Torn Hamstring

[Domjo54]

Injured playing baseball (non-contact injury) nine days ago. Hamstring is swollen / painful / rotating bruising, with related pain in the knee and glute. Yesterday's MRI reading just came in:


FINDINGS:
Complete tear of the mid semimembranosus tendon. The tear is located approximately 10 cm inferior to the ischial tuberosity. Retraction of the distal tendon with approximately 7 to 7.5 cm gap between the torn tendon segments. Moderate ill-defined fluid and hemorrhage in the fascial plane. Small amount of hemorrhage and edema around the adjacent sciatic nerve.. Associated ill-defined T2 hyperintense interstitial edema and hemorrhage in the distal semimembranosus muscle belly."

The biceps femoris/semitendinosus are normally intact.

Signal intensity of the visualized femur is normal. The anterior compartment musculature of the right thigh is normal.

IMPRESSION:
1. Complete rupture of the mid semimembranosus tendon with moderate retraction.
2. Associated strain of the semimembranosus muscle belly.


I am meeting with an orthopedist in two days to review. While I've been cautious thus far, I'm self-aware enough to acknowledge my own tendency to push myself faster than he'll likely recommend (and am balancing that against the bias that surgeons are more likely to recommend surgery). Trying to gather what questions / perspective I should go in with, as well as whether I should be doing anything but RICE.

(I acknowledge none of this is official medical advice.)

[Mark Rippetoe]

You waited 9 days before getting a diagnosis, and are waiting 2 more days to get the advice of the surgeon. It's a bit late to repair anything now, since it's already "healing." How old are you?

[Domjo54]

You waited 9 days before getting a diagnosis, and are waiting 2 more days to get the advice of the surgeon. It's a bit late to repair anything now, since it's already "healing." How old are you?

To clarify: I got medical attention last week, but it took a week for the MRI. Original expectation was that it was a strain. Getting on specialists' calendars is a bitch.

Age 31. Have been training for a dozen years. Like everyone else who trains, I've accumulated injuries, but never of this kind.

If it were strictly a muscle injury, AND had been closer to the time of injury, Starr Protocol may have been appropriate. Given that it's a full rupture of the tendon, I find myself pretty unsure.

[Mark Rippetoe]

It should have been repaired, about 8 days ago. Now, you'll just have to work through it.

[Domjo54]

It should have been repaired, about 8 days ago. Now, you'll just have to work through it.

Work through = …?

And is the implication that, at this point, I should avoid surgery?

[Mark Rippetoe]

I doubt you'll find a decent surgeon who would repair it at this point. Start the lifts light, and progress as possible.

[SmokeyStrong]

It should have been repaired, about 8 days ago. Now, you'll just have to work through it.

Rip, this could very well be a stupid question, but do you have any tips you’ve learned and follow of what injuries require immediate diagnosis and which can be a more “wait and see”?

I’ve read some other posts on here about back injuries and have learned from you sometimes back tweaks happen and you can work through it slowly. This case should have been seen immediately but I could picture myself also waiting to see if it got better on my own, which I’m now learning wouldn’t be best.

Maybe it would be more obvious when it happens just from how bad it hurts, or is the back just more of an exception, and it’s usually better to just get things checked out to be safe?

Thanks

[Mark Rippetoe]

Tendon ruptures need to be repaired ASAFP, while muscle bellies usually heal pretty well unless the muscle is torn completely in two, which doesn't often happen in the weight room. Back tweaks heal, and unless there is neurological deficit, e.g. numbness, loss of control, they don't usually need to be seen. But there are exceptions, so don't hesitate to ask somebody.

[BareSteel]

What is unique about tendon ruptures that creates a brief window of opportunity for repair?

[SmokeyStrong]

Tendon ruptures need to be repaired ASAFP, while muscle bellies usually heal pretty well unless the muscle is torn completely in two, which doesn't often happen in the weight room. Back tweaks heal, and unless there is neurological deficit, e.g. numbness, loss of control, they don't usually need to be seen. But there are exceptions, so don't hesitate to ask somebody.

Thank you