I'm in the process of training for a half marathon but have been sidelined. I was on a 9 mile run on March 6th and was fine the whole way through. My hammy started getting really sore later than night and I could barely walk the next day. The following day I could walk with minimal pain. It's been 12 days now and I am still not able to run. I iced it for about the first 5-6 straight days off and on and have been taking IBprofen regularly. I have been stretching it 4-5 times daily. I have also been using the stationary bike off and on. I tried to run last night and I could feel it tweaking only a few minutes into it and I stopped. How much longer should I be expecting to be out? The race is April 25th (about 6 weeks). Will I have enough time to be ready? What else do I need to do to heal as fast as possible? Also, what other exercises can I do, so sort of keep my body is shape, since I cannot do any cardio? Thanks for any help!!
I'm not a doctor or PT, but it sounds like you're doing the right things to heal as quickly as you can...rest and ice coupled with some ibuprofen should be helpful. Muscle injuries can end up getting dragged out because you think you're all healed up and then find out you're not when you go out and run again. It ends up being a cycle.
Have you gone to your doctor? Maybe that would be a good idea to do that and get in with a physical therapist.
There are plenty of cardio exercises you could do. How's the bike been for you? If that has been working it's a good cardio exercise...also a good off-day exercise. If you have access to a pool swimming is a great workout. It would be a great way to keep getting in a solid cardio workout. Short of running, I think swimming is the best cardio workout going.
You could also get a foam roller and use it to help massage your hamstring and surrounding muscles. There's lots of foam roller "exercises" you can watch on you tube to get an idea of how it works.
For your half marathon, it sounds like you already have a good base built up (assuming the 9 miler was your long run for the week I would guess you're doing 20 or so miles a week) I think you have enough time to heal up and still be able to finish the run. But, when you get back to running you should probably think about starting easy to make sure you're hamstring is ready.
You should also keep in mind that there will be plenty of opportunities to run another half marathon. I think there's one within a couple hundred miles of my house every weekend. If you're not ready by April 25th, you're not ready. I wouldn't run the race just because you've already registered if you'll end up finishing in a lot of pain or perhaps not at all. Listen to your legs.
I'd have to agree with the very sound advice given above. You are doing some very prudent things to recover right now. The best course of action is to see your doc and get to a PT person. There are always more races... and you are worth the effort of staying healthy for the long term.
Your hamstring (there are 3 on each thigh) is probably just fine, mostly. What you probably have is a myofascial trigger point at one or more locations in one of those muscles, possibly all of them. The one most likely is the powerful Biceps Femoris (outer hamstring), which ends at the outer tendon in back of the knee and splits in two (hence the name biceps) as it orignates high on the back of the femur (short part) and at the "sit bone" you feel on a bike seat called the ischial tuberosity (long part) at the bottom of your pelvis.
Here is a visual aid to show you the location and function of these muscles...
You can read WebMD material about myofascial trigger points and strategies for dealing with them here...
I would be happy to recommend a doctor or physical therapist to you who has sufficient training in myofascial pain and how to treat it, and a lot less training in competing therapies that waste money and time, but they are hard to find. In some cases they may hide the deactivation of a trigger point inside a number of unnecessary procedures, but most of the time, it is incidental or they do not bother. Eventually, you may wind up being subbed out to massage therapists who locate and rub out the myofascial trigger points by increasing circulation and immune response directly in the tissue with their thumbs... but why not use your own thumbs?
Whether or not your insurance covers treatment, it's your dollar. I would give self-treatment a try first, since the results are immediate and often, all you need. I've nursed myself through many a sore hamstring, despite my yearly training from 30-second 200 meter sprints to running 30 milers. These kinds of soft injuries occur in runners all the time, so you want to add some pain control to you toolkit, just like your water bottle. If I (or anyone else) can do it, you can too!
Trigger points are small portions of muscle fibers that contract like the rest of your muscle, but do not release. This can happen in response to injury (even small micro-tears in muscle fibers), overuse, neurological problems, inadequate nutrition/hydration, and even emotional stress. They can range in size from microscopic to large enough to see through the skin. They can persist long enough that they have been photographed in fresh cadavers, which is why rest and relaxation rarely cures them. Most importantly, they are usually aggravated and intensified by stretching and exercise, even if these interventions temporarily numb the muscle. It only takes one tiny trigger point to cause pain, stiffness, and weakness in that muscle and neighboring ones, just the way only one hair of your head has to be pulled to cause you to stop moving.
Most of the time, trigger points occur in response to relentless repetitive movement like running, which is why many healthcare professionals council against it, but there is no reason to give up your sport when you learn how to handle myofascial trigger points. If there were, we would have no professional athletes at all. While they can afford to have their muscles fixed for them whenever necessary, you like most of us, probably cannot. The other reason I recommend frequent self-treatment is that muscle dysfunction left untreated easily develops into tendon, joint, and bone problems by creating wear and tear.
Healthcare costs are high and becoming more so every day. If enough of us learn to treat the simple causes of myofascial pain, the demand for superfluous services will decrease and costs will go down with it. I guarantee that self-help will not threaten the medical industry at all. If anything, it will improve availability and outcomes as demand drops. Who knows, we might all even exercise more!
Regarding other interventions, such as the use of freeze spray, electrical stimulation, ultrasound, injections, even surgery - they all have one thing in common, which is that they consume less practitioner time and bring in more money - to the practitioner, supplier, insurer, and all interested parties. Self massage, ideally performed a few times a day for two or three weeks, would be prohibitively more expensive billed at $100-$300 an hour as a packaged medical product. Ironically, this frequency and duration produces the best results, so you are likely better off trying it first.
There are many resources on-line for understanding muscles, trigger points, and methods of treatment and treatment devices. Beware of them if they want you to buy something. The latest craze is the foam-roller, which is so unspecific in its pressure as to be worthwhile mostly for healthy tissue, but too soft to handle persistent trigger points. Using your actual thumbs and fingers (hard to get most healthcare professionals to do), you can easily find a stiff, sensitive area in your muscle and rub it out with moderately aggressive circular motion. Another technique, called ischemic compression, is best left to professionals since it temporaily cuts off blood flow to the tissue. Most of the time, you do not need to press and hold an area longer than 3 seconds. The pressure should be repeated several times, but for no longer than a few minutes per point, per session - and any gliding should be in the direction of the heart to preserve vein health.
Trigger points tend to occur frequently in the center of a muscle belly where the nerve impulse is often strongest. Be aware that some muscles, like the Sartorius across the quads, and the Rectus Abdominus (sixpack) over your stomach, have mutiple muscle belly sections chained together. Another important thing to know is that one single trigger point that you may not feel can cause other muscles to develop trigger points that you can feel - sometimes more painfully - which is why rubbing a painful spot does not always produce results. You have to find the origin of the domino effect. Once again, you can pay somebody to do this, or save both yourself and (possibly) a practitioner time by ruling out some spots. The longer you delay this process, the more it becomes like whack-a-mole.
You might think it is crazy to share trade secrets of what I do for a living, but I'm doing quite well (thank you), and have found that the more you give in this world, the more you get. Besides, most states (like mine) require professional schooling, licensure, and insurance to do the work I do. Unlike many healthcare practitioners, I have nothing to fear from an educated public; it just makes my job easier. The best part for you, is that unlike prescribing drugs, giving injections, and performing surgery, this is something you can easily do for yourself, even with the help of friends and family.
OK, so I wrote a book again, but it's custom made for you. For other resources (some of which cost, like textbooks, software, and tools), here are a few more links of interest, with many more out there to view (caveat emptor)...
A short case history that explains why "weak" muscles do not always require more exercise (are they calling you lazy?)...
Excellent post. Awesome info. Seriously...excellent. Thanks for sharing. It's a big part of the reason I spend so much time here.
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