guys are looking for information about why I'm doing this, there was a great Tim Ferriss podcast with, I think it was Tim Barr. I'll look it up right now really quickly before I get driving too far on the road here. So it was episode 797. It was Keith Baar, B-A-A-R from UC Davis, which talks about tending loading protocol.

Uh, I know this is not necessarily tending, but usually tears happen in the musculatendous junction, which does head from properties in the tending itself. But overall, uh, I'm, I'm a big fan of realizing that tendons and the muscles kind of work together in some, some unison. So I'm not going to say they respond to exactly the same things, but I think the logic is, is there. So I'm going to use this protocol this time. Uh, there were some good mentions in there around, I think is the, around the one hour mark or so that maybe it was a 50 minute mark or so where they're talking about tendon loading protocols for Achilles tendon.

And when would you load it first? And it's the immediately the day after surgery. And so last time with the right hamstring, I didn't necessarily do that that quick. I waited about, about 10 days or so before I started really trying to put load into the tendon, but it didn't mean I wasn't walking either. So I was doing some and I, I was doing other activities that I could do. I even went to the baseball field, uh, the very next week to throw balls and do a little bit of shagging of balls, which is probably not advised, but I did it anyways. And I think that one fared pretty well. So I'm going to do some isometrics.

Uh, I did isometrics this morning. So it took me 10 minutes total. I laid there on the floor. I was in my dog's bed drinking coffee. And so I did a long legged version. So almost like if I was sleeping and I started driving my heel slowly into the floor, not with a big jerk. And so I started to ramp up my effort and put the timer on my phone and did 30 seconds of work followed by two minutes of rest. I did this four times. So it took me about 10 minutes total. My dog and came, my dog came and laid by me at, at the same time. It was really nice. The general protocol is if it feels like there's a knife stabbing through your, uh, hamstring in a specific location, this is probably no, no.

And the load may be too high, but if it just burns like a little bit of a pump or a good pump, like with exercise, then it's probably okay. And, uh, that's generally how we end up operating with a lot of the loading and isometric protocols we use anyways at performance place. But this one, I just took a, I'm taking a little bit easier. I'm just making sure that I am putting load through it early. So the, so the alignment of the repair site is not so haphazard, which is more descriptive of like a scar. I know a lot of you have probably worried about scar tissue over the years. And that's what a lot of, uh, soft tissue protocols are actually based around as quote unquote, removing scar tissue, which in my opinion, isn't very much possible.

You're not going to remove it. You may soften it a little bit, but you're not necessarily going to scoop it out and remove it with something else. So I'm going to do that today. I'll do some probably diagonal sits as well and some core or anti-extension exercises. I am going to go to the office and record some of these. So if you guys are not aware of our YouTube channel, I'll put a link in the description for our channel. I'll do my best to put a link to the actual videos themselves. But if you can't search performance place and hamstring tear exercises, I'll probably call it our virtual surgery.

We have done a virtual surgery for a sports hernia before Dawne Costantino recorded it. It was a six week video series. I think it was great. I may do the same thing for this, but the only trouble is that Dawne Costantino did that when she was not hurt. So I'm going to do my best to record some of them today because I know how it's going to go. In a few weeks, I'm going to get busy and I won't be able to record them. So there may be a little bit of a lag on that, but I think I'll record maybe weeks one and weeks two today and just do the best of my ability and dictate what you guys should be experiencing in that time. Now I'll tell you from the podcast that I did just yesterday, I'm even moving even better.

This has been about 36 hours since the original injury. I'm able to walk a bit downstairs. My foot doesn't get caught on rugs anymore. I can lift my knee up towards my chest. But as I start getting past, like say, say my thigh starts to come up off the chair, like I'm in the car right now and my thigh is starting to come off of my seat about a foot fist distance. It's like I do start to feel it. So it's not perfect, but it is improving and I expect it to keep improving at the timeline of a bruise, essentially. Like if you got punched and the bruise hasn't healed in like one hour, that's expected.

It should take about five to 10 days to really start settling down, at least for that inflammatory aspect of it. Now in the video that I'm going to do today, I decided I'm going to do my best to keep it concise, but also give you guys some ideas of context with things. And I'm finding that, I don't know if you guys are YouTube people or not, but I'm finding that some people, I don't want to say everybody, but some people on YouTube are very, their attention span is really low. I find that people who listen to podcasts, it's quite a bit longer, but I think everything comes down to context. So I'm going to share with you now the things that I'll share on there in addition to the exercises, but hopefully everyone on the video series can listen for about a minute or so of talking before I show any exercises.

But if you guys don't know at least some context of, for me in baseball, because I did injure this during baseball, I'm going to show you how long I have been playing and how many things I've been through. I didn't write all this down, but I did write some down this morning. So I started playing in minor B, which is I think about eight years old or so. I had my first injury at 15. It was a low back disc herniation. I was out for about eight months. And keep in mind, as I go through this, you'll notice that my time frames for return are actually much quicker. I think I'm starting to get smarter about things over time.

Next was at roughly 25. I took about three, four years off from college and I started to play in adult recreational baseball league. And I think about two to three years into that league, I was playing center field and I was fielding a ball to left center and it was right in the gap, right around the warning track. And I was, I remember thinking I was about to dive, but I ended up falling and I felt like someone had thrown a baseball at my leg because I felt like a pop, right? It didn't really hurt at that moment, but within, I mean, I couldn't really get up without limping, but it felt like someone really threw a ball at me.

I felt a pop and I'm pretty sure I heard it too. At that point I was out for about, I want to say two to three months. Like it was, I remember coming back too soon because I was limping quite a bit and I didn't have a pinch runner. You can do that in adult baseball, but I didn't really play the field too much and so on. I think I was, I was definitely not more structured at that point in time, but I remember looking at some of the research with timelines of healing at that point, 21 days is when this, when there starts to be able to be load transferred through the actual void in the tissue itself.

And for me, that kind of concerned me, at least in the first few weeks, don't really load the area too much, but I think I maybe did myself a disservice, but I think I learned don't stretch that too much either. So I did come away with a little bit of knowledge there. Next is about, I want to say around 20, about five years later, around 29, 30 or so. I switched teams and I went to a, I went to the adult world series out in Arizona. So we play in a lot of the spring training fields as well as some of the stadiums. I remember we were playing at one of the stadiums, it was Salt River. I think it was where the Rockies are.

And within the first inning, I had already, I think this one was a strain. I didn't feel a pop. And so it was my right leg as I reached out towards first to try to beat out a ground ball. And I think at that point, the issue was, I mean, we were, we were drinking all night. I think I was dehydrated. I don't remember, I don't remember peeing at all during that, like that first day. And we had an afternoon game. So I think dehydration was a part of that one. And maybe that's why it was more of a strain versus a tear. But we do know that tissues are more dehydrated, like beef jerky, if you're not hydrated.

So at that point, moving forward, I learned that I will not take a drink the day before a game. So we play on Sundays and on Saturdays, I, I don't like people ask, hey, you want to go out and do this or that and go to a party or have a beer? And I usually say no. And I've gotten a little lazy over that over the years. And I've, you know, I'll do one, but I won't necessarily do any more than that. I reserve my, any partying time, which I don't want to sound like I'm partying all the time, you know, two, three drinks. That's a Friday night thing. So at that point, I got back in about, I think it was about three months because that is about at the end of the season.

Those tournaments are always towards the end of the season. And I didn't really have to play again until February or March time, probably March time. So I remember I was doing stuff. I was strength training and so on, but I didn't really document a lot during that period either. But I remember being frustrated because I went out way out there to Arizona. I didn't really do anything, you know, I, so I think I took an at bat in the last game, but I was, I was pretty done for a bit. And then I did it again this year. So I was 42. I was playing on a team called the Seawolves and I actually had to get back.

I wasn't on the Seawolves. I was on the Yankees at the time. And so I had been doing a lot of games because I was playing on two teams at the time because I'm 40, it's 42. And so at 40 years old, you can kind of decide on like a B team. So I can play on one team. And then if I choose to do more innings on another team, and if it doesn't conflict with time, I can play on the other team. And so I went over and played on the other team. We're all in the play, we're in the playoff. So I would play on both teams and it was hot. Again, maybe dehydration, a component. There wasn't any drinking involved.

And I also did play a tournament. We played seven games over the course of four days. It was a Labor Day tournament. So that was a lot of baseball. I think what I realized from that period was there was a ramp up of activity. We call it an exposure spike. And I kind of knew it at the time. Like my hamstrings felt stiff quite a bit. And I remember diving to first base on a few times where I would have just strided my leg out because I remember the other times where I got hurt striding. And I would just dive if it was a close play. And obviously, that's probably not the way you want to do things fundamentally.

But someone asked me, like, why are you diving to first? I do it like once a game because it was a close play. And I said, because I don't feel comfortable stretching my leg out. So I kind of knew. But eventually, I did pop it. And it was on a ball hit to right. I thought it was a double. So I turned hard. And I popped it right at the first base as I strided out and tried to turn base. So at that point, that was the end of a season. That was the very last game, very last at bat. And that was basically about a month and a half out. So I did go the very next week, though, to a game that I already paid for at the Big A.

I didn't play the game. I tried to be smart. And I volunteered to not take any innings in the field. I did take one at bat at the very end because the game was a little out of control. And I just kind of jogged really slowly to first base with a limp. But I went out to throw with people and, like, BS with everybody and wrote everyone on. And it was still fun. I did shag some balls in the field during batting practice, too. Now, since then, I feel like I've really come around. I've felt I've learned a lot of lessons. Number one, don't be dehydrated. Number two, don't get an exposure spike. And I don't know if I really learned anything from that first one.

But just the other day, I did pop it again, fielding a ball from from center field to right field. I planted my left leg. I did the non-fundamental thing. I threw across my body versus pivoting and turned. And I felt it pop and I was down again. So, and that was, again, that was about seven months after that last injury. So, I feel like I want to give you guys, other than just the exercises today, I want to give you some rules of engagement when you're dealing with your hamstring tear for the first time to make sure you don't make some of the same mistakes that I've made. Or at least you can learn from my experiences.

And remember, if you guys do want help with this, we do have telehealth and we do have in-person services. Just call us 714-502-4243 or just find the link in the description for the podcast player. But we have consultations. I'd love to talk to you guys and help you out, especially if you're a ball player. So, before we get into the rules, let me take a sip of coffee. Okay. So, rule number one is I would say don't stretch. Without fail, both or all the times that I had the injury, someone came over from my team and they're, you know, they're trying to help and they say, do you want help stretching?

And I say, no, stretching the, in a tear is probably not the best idea. Not to say you shouldn't do it at some point, but I don't think it's something that I would be doing at that moment. I mean, it hurt like hell. And to stretch my leg out, it was, I mean, it felt like an ice pick, like there was a guarding response. So, I would not stretch that area. Rule number two, I would start to do isometric loading this time the very next day. I don't know about the first day because I'm, I was pretty frustrated, but the very next day I did some light stuff and now I'm doing it twice a day or there's a, we call it a refractory period where it can, there's a more, it would be more prone to respond in a favorable way within about eight hours or so.

So, I did mine this morning and I'm going to do some this afternoon. I'm going to set a timer for it. Rule number three, get back in the field in some form within two weeks. I plan on going next week or this weekend. So, it's about five days from now. I'm going to go throw a little bit and I'll probably take some batting practice before the game and I'll BS with the guys. I may coach third or, you know, I might just say, it's weird. I'm going to go home halfway through the game. I don't really know yet, but I think keeping social circles is important, especially if you're in recreational sports and working on some of your other skill development is important too.

This is a game, so we don't necessarily get all the fielding and stuff like that, but if I was an infielder, I'd probably still take ground balls, but I'm not. Rule number four is work on other skills like bunting, throwing, and batting. So, I can probably oppo the ball. If someone threw inside of me, I would be scared to death. So, it'd have to be a controlled setting, but I can probably still oppo hand-eye coordination. Throwing the ball is fine. Just make sure that you're being aware if it hurts or not, because sometimes it does hurt based upon the leg or your front or back leg that you did it on.

And bunting shouldn't really hurt too much at all, but those should all be important. Number five, you should depend upon the skills of an experienced healthcare practitioner to help organize you. People do a bunch of haphazard stuff, myself included, and I had to reach out to one of my friends the other day to tell him, here's what I'm experiencing. How soon should I do this? What should I not do? What do you think about X, Y, and Z? And so, he gave me good advice. And that is super valuable because now I've accelerated my timeline by about two weeks of doing stuff, and I wouldn't have done that.

And I know a lot about the body. I don't want to brag or anything, but I still needed help, and a lot of you guys do too. Number six, don't get frustrated. This will happen again. I know it'll happen again, but make sure that each time you do learn something and that you come back faster and more educated. When they say it's the older you get, the wiser you are, or youth is wasted on the youth, you know? And I do think there is something to that. So, just make sure that you are educating yourself through these periods and make sure you can play for a very long time. So, again, if you guys want help, go to our YouTube channel.

I'm going to record that video today. I think you guys will like it. I'll release it early because we are scheduled out for quite a few months. And if you guys want help with a consultation, I'd be happy to talk with you, but also Mandy and Dawne Costantino can help as well. We're all licensed in different states, and based upon the state that we're in, you can work with one of us. So, give us a ring, 714-502-4243, or all the contact is in the podcast player description. Stay tuned for the other podcasts, which I will do more about this as time goes on, and I hope you get back into the game as well. See you guys later.