Pro Athlete in need of help (Hamstring/MCL)

[kudisbetta]

Hello

I am a Pro soccer player and have been battling some injuries that have really hindered my career. I am only 22 but I having some serious issues.I have sprained my right knee many times in the past due to over training, I damaged my ACL in the past but I managed to over come it however.

About Mid- March I did something to my knee during a game. I had a cramp and kept playing. After the game I could barely walk. The tendons in the back of my knee hurt bad and my inner knee was painful a well. As usual it took forever to get a doctors appointment. I had MRI and was told i only had inflamation to the knee and a back hernia. I was told to take a month off. I took the month off and my knee was still in non useable condition. I the went to a therapy place in Boston and did rehab there. At the rehab the lady kept pushing me to do some hamstring strengthening excersizes which involved pulling my self from a chair using my injured leg. Well my hamstring ended up spasming and it hurt. She forced me to do another round. This was June and ever since then my hamstring is in pain. I have alot of pressure on me but I have really tried to get it better. After the rehab stint, I took a good 2 weeks off. I know the importance RICE and epsom salt, messages, proper nutrition and sleep, but I can't get over this hamstring injury.

Its just a pain in the middle of my hamstring. and then is goes to the tendons in the back of my knee. It comes when I walk. Just a second of sharp pain and then it feels like the muscle is detached from my leg. When I swing my leg forward its not usually a problem, but then when I step down and my other leg comes forward, I feel the pain. Currently, I have taken a full week off from activity and although it feels a bit better, I still get sharp pain sometimes when I stand and walk. I really want to sue this rehab place, but I let bigger force be the Judge.

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[kudisbetta]

Well I have to get back to training on Tuesday. My hamstring is feeling a few levels better, but it still doesn't feel right. I began stretching about 4 days ago. I still feel a little strain at the tendons behind the knee. Also my knee on the inside(MCL) feels slightly tender at the point of injury. I feel it the most when I squat all the way down. anything i can do?

[neuromuscular]

Well I have to get back to training on Tuesday. My hamstring is feeling a few levels better, but it still doesn't feel right. I began stretching about 4 days ago. I still feel a little strain at the tendons behind the knee. Also my knee on the inside(MCL) feels slightly tender at the point of injury. I feel it the most when I squat all the way down. anything i can do?

Dear kudisbetta:

One of the most overlooked muscles group in the knee is the muscles that lock and unlock the knee. Have a practitioner palpate the popiletus and the planterius. These can and do make the knee feel like it cannot move or moves with difficulty.

The other muscle often overlooked is the adductor longus. It acts in harmony with the hamstrings. Have a practitioner assess the adductor longus. You can do a self test on the adductor longus and pelvic bones positions. Stand in front of a mirror. Find the ASIS of the innominate bones ( the prominent feature of the pelvic bones on the anterior) both right and left. Stand in a closed foot stance and widen the foot stance directly lateral to 30 cm, 60 cm, 90 cm, 120 cm. If the left ASIS moves superior to the right or the right moves inferior to the left then you possibly have a left adductor magnus problem. There could be much more that is needed than this. Have your practitioner contact me. The superior movement of the left ASIS is a flag that the adductor magnus is in a guarding response, but other factors could also be indicated.

Please let me know what you find out.

Best regards,

Neuromuscular.

[pgacaddy28]

Hello kudisbetta,
The knee is such a complex sturcture, that humans often times disagree on treatment for it. I do however agree with neuromuscular's post. The plantaris and popliteus muscles should be assessed.
I do have one other piece of advise to add. As for the practioner you use to palpate these structures, i would look for an ART practioner. And i would also, recommend , that you yourself should look into ART. I have personally used ART(active release techniques) in the past and found fantastic results.
So much so that i decided to become certified myself.
I now work with professional golfers at the highest level.

It doesnt hurt to understand different theories that are offered on assessing, palpating, and treating, injuries.
Do a little research,personally. Once you have a better understanding about you're body and you're pain, you can then choose a treatment(s) that best fits you. Once that is achieved, then trust can be formed.(between you, the practioner, and the treatment.)
Sorry to hear about your unfortunate experience in Boston.
Trust is a really big issue, and it should be. This is your body and essestially your company. You must take care of it, if you want it to succeed.

PGAcaddy28

[Yarok]

hi

can you explain

well. As usual it took forever to get a doctors appointment. I had MRI and was told i only had inflamation to the knee and a back hernia. I was told to take a month off. I took the month off and my knee was still in non useable condition. I the went to a therapy place in Boston and did rehab there.

tell me more about your back hernia please

thanks

[physiobob]

Sounds to me like to do not have a definitive diagnosis and therefore I suggest seeing someone else for another assessment and opinion. I am also unsure about the hamstring exercise you were doing suffice to say that any hamstring exercise should be directed at you ability to extend at the hip joing in unison with your gluteals and NOT focused in anyway on flexion of the knee. Yes hamstrings are used to do that but never with any more weight that the lower leg with a shoe on. So it is NOT designed, nor is the knee joint, to take greater loads in knee flexion.

On a side note as a 'professional player' you should have access to good physiotherapy followup on the day or within a few days of the game. You shouldn't be waiting to have someone assess an injury.

[kudisbetta]

Hello again,

Its been about 2 months since my last post. Guess what. I am still in PAIN.
I had an MRI my knee and hamstring.
I have 2 meniscus tears in my knee.
Grade 2 signal intensity in the posterior horn of the medial meniscus reaching articular margin
Grade 1 signal intensity in the posterior horn of the lateral meniscus

My hamstring came out clean on the MRI, But it is were all my pain lies. My feeling is I have alot of scar tissue there cause in the pain. To get an idea, Every time I massage my hamstring, it flares up the pain and it is quite bad, i limp for a few hours after. I also did research to see if it was a sciatic nerve problem, but i don't think so.

In regard to being looked at. I am a a foreign country and am a free agent and am in no position to seek help. Going back home to rehabilatate is my best option.


Thank you

[opihiman]

does compression make your hamstrings feel better? If you haven't tried a compression sleeve or a 6" ace wrap may be able to provide you with some relief.

If it does provide you with some relief you have complete part of your differential. If not you may need to cont to dig

OPI

[kudisbetta]

is it ok to play on the mensicus tears mention above? Its been about one month since the diagnosis and I feel better. I do know i need surgery eventually. It just not possible at the moment.

Hamstring is MUCH better, I have been jogging on it. The compression wrap does help a bit.

[opihiman]

Anything is possible...the question should be "is good for me"

playing with the tear risks making worse. and the most probable increased pain for a long time. If your goal of cont to play out weighs your longevity...go for it...if it doesn't..you should have it done sooner that later so that you can play at full speed.

HS strains take a few months to get fully better. especially after re-injury. expect about a 6 to 8 week recovery period in which you can train pain free..no quick starts and stops, or cutting.

Ice, cmopression, and light stretching will help

Good luck

OPI

[Yarok]

HI Kudisbetta

Sorry,but im asking again can you explain your back hernia problem, please

take care

[angela1]

When reading all the posts, I knew instantly what you had done the first time you explained it. MRI's don't always show them up, sports doctors here in Aus don't even bother with them. Physiotherapy is futile. you need arthroscopic (day surgery) to get rid of the pain. the hamstring pain is refered pain from the posterior horn meniscal tear (ie torn cartilage inside and to the back of the knee). Your surgeon will tell you after the surgery if you should continue to play or not. Good luck...and get it sorted!!!

[eshuro]

Hi,
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[karen.hankey]

Just another thought. Are you fully straightening your knee when you are moving? If you are keeping your knee bent, you will be using your hamstring to do this, and therefore causing it to go into spasm. You need to ensure full movement of the knee, stretching of all the muscles surrounding the knee and ultimately strengthening of it.

[kudisbetta]

HI Kudisbetta

Sorry,but im asking again can you explain your back hernia problem, please

take care

Yeah. It started from weight lifting. I put too much weight on while squat ing and tweaked it. The major incident was during a game. I went for a header and came down totally wrong on my heels and jammed my back. I was diagnosed with a back hernia. I hatve it under control though.

Great news ! My anthroscopic knee surgery is on the 19th of jan. This is a big day for me.

Hamstring is better. The pain is still there from where it spasmed over the summer. I cant believe it. Its been 6 months. I am doing isolation on it. Hamstring curls and stretching. I try to massage the hamstring myself.

Any ideas on the hamstring and how to get it to normal?

[kudisbetta]

so i am trying to break up the scar tissue i think is causing the pain in my hamstring. i am using the end of a can opener to massage my hamstring muscle. I am putting pressure to the site where pain is and gliding across the surface of the muscle. It is painful and i over did it. I sort of ripped a little of skin off.
I think i just have to continue this a few times a week along with normal massage sauna, streching and weight training.


If any one has advice on this hamstring issue that has put me on the sidelines for 6months let me know. Again i did an MRI and nothing showed

[opihiman]

The stretching and light weights is probably some of the best things that you can do. I am not sure but you spoke of isolation exercises. Is that isometric ex. if it is you may want to lay off those for a little while longer.

I know at this point you are getting frustrated, but hang in there. YOU SOUND LIKE YOU ARE GETTING BETTER. 6mos is long but you were really pushing on your injured leg.

glad to hear that you are doign better and that your surgery is scheduled.

OPI

[kudisbetta]

UPDATE:

Knee:
I have completed my knee surgery. I am 4 weeks post op. There was a bynch of swelling. It seems like they did a good job. I had my operation done in Aspetar, Qatar. Good facilities, terrible service. I will post pics of the procedure. For some reason my knee locks sometimes at the top of the knee cap.

Hamstring:
The ultimate mystery. YEP, its still there, better some days, worse the next. Ive had some therapist tell me its a posture problem with my pelvis lower back. Some therapists telling me its a problem deep in the muscle. I do magnetic therapy, utrasound, electric stimulation, and ART technique(hurts)1-3 times a week. Yesterday i was on a eliptical fotr 15 minutes. Towards the end it froze up. I also get this weird bubbling feeling in the muscle sometime, and a pulling in the back on my the tendon behind the knee.

Symptoms:
1. hamstring freezes
2. Bubbling sensation in the muscle
3. pain/pulling in the tendon behind the knee
4. pain in the middle on the muscle
5. feeling of overall tightness after any sport ( light or heavy)

[smshaffe]

some of the symptoms are possibly nerve related. you cannot be certain that is is a simple knee problem if no one has tested neurodynamic maneuvers (slump, straight leg raise, etc) and i don't really see anyone considering that.

can you explain what you mean by "bubbling" feeling in the hamstring? is this what may also be called "tingling," "pins and needles," or "ants walking" or is it a different?

if neural elongation test is positive it makes half of the conversation a moot point. all medical professionals constantly miss referred lumbar dysfunction and call it a "hamstring strain." it could be a nerve, low back joint, or muscle among other structures that cause the posterior thigh pain. The hip or pelvis may also refer/send pain to the posterior thigh.

one cannot properly differentiate between the two without doing sufficient in-person testing. but, try this.

"slump test" - sit down, slouch into a poor posture position, look down (move chin toward chest), slowly straighten the knee (making sure to not sit up any higher out of the slumped posture (you should have someone gently hold you into the slouched position because most people accidentally sit up part way), and finally pull your toes up toward your nose (ankle movement only). if, at any point in the test you can move your ankle (point toes up and down via ankle movement) and it changes the way your posterior thigh feels, it is not likely your hamstring causing the problem and you more likely need nerve directed treatment or low back treatment.


good luck.

[kudisbetta]

UPDATE>>>>>

Hi Everyone,

I am back on the sidelines and its been 4 weeks since I have played. My hamstring still feels odd.
These are Observations:
1. My Hamstrings are weak ( LAGGING body part)
2. My problem is now at the insertion point (glute/ham) to the tendon behind the knee(bicep femoris)
3. They are tight as hell(both). Right Burns sometimes, bubbles (water pop pop).
4. I am on the sidelines


SOLUTION: The last resort comeback

1. Cortizone shot
+
2. Prolo Therapy
+
3. IGF-1 shots course
+
4. Deep tissue massages
+
5. needed therapy

[neuromuscular]

Dear Kudsibetta:

Sorry for all the trouble you are experiencing.

Has any one tried to treat your adductor magnus? It acts like and aids in the hamstring for some of the muscle.

If the pain is on the medial side, then the adductor magnus could be part of your problem and will seem to be a hamstring problem.

The popiletus, planterius and the adductor magnus are often overlooked. have someone check these for you and note if they could be part of the problem.

Best regards,

Neuromuscular

[kudisbetta]

Dear Kudsibetta:

Sorry for all the trouble you are experiencing.

Has any one tried to treat your adductor magnus? It acts like and aids in the hamstring for some of the muscle.

If the pain is on the medial side, then the adductor magnus could be part of your problem and will seem to be a hamstring problem.

The popiletus, planterius and the adductor magnus are often overlooked. have someone check these for you and note if they could be part of the problem.

Best regards,

Neuromuscular

Yes... ABDUCTOR Magnus.. After looking at a detailed hamstring anatomy pic. All my problems lay in the deeper muscle( abductor Magnus) from the insertion point of the glute/ham.. All the way to the tendon behind the knee at the opposite end.

What do I do??

[kudisbetta]

Adductor Magnus

pinpointed problem areas

[neuromuscular]

Dear Kudisbetta:

Try mild digital pressure into the adductor magnus to see if it IS tender. Then consult a practitioner of your choice and tell the person of your observations.

Also, make sure that they test your popletus and planterius.

That may resolve your problems.

Hope you the best.

Best regards,
Neuromuscular

[bet03system@mail.com]

.., im also into sport.. having a specialist for the whole team sport like soccer is a must..