Hamstring tear recovery: what I wish I knew the first time

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. And now, your host. Hey everybody, it's your co-host Sebastian with the Restoring Human Movement Podcast. Thanks for joining the show today. This is your first time on the show. Welcome. We have a ton of old podcasts that have excellent information that you can apply on your own for lower cordial conditions, sciaticas, low backs, hip impingement, sports hernias, patellofemoral knee, plantar fasciitis, and much, much more. Today, we're going to be covering a hamstring strain today.

Actually, I take that back. It's a larger level strain. It's going to be a tear. If you'd listened to the show in the recent months, you realize that I sustained a hamstring tear actually over the course of the last 365 days. I've had it actually happen three times, unfortunately. So, it's fresh in my mind, and I wanted to give you guys some insight about things that I wish I knew, especially on the first go-through, because it is very scary to have, and people tend to think it's the end of their athletic career. So, I'm 43 years old right now. I've been playing baseball since I was young, young, but I took a hiatus after college and didn't play again until about 25.

And now I play in an adult recreational baseball league, and I have a bunch of people of various different agents that I play with, and a lot of people are very mobile. There are some are very fast. Some are very sprinty, and some take a little bit easier. And so, I'll share some of the insights that I wish that I knew, but also I think a lot of people do end up missing. By the way, if you're ever interested in help from us, we do have telehealth options. Our contact is below. The first tidbit of information, the first tip, pro tip if you call it, is don't panic. When you first sustain your hamstring pop, it's going to feel really bad within the first, I would say, 15 minutes or less.

And so, for a lot of people, they can't actually move very well. It's hard to lift their leg up because the hip flexor and hamstring couple together in movement, called coupled movement. And so, it's hard to walk upstairs. It's hard to do a lot of things. And so, I've met many people over the years who have sustained it months and months ago, and they have a similar story. They said it was terrible, and then it got a lot better, usually within the first week. Even within the first 24 hours, people tend to feel like a lot of things are much more possible. They can walk better. They can walk better upstairs.

Some people use canes and walkers the first day. I don't think there's any need for a wheelchair. I think people should just limp around a bit. The moral of the story of Pro Tip 1 is that don't panic. It does get better very, very soon. But it doesn't mean that you're actually going to get back into supporting activity within a week. So, let's be realistic. Number two, I think we need to assess now our Pro Tip is going to be about timelines. Timelines, just as I mentioned before, within the first 24 hours, it'll be easier to walk upstairs and easier to walk. Within the first week, it's going to feel like, man, I can't believe how bad I was a week ago.

I remember I went walking on the beach within seven days. I was actually jogging around a little bit, kind of playing with my dog on the beach, and it was surprisingly okay. I actually went to the gym within the first three days as well. I didn't do hamstring stuff. I didn't do deadlifting. I didn't do single leg RDLs. I did squatting patterns and pushing and pulling and benching and so on, and all that was okay. So, knowing the timelines is important because you can do certain things, but remember not challenging the irritated tissue within the first few weeks is actually a pretty big deal. You can do isometrics on it, which I'll cover in the next tip, but overall, just understand that you're going to be limited with sprinting for about six weeks or so, and that's totally expected.

But you should be back into doing some version of a deadlift probably within three weeks. Now, for some of you who are listening to this late in the game and you feel like that's unrealistic, it's completely ridiculous. I did not recover in that time. Right. Everybody has their own experience with it. Sadly, a lot of people are creating their own problem, again, unknowingly. So, they stretch their hamstring and they do things too early in the recovery phase. Like, they'll start off day one just doing a bunch of soft tissue work and they'll stretch the living daylights out of it. Now, it sets people back.

It doesn't make it so they can't actually feel better and get better, but it does delay the timeline sometimes. So, if you are late in the game, don't worry. It can get better, but also hopefully believe that the timelines are appropriate. Everything, all the soft tissues, even hard tissues, like I could say bones, in the body of timelines. Eight weeks, fractures heal, especially like smaller fractures. Sunburns go away in three days. Like, these are expected timelines. Everything has an expected timeline. If you're falling outside of that expected timeline and also equating that for the task involved, such as sprinting or deadlifting or etc., then you need to make sure that you have professional help because something's clearly not going in your favor and you may need to help get reorganizing.

Tip number three is isometrics. I wish I would have known in the first go-through that I could do isometrics for long hold times, usually about 30 to 45 seconds. Two minutes off is pretty fair. I'm doing four rounds of that each day, actually. It's important to note that you're not supposed to be going to the point of pain. It'll warm the tissue up. It'll feel like the whole muscle is working. And I've had people do this actually one day after the injury. I usually give them the first day off of like, look, relax, watch a movie, don't freak out. And then we'll start to build a game plan around it.

But you can do isometrics very, very early and there's a lot of benefits to it. I'm not going to cover all the benefits in this podcast today, but just know it helps out with tissue remodeling and it helps out to build a brain muscle connection again because it gets lost really, really easily when people discontinue use of that tissue because they're waiting, waiting, waiting. It's hard to believe that going back into sport after six weeks of not actually using that tissue at all and just babying it is a good idea either. So there has to be in the middle ground. Isometric is the lowest risk, highest reward version of loading the tissue soon.

Personally, I like to do it when I'm driving. If I, at least in the US, if I'm driving and I use my right foot as the pedal foot, my left foot, which is where my hamstring tear was, is the one that I can do when I'm driving. Obviously, maybe not when you're driving with a lot of attention, but if you're highway and nobody's really around you, you don't have to dodge and weave like, like loading it for 45 seconds at a time is good. Now, can you do all those sets, all the reps, the sets all together? Yeah, you can, like you just all continually. But I think that for a lot of times, uh, busy people like myself, it just get it in.

Like, don't worry about the finite, perfect way, reps, sets, et cetera. Just do something. And I've had a lot of people that we've loaded early, actually, it's helped them actually walk better, surprisingly. So it can have a treatment effect as well. Tip number four is icing and heating. I get this question a lot. I mean, a lot. I would say that icing, heating is actually not as beneficial as we think, but I'm not saying that I didn't do it. The first day when I had my hamstring tear, I actually iced a bit, 10 minutes on, 10 to 20 off, you know, not a hard science with it. I didn't like put a clock on or anything, but yeah, it's about 10 minutes or so.

And I would just take it off and, you know, wait for another time of the day where I felt like I could do it again. It made me feel more comfortable. It definitely decreased some pain. I put something between the ice and my thigh, and that was just a paper towel. It wasn't really on me long enough to really make the towel wet. So that worked fine. If it's too thick, you're not actually going to get the ice to you. If you put the ice directly in the skin, you may burn your skin. I think the biggest collateral that people ever have with icing is they just burn their skin. So don't, especially if you've already been, like if you've been salty, like if you were already in sport and put on your skin, there was actually a challenge that they did, I think on social media, they called it like the ice challenge or something.

People would put salt on their arm and then put a cube of ice on it. A terrible idea. It just burned your skin. So I would not do that and should make sure you use the protective barrier. Heat, I think, is a waste of time, especially in this phase. If I had to pick one or the other, I'd pick ice. Heat is more for like, we tend to use more chronic pain people. If there's an inflammatory aspect, which is happening, which did happen because there's a pop, the ice would arrest the process and arrest the pain. It also arrests the redness and, but also some of the healing too. And so years ago, I forget, I think it was like five years ago, one of the gentlemen who back in the seventies or eighties came up with the rest, ice, heat, et cetera, the rice method.

He came out and said, I apologize. I was so wrong with some of this icing. I think it was Dr. Matoff, maybe it was, it was something with an M. We'd have to, I had to look it up and put a post on it, but he had a website and he apologized. He said, can we please stop doing this? And I think that was great, you know, updating the information. But the problem is popular culture. It's still around. I don't think it's a huge detriment to do it, but I think, I think continuing to do it for a long period of time is, is not really getting the inflammatory healing process that you need. I would say without fail, like most of the time I give people a stretch or an exercise to do or give them a strategy to mend the problem and, and to get back on the field.

And then before they leave the office, they say, do you think I should ice or heat? Neither. I don't, I don't really care. But again, I did it myself just for about a day. And that was about it. The last thing that I would add as a tip, and this is for later, it's probably about like three weeks or so, four weeks or so into the, into the recovery process is to add something like nerve flossing. Static nerve flossing can be very beneficial. If you don't know how to do it, you may have to be coached. I'm sure there's endless good and bad references on YouTube. So don't hold me to that. I know we posted some of our own videos on it, but it doesn't really hurt to do.

If you do it too early, the hamstring does not want to actually allow it to happen. So early on, you may not want to do it, but as scar tissue tends to build up around the injury site, which is a good thing. Don't bash scar tissue. It does its thing. It's making it so you can actually perform again or compete again as well. But sometimes there's irritation around it and it can create some stickiness between the nerves as nerve as the sciatic nerve goes between the hamstrings on its path down into the bottom of the foot. So what you sometimes need to do is create, create relative slide between those tissues.

And the way that would work is moving your ankle and it would pull it to the end while the hamstrings are not really moving. So a big mistake that people do make is they, is they move their knee, which is going to be moving their hamstring and the nerve at the same time. So it doesn't really accomplish what we want. And so I've met a lot of people who they actually have all the timelines that are working in their favor. They've done a good job of like discontinuing some activity early on in their recovery process. They've done their isometrics and so on, but they still have this like remnant hamstring cramp.

And some of that is actually due to more of a neurological aspect to the problem. And for a logical approach, I know that a lot of people feel like, well, why are we messing with nerve stuff? This was clearly a hamstring injury because it popped. Yeah, true. But there's stuff that goes through and amongst the area as well. And so creating relative slide between those, especially the interface where the nerve and the muscle collide into each other or like they create like a tunnel is a really good logical approach to take later on as we're trying to get some of the hamstring and sciatic nerve or limb mobility back to be able to get back into your sport as well.

So normally I suggest these people again about three to four weeks out from their original injury, mainly because I don't want to provoke and stretch the injured tissue too much. And I usually coach them on how to do it because there are a lot of people out there who still are of the no pain, no gain. None of this should hurt. As I mentioned with the isometrics, it doesn't hurt. It just warms up. Flossing shouldn't hurt. Reintroducing deadlifting or single leg hinging or sprinting should not hurt either. And so be smart about this process. Again, I think I came back to the game a little too early earlier this year.

I was out about five weeks or so. And so I thought I would be able to play with less intensity. And I found a moment to sprint because I was reacting to a ball in a hole and I popped it again. And so I'm trying to remind myself this time since I'm more than six, seven weeks out. And I did play the other day, but there is a recovery time. The tissue is healing. But at some point, the tissue is healed enough. Like we can't expect doing more rest or strategic rest would really make it any better. So I'm trying to reintroduce the sport and keeping my skills in place, such as hitting balls and throwing, jogging.

I did some structured sprinting as well, and I feel perfectly fine. So I'm hopeful that you guys have heard the easy tips, the pro tips, and you will use them. Remember, this is not medical information to you since I don't know anything about you. But if you do want my help directly, 714-502-4243. I have licensing in different states and so do some of the other people here at Performance Play Sports Care. So our contact is in the information below. We'd love to hear you guys on a Zoom call so we can help you out directly. Take care.