Hamstring

[Deborajen]

I'm still doing battle with my hamstring, too. If I come up with anything - causes, solutions, etc., I'll let you know. It's really frustrating, I know.

I've been going to PT for a little over a week now and it's been getting worse. My therapist has added some stretches and has done massage at two of the sessions. The first one felt really good for a few hours and then became really painful, and I was sore all over the next day. I swore I'd drunk enough water, but apparently not. She massaged again and I was sore afterwards but improved a few hours later (I drank LOTS of water). She doesn't really know the cause but says my legs are very flexible but my back is tight. She says if the back is tight the legs have to give and vice versa. I've been thinking for years that my hams are tight - ? She says it could also be piriformis but I've been stretching that for three months now. She's added a "big gun" piriformis stretch to my regimen - says that still might be a cause. Anyway, I go back on Tuesday and she says if I'm not better she might try iontophoresis.

Right now I can only walk for a few minutes without the ham getting really painful. Except for some really short jogs (less than a minute at a time), I haven't tried running since June. Riding bike feels o.k. but the doctor recommended I hold off on that until the pain settles down. Standing is the worst. Standing to cook, even something quick like macaroni and cheese, is hard. It's SO frustrating! I'm stretching and taking my Mobic - and here it is, fall, beautiful weather, and I'd just love to go for a run or do some good riding -- ugh!

Well, keep hanging in there. Misery loves company, but hopefully we'll both be rid of this soon.

[Catrin]

I certainly hope that things improve for you soon! It sounds like your problem is more advanced than mine.

Had a talk with my fitter about this yesterday, and he seems to think that it is related to my saddle height and that it won't resolve until we get my knee angle closer to 30 degrees rather than the 45 degrees it currently is on the bike. We are inching the saddle up, 3mm every few weeks, and he isn't recommending we increase the timing or distance of that. There were good reasons why the saddle has been so low.

If it doesn't start to improve soon then I will need to seek the advice of a PT - ideally one who is also a fitter if there is such a person in the region. I did take the weekend off the bike. Went hiking today (a gentle 3 mile hike in an area that is flat). The hamstring was fine during the hike, though it was aching a little on the drive home. Considering last week it starting hurting after 3 laps on the track at my club I am hopeful!

[Selkie]

I'm still doing battle with my hamstring, too.

I've been going to PT for a little over a week now and it's been getting worse. My therapist has added some stretches and has done massage at two of the sessions. The first one felt really good for a few hours and then became really painful, and I was sore all over the next day. ... She says it could also be piriformis but I've been stretching that for three months now. She's added a "big gun" piriformis stretch to my regimen - says that still might be a cause. Anyway, I go back on Tuesday and she says if I'm not better she might try iontophoresis.

Deborajen-- It sounds like you're going through something similar to what I experienced more than ten years ago. Piriformis syndrome ended my running "career." I was a long-distance runner, half-marathons were my preferred event. For months, I thought it was a hamstring issue but it was PFS, which resulted in sciatica. Chronic pain when sitting, which was horrible since I'm a desk-bound bureaucrat. Took a long time to get better and luckily, I haven't had a major recurrence of it.

I highly recommend seeing an Osteopath for an evaluation/treatment.

[Deborajen]

I've been suspecting piriformis might be my problem, too. I tried doing some new stretches from a running website back in July and the piriformis stretch seemed to pull a "bad spot." But after stretching it regularly for three months, it's not really getting better so I don't know. I don't have any pain when sitting (thankfully! I have a desk job, too). If I recline, though, and the pressure is above my sit bones, that hurts and then I get tingling in my hamstring and foot.

I'll see what happens at PT tomorrow.--

Catrin - This might sound kind of odd but when I worked for an orthopaedic surgeon years ago, he used to say that one thing that can help a hamstring pull is running backwards. I've tried a little of this at the park when walking my dog with no luck but might give it a try on the elliptical at the gym. It sounds really wierd to me but on the other hand it's the reverse mechanics of walking/running/pedaling which seem to aggravate the muscle. I don't know about you, but I'd try anything right about now.

[Catrin]

Good luck with the PT today!

I am feeling better - after taking the weekend off I went to spinning class last night and after weeks of this it seems to, finally, be resolving. Not saying that I didn't get a twinge or two, but that was all Will take a gentle ride tonight in my favorite park and see what it feels like.

[Catrin]

Good luck with the PT today!

I am feeling better - after taking the weekend off I went to spinning class last night and after weeks of this it seems to, finally, be resolving. Not saying that I didn't get a twinge or two, but that was all Will take a gentle ride tonight in my favorite park and see what it feels like.

edited: The 16 mile ride last night went just fine - so we will see what happens with a longer ride

[KnottedYet]

Right now I can only walk for a few minutes without the ham getting really painful. Except for some really short jogs (less than a minute at a time), I haven't tried running since June. Riding bike feels o.k. but the doctor recommended I hold off on that until the pain settles down. Standing is the worst. Standing to cook, even something quick like macaroni and cheese, is hard. It's SO frustrating! I'm stretching and taking my Mobic - and here it is, fall, beautiful weather, and I'd just love to go for a run or do some good riding -- ugh!

.

Ask your PT to explain the symptomology of a lumbar anterior derangement to you (in particular how it effects WOMEN), and have her show you the flexion (bending forward) movements to correct it. Once it's corrected, the ham and piri will stop freaking out. The tingling with extension will also go away.

Also, ask her to teach you to stand properly in a neutral pelvic tilt, with knees unlocked and core engaged.

[Catrin]

I guess this is just going to take time to heal completely. This week has gone so well for my leg, was even able to hammer it on my ride last night. Today? 15 minutes until my ride the hamstring started to hurt a little going up a hill in my favorite park. Good thing I was in the park - which meant that I was close to my car. Otherwise I would have just ignored it. Instead...I went home and iced it, took some ibuprophen. I could still feel it when I got home

Hopefully this means that I can ride tomorrow since I listened to my leg today May just go for the elliptical at the gym instead though...I WANT to go have a nice LONG ride on my bike tomorrow ...dagnabbitx&@*#$Y)Y%#@ Perhaps a short one, we will see...

[Deborajen]

Ask your PT to explain the symptomology of a lumbar anterior derangement to you (in particular how it effects WOMEN), and have her show you the flexion (bending forward) movements to correct it. Once it's corrected, the ham and piri will stop freaking out. The tingling with extension will also go away.

Also, ask her to teach you to stand properly in a neutral pelvic tilt, with knees unlocked and core engaged.

I'll be sure to ask her about that at my next visit on Wednesday - thank you! At my appointment a few days ago, she did some more massage but worked the lower back a little more, and she also mentioned again that the back is always suspect when the hamstrings act up, especially when there is tingling in the legs and feet. She didn't add any back stretches yet, but she seemed to be a little more suspicious of the back. It'll be interesting to see what she says next time.

[Catrin]

This backing off thing is for the birds.....but I AM doing it. Went to spinning class tonight and agreed with the instructor that all I could do was to just spin easy - he knows me as he said "none of this seeing how much you can do and waiting until there is pain to back off" (he is also my personal trainer).

It was quite hard to do that, but I just sat there and spinned?...spun? for 50 minutes - and stayed in the seat. My trainer isn't shy and he gave me "the eye" once when he thought that I was pushing too hard. Since EVERYTHING gets my hamstring's attention am trying to find some way of exercising - though this barely got my heart rate up to 105...so I probably did it right

Tomorrow after work I have a deep tissue massage scheduled with one of the specialists at the spa that happens to be located in my health club - the entire place is a medically based facility. I am sure it won't be a pleasant experience, but hopefully it will be therapeutic.

Should there not be improvement by Friday morning, I have an appointment scheduled with my doc.

I want to ride my bike this weekend...

[KnottedYet]

If you don't seriously STOP and let the damm thing heal, you won't be riding at all.

[Catrin]

If you don't seriously STOP and let the damm thing heal, you won't be riding at all.

I think that I had to see for myself that even spinning that gently wouldn't help...it did not seem to hurt anything, but I am now stopped. In the past I've always gotten away with just continuing through while something healed. I mean, I was back at work once 6 days after major surgery (that wasn't by choice).

So I have the deep tissue massage scheduled for tonight after work and while I am still meeting with my trainer we won't be doing any lower-body work. I can't even find a sore place with my fingers, though the warmth I get sometimes indicates inflammation. The guy I am seeing tonight is quite good at this - I would prefer to see a woman but this is the best MT they have that has an opening this week.

[Catrin]

Went to a massage therapist this evening and had a good massage that focused on my hamstring. He did not think it a good idea to do a full deep tissue massage, though he did do that along with other things.

Apparently my hamstring (the one with the word bicep in the name) wants to enter a rock and roll band because he said it is tight enough to get a tune from it. Joking aside, he said that my hammie is so tight that it is probably trying to protect an injury such as a microtear or something of that nature.

It feels better already, though it is still quite tight. He gave me some stretches. I will still stay off the bike for a few more days and stretch/ice. There is inflammation, which is what the warmth is from. The sorest place he found is where that particular hamstring attaches at the top, though there is another sore place in the middle of the hammie in the middle of my thigh.

I do feel better about the whole thing as there doesn't appear to be any real damage. Part of the tightness may well be related to the height of my saddle - it isn't high enough - but I am just speculating here.

So stretch, stretch, stretch, and when I get back on the bike this weekend I will take it quite easy. Really.

[Deborajen]

Ask your PT to explain the symptomology of a lumbar anterior derangement to you (in particular how it effects WOMEN), and have her show you the flexion (bending forward) movements to correct it. Once it's corrected, the ham and piri will stop freaking out. The tingling with extension will also go away.

Also, ask her to teach you to stand properly in a neutral pelvic tilt, with knees unlocked and core engaged.

Thanks again, Knotted, for the recommendation.

I've had a couple more PT sessions and I asked about anterior lumbar derangement. She explained what it was and said it's a possibility as is spinal stenosis (walking the dog and leaning back/getting pulled is more painful than pushing a cart in the grocery store), and she put me on some stretches and strengthening exercises for the lower back. I'd been doing piriformis and hamstring exercises for several weeks and they weren't helping much.

Today, I mentioned that I noticed that crouching helps with the spasms and she said that sounds more like psoas muscle. Lying on the table on my back with my left leg hanging off the side was painful in the "spasm" area, lying on my back rotating both legs (knees bent) side to side was painful in the same area (left side) when rotating knees to the right - both of these she said point to the psoas muscle. She sounds very convinced that this is the problem, and since the exercises do pull the sore area I'm a lot more confident we're on the right track now, too. The only doubt I have is that the tingling didn't sound like a psoas symptom, but she did say that everyone is built differently.

Anyway, I hope I'm finally on track to getting this thing settled down. I'll keep doing the exercises and listening to my body. It sure would be a lot easier if body parts didn't blame each other so darned much!

[KnottedYet]

Today, I mentioned that I noticed that crouching helps with the spasms and she said that sounds more like psoas muscle. Lying on the table on my back with my left leg hanging off the side was painful in the "spasm" area, lying on my back rotating both legs (knees bent) side to side was painful in the same area (left side) when rotating knees to the right - both of these she said point to the psoas muscle. She sounds very convinced that this is the problem, and since the exercises do pull the sore area I'm a lot more confident we're on the right track now, too. The only doubt I have is that the tingling didn't sound like a psoas symptom, but she did say that everyone is built differently.

Anyway, I hope I'm finally on track to getting this thing settled down. I'll keep doing the exercises and listening to my body. It sure would be a lot easier if body parts didn't blame each other so darned much!

Psoas muscle is anchored on the 5 lumbar vertebrae. If it is so tight that it is pulling you into an anterior derangement, a tight psoas could indirectly cause tingling. (via what position it forces the vertebrae to take and the corresponding weakening of the disc between them)

The problem with a derangement is that the outer wall of the disc becomes overstretched and weak, and tends to take a blobby shape instead of a nice firm-edged shape. (perhaps overstretched from the tight psoas yanking on the adjoining vertebrae like I mentioned above) Now you have TWO problems: a messed up disc wall that needs to be addressed so it can heal, and a tight psoas. The messed up disc wall is what ultimately causes the tingling in lumbar extension.

But actually, you have THREE problems to address: blobby disc wall, tight psoas, and WHAT THE HECK CAUSED THE PSOAS TO GET TIGHT IN THE FIRST PLACE?

Again, please ask your PT to coach you through lumbar neutral in standing and walking, coach you how to protect and re-shape the disc so the weak blobby area can heal, and analyze the forces your lumbar spine experiences that may have caused the whole business to start in the first place.

(based on what you said about supine lumbar rotation, it could be a lateral relevant derangement rather than an anterior derangement, both can cause tingling in extension. Your PT should be able to figure it out in about 5 minutes and will teach you how to push it back into shape and what to to do keep it there for the 7 days it takes to heal the disc wall.)

ETA: as far as her initial mention of spinal stenosis is concerned: your asymmetrical response to supine lumbar rotation pretty much ruled that out, which is why she didn't pursue it further.