Question
I've been dealing with a hamstring strain since oct. 22 from over lifting and exercising. I rested for two weeks came back and then re injured it. I have been doing many different therapy regimes i have found online but after awhile it goes back to pretty good pain again. I dont know where to turn. Was i just doing the therapy too quick? what stretching and strengthening exercises should i be Doing? should i be doing heat or ice at this point? and how long should i expect to see results? for now i am wearing compression shorts during light stationary biking and i cant jog because it hurts to much. please help

Answer
Dear Chris,

You remind me of Kevin Johnson.... do you remember him?  Kevin, or "KJ" as he was known here in Phoenix, was an explosive basketball player for the Phoenix Suns.  He wasn't very tall, but he had great quickness and hops.  He also had a bad hamstring!  As a pro player, he had access to all of the best of care. He wore a compressive support.... and in spite of it all, he would have repeats of the injury at least once per year.

The hamstring is a muscle, and when it gets "pulled", we are actually tearing the muscle. Any muscle tear or pull is either mild, moderate, or severe. Mild is a general tearing and straining. Moderate is a partial rupture, and severe is a complete rupture. Since you are still ambulatory, I must assume that it is a mild or mild to moderate pull.  That is the good news. Severe strains require surgical re-attachment.

I often tell people that it is better to break a bone than to pull or tear a muscle. That is because bones heal so well, while muscles are much more difficult.  

For a mild muscle strain, it requires anywhere from 1 to several months to heal. Even when it does heal, it does so with scar tissue, which is never as strong or flexible. (that is why KJ continued to hurt his hamstring year after year).  

Another possibility, Chris, is that you did not strain your hamstring at all. Spinal pain with nerve sciatica often mimics hamstring muscle injury symptoms.  Are you having lower back pain at all when the leg is acting up?

Assuming that this is a hamstring pull/tear/strain, this is what you should be doing....

1) at this point, heat is your best option. It will help to bring in new blood and improve nutrient and waste exchange to the cells. Heat improves  flexibility.
2) Gentle... GENTLE stretching of the hamstrings is appropriate, but much care should be taken to not re-injure the muscle.
3) Gentle.... muscle strengthening exercises.  Low weights... If it hurts, you are working it too much.  Very low weights should be used, with slow controlled contractions. Leg curls with you lying on your belly are perfect for this. Be patient and do slow, easy work.
4) I like the compression therapy during exercises.
5) Every time you strain it again, you go back to square one... which means that it is going to take two months for the muscle to heal.  When was your last exacerbation of the problem?
6) Finally, you should be seeing a good physical therapist who can help you through the healing process. You cannot be expected to navigate uncharted waters on your own.

I hope that this helps you Chris.  Consider the alternatives for diagnosis... and find somebody to help you with the diagnosis and treatment.

Good Luck,

Keith Biggs, DC
http://www.eastmesachiropractor.com
http://www.biggschiropractic.blogspot.com