How to know when it is time...

[Catrin]

I've been asking/grumbling here about my hamstring problem for about 3 weeks now - and am starting to wonder when to know when it is time to seek medical advice.

It isn't getting any worse, and indeed for most of the past week it felt fine. Even managed to ride close to 40 miles (not at the same time). Today however, it is just aggravated. I honestly don't know if it if overly tight or pulled. The pain, if that is what it is, isn't bad, just enough to let me know that the hamstring exists. Sometimes it does this when lying on my back, sometimes when seated, or walking, or...whatever. Then I can hammer out +1 hour on the bike and not the slightest twinge.

I am hesitant to go to the doctor because I figure they will want an MRI - and with our insurance we have to pay 20% of that cost...I just cannot handle that - even if I wasn't moving in 3 weeks.

I know that hamstrings take a long time to heal once they are strained. I have really backed off on the intensity of my biking/spinning/weight lifting - but I have to exercise to keep my blood sugar under control. I have stopped almost all of the lower-body weights at the gym.

A few weeks ago there were times when there would be twinges of pain and warmth - and those do not happen any longer. I do think there is improvement...but I am a stubborn woman when it comes to such things. How long should I give it before seeing my doctor? He is an osteopath...

[KnottedYet]

Unfortunately, you are the only one who can answer that question.

And any doctor who cannot start to help you without an MRI first is a dunderhead. Tell him you can't afford the copay on a $3,000-$5,000 MRI.

A D.O. has a huge pile of skills to call on before flinging MRIs around. I doubt you'd have a problem getting help from him.

[Catrin]

Unfortunately, you are the only one who can answer that question.

And any doctor who cannot start to help you without an MRI first is a dunderhead. Tell him you can't afford the copay on a $3,000-$5,000 MRI.

A D.O. has a huge pile of skills to call on before flinging MRIs around. I doubt you'd have a problem getting help from him.

Thanks Knotted, I had wondered about that, this is the first D.O. that I've had as my PCP.

I think I will give it another week before picking up the phone. I have just been so frustrated with this since yesterday...

[pinkychique]

Sorry I haven't heard your grumblings before this, so this might be a dumb question, but have you tried massage? I was having a lot of issues with tight/achy/downright painful muscles and it turns out it's a bunch (and I mean a BUNCH) of trigger points.

I picked up The Trigger Point Therapy Workbook Second Edition by Clair Davies, and it's been very helpful and informative. I'm certainly no expert, but it's an alternative if you want one.

Best of luck.

[Chicken Little]

That's a massive pile of muscles in there. I would suspect that you could get an adequate diagnosis without and MRI, and CT's are certainly cheaper, but a good doc can probably give you a good idea about what's going on with just an exam. Either way, it's going to take a ton of patience to get it to settle down. Rest is always your friend, but I feel your pain.

[Catrin]

Rest? Rest? Who needs rest?

Indeed, there are a lot of muscles there - and all of this seemed to get started when I had a session scheduled to get stretched because my hip flexors were so tight. In retrospect I probably should not have done that - but I did not know. It won't happen again...

I've requested an appointment with my D.O. on Friday, if it calms down before then will just cancel the appointment (my dr. office uses the internet a lot for scheduling).

I still have to exercise, and I am not off the bike entirely - just limiting myself to shorter rides, taking a day off between them, and avoiding my country roads where I WILL over-do things. There has been some improvement, but this has shot my plan to have a century done by my 51st birthday all to pieces. My birthday is in 2 weeks and the longest ride I've had in the past 3 weeks was 50 miles...three weeks ago

My fitness club does have a spa where they do sports massage, it might be worth a conversation with them to see if a little massage might be in order.

[BleeckerSt_Girl]

It sounds to me like most of the exercise you do is very straining/pulling on your hamstring and leg muscles.

Maybe this is silly advice, but...
How about doing a lot more walking? I do a lot of walking at a nice comfortable but brisk pace- like maybe 5 miles twice a week. It's GREAT for my muscles all over my body, and also for my hip joints I find. Walking does more for me all over than biking does, actually.
When I neglect my walks, after 3 weeks or so I wake up all creaky in the mornings and feeling stiff and... old. This happens even if I'm still biking. So I know that walking keeps me much more flexible in both my muscles and my joints. I feel totally stretched out and relaxed after a long brisk hour long walk. Sort of a 'poor woman's massage'- lol!

It might be just the ticket for your injured muscle?
One thing's for sure- it's cheap and easy to do! Why not just give it a try before seeking medical treatments? Start with a brisk 2 miler and work up to 4 or 5 miles, twice a week. Or maybe 3 miles 3xweek. I'd say jogging/running might again put too much strain on your leg muscles while they are trying to heal.

[JennK13]

With Lisa. You haven't been off it to let it rest enough to heal. I get that you have to exercise, but you can do things that are less stressful - like walking. I would think that no matter what is wrong with it, with or without an MRI, a doctor is going to suggest rest, too. Unless you're ready to do what is necessary for any injury, I wouldn't "waste" the money to go to the doctor. Really, taking at least a week "off" to let it heal is worth it when you consider the alternative.

[Catrin]

Good, and direct, points...and well taken. I've been quite resistant to taking time off because walking has caused just as much discomfort as biking - and even hiking difficult terrain no longer raises my heart rate above 95. So I figured if walking has the same effect as biking, then why stay off the bike?

Friday's discomfort may simply have been because I went riding after strength training. I will go for a gentle ride today - and if there is any discomfort at all, I will take the week off the bike.

As Lisa pointed out however, walking serves more purposes than cardiovascular and while I do walk several times a week, I will do more of it.

[indysteel]

And stop doing lower body resistrance training this week while you're at it. There's no sense staying off the bike if you're just going to do strength training instead.

[Crankin]

+1 with Lisa's advice. I no longer can get my HR up with walking, but I still do it a couple of times a week. It makes my body feel good in ways that are different. Sometimes I don't have time to do anything except the 2.2 mile walk up and down my street... since it's a hill, I just walk really fast and I can now get up a sweat doing that. But other times, I walk with DH, who "complains" about walking faster than about a 3.5 mph pace (he has "delicate" feet.) This is what really stretches out my body. Since I decided I can no longer attempt to run (which I loved for weight control), which wreaked havoc on my back, I have decided to keep walking as an important part of my fitness routine. I often combine it with yoga or core work when I get back. Since I no longer belong to a gym, this is what I do on days I would have been at the gym.

[JennK13]

Good, and direct, points...and well taken. I've been quite resistant to taking time off because walking has caused just as much discomfort as biking - and even hiking difficult terrain no longer raises my heart rate above 95. So I figured if walking has the same effect as biking, then why stay off the bike

.I do agree with you on this! There are other things, though. When I'm on an off day, I ride my cruiser at an easy pace - different riding position, and I'm not inclined to go fast or push myself at all. Being on that bike reminds me not to. Do you have access to a pool - how about trying some swimming or water exercises? You could try different strokes to see which doesn't hurt your hammering, or even just use a buoy and do arm pulls (if you aren't a swimmer, this is a great workout!)
The main thing really is to not aggravate the hamstring. As an athlete, I know how frustrating rest and healing can be - I've also suffered LOTS of injuries; some that jagged me for far longer than they needed to because I didn't let them heal, and others as a result of me favoring the injured limb and hurting something else in the process! And my performance was far less than optimal, so it's not like working through the pain helped me at all! Even now, as an adult I'm still stubborn and have to remind myself of these things - I hadn't been on my bike for two weeks due to a cheat cold and sinus infection. I have a "rule" that I never go more than three days off the bike, but I was S-I-C-K! No matter how much I wanted to ride, I stayed off so I could get well. It's only taken me 15 years and numerous visits to the urgent care after coughing up blood to "figure out" that I can't push the envelope when it comes to injury or illness! Went for a brisk 30 miles yesterday and felt great!

[Catrin]

I hear you IndySteel. My trainer and I have been very cautious with lower-body work, most of my work has been upper-body since this started - outside of a few deadlifts and squats - neither of which caused pain or discomfort of any kind.

I have decided to stay off the bike until Friday - that will give me a solid week...and yes, that will include the spinning bike. I was actually trying to justify going to spinning class and just take it really easy - but this kind of defeats the purpose. I mean, sitting here at the computer I am aware of that hamstring...so I don't need to take the bike out to test and see if there will be discomfort. There would be.

I've always been the type to just push through pain until it gets too bad to ignore - but in this case that is just silly. I will walk at the gym and do upper-body workouts.

You know, this cycling is quite addictive - but there are far worse addictions to have It would be easier to stay off the bike if the weather wasn't so nice...

[Veronica]

Just go to the doctor. Then you'll know what's wrong and what to do about it.

Veronica

[azfiddle]

Catrin,
You're getting some good advice and suggestions. Here's a related story with my 2 cents worth of advice. Last spring, I suddenly got pain on the outside of one knee when cycling. I came to the conclusion that the IT band was irritated, due to too much hard climbing on the bike.

I went to the doctor and she sent me to a PT. Yes, there was inflammation in the IT band, but as difficult as it was for me to accept at the time, the PT blamed my hips being out of alignment, and prescribed a bunch of stretching and strengthening exercises for my legs, lower abdomen, etc. My hamstrings were really tight, as were my calves and piriformis (a muscle in the butt). I was very unstable when standing and walking for a while.

The PT took me off the bike completely for a couple weeks, then encouraged me to ride short, flat and easy rides for a while. The whole thing felt worse before it got better, and it took about 3 months altogether. At the end of 3months, I was able to ride up to 100 miles a week again, including a long climb up Mt. St. Helens. My left side still has some tight hamstrings at times, much more than the right, but if I go back to the stretching, even a couple of days, it improves right away.

A car accident a week before the pain started may or may not have been responsible for the hips being "out". On the other hand, it may have just been overuse, without enough stretching. We're not kids anymore and we have to be a little bit more careful with overuse...

Main points:
1-no MRI or other expensive tests were needed to identify the problem- it was a hands-on and observation by the PT.

2. I was faithful about doing the prescribed series of exercises, although I tried to ride again too much/too soon and probably set myself back a little.

3. I went for several massage therapy and chiropractor appointments, and I think they were helpful and confirmed what the PT was saying, though the perspective was not identical.

4. Go get it checked out- and do your stretches!