I Think I Pulled a Hammy

Golf Today Northwest - - Contents - By: DR. HARRY G. SESE, DC, BS, RMT, GOLF IN­JURY & PER­FOR­MANCE SPE­CIAL­IST Dr.sese is the Clin­i­cal Di­rec­tor at the Wash­ing­ton Golf Per­for­mance In­sti­tute in Belle­vue, WA.

Most peo­ple have ex­pe­ri­enced a ham­string pull, or tech­ni­cally a ham­string strain, to some de­gree or an­other. For in­stance, if you have gone for a long run or worked out your legs in­tensely in the gym, you may have no­ticed some ham­string pain im­me­di­ately af­ter­wards or the next day. Or maybe you were jump­ing and heard or felt some­thing “pop” in the back of your thigh. These signs are all in­dica­tive of a pos­si­ble strain and mus­cle dam­age, but the sever­ity is what helps dif­fer­en­ti­ate be­tween what is nor­mal and what is a po­ten­tial in­jury. Let’s take a closer look at what a mus­cle strain is. First, a mus­cle is made up of sev­eral tiny mus­cle fibers. Con­nec­tive tis­sue sur­round­ing these fibers help put them in larger groups and even­tu­ally cre­ate a big­ger mus­cle. The ham­strings, “Dear The Golf­ing Doc. I was work­ing out and felt some­thing pop in the back of my thigh. I dropped to the ground with a lot of pain. I think I pulled my hammy? Please help. Thanks."

—George A., Ta­coma, WA

which are made up of 3 large mus­cles (bi­ceps femoris, semimem­bra­nosus, semi­tendi­nosus) are a great ex­am­ple. These fibers can stretch but when they are over­stretched, they be­come trau­ma­tized and in­jured. This can hap­pen with ag­gres­sive stretch­ing, a sud­den con­trac­tion of the ham­string, or even a di­rect blow to the mus­cles. A ham­string strain can be cat­e­go­rized into 3 cat­e­gories: Grade 1: Mild dam­age to the in­di­vid­ual mus­cle fibers, usu­ally less than 5% of the fibers. Signs and symp­toms in­clude min­i­mal loss of strength and range of mo­tion. Grade 2: Moder­ate dam­age and in­volves more mus­cles fibers. This grade can be used to de­scribe tears up to 90% but the mus­cle is not com­pletely rup­tured. Signs and symp­toms in­clude loss of strength and range of mo­tion. You may also ex­pe­ri­ence some limp­ing and gen­er­al­ized bruis­ing. Grade 3: Ex­ten­sive dam­age and com­plete rup­ture of the mus­cle or ten­don. Signs and symp­toms in­clude sig­nif­i­cant pain, sig­nif­i­cant loss of strength and range of mo­tion, pos­si­ble in­abil­ity to walk with­out as­sis­tance, and swelling. When it comes to treat­ment, it all de­pends on proper di­ag­no­sis by your doc­tor and where you are re­ferred to for ther­apy. Here are some gen­eral rec­om­men­da­tions and guide­lines:

Grade 1: Don’t try to stretch the ham­string too much as it is al­ready over­stretched. In­stead, rest it and ice it. If you don’t make it worse by ag­gra­vat­ing it with ac­tiv­ity, then it will nor­mally take 2 to 3 weeks to im­prove. Grade 2: Treat it like a grade 1 strain but you may need to take some­thing for the pain. These can take 2 to 3 months to im­prove with the ad­di­tion of some form of re­ha­bil­i­ta­tion ther­apy. Surgery is usu­ally not nec­es­sary. Grade 3: De­pend­ing on what part of the ham­string is rup­tured, surgery may not be nec­es­sary. How­ever, keep in mind that it may be re­quired to reat­tach the dam­aged mus­cle or ten­don. Heal­ing time in­clud­ing ther­apy and re­hab ex­er­cises may take 12 to 15 months un­til full strength and range of mo­tion is re­stored. So, de­pend­ing on the grade of your ham­string strain, your abil­ity to golf may or may not be af­fected. A grade 1 might be un­com­fort­able to golf but it would be best to avoid any swings that ir­ri­tate it. A grade 2 is more sig­nif­i­cant and I would rec­om­mend not golf­ing if you can feel that ham­string while walk­ing or swing­ing. A grade 3 is the ex­treme case and I would wait un­til you are cleared by your doc­tor to golf. My ad­vice is to take care of your ham­strings be­fore you have a prob­lem. One way to do that is to foam roll the mus­cles reg­u­larly. This will help mas­sage the fibers and even help loosen up any knots you may feel. An­other thing is to stretch them reg­u­larly. If you go to the gym or have weights at home, do a few re­sis­tance ex­er­cises to help keep the ham­strings strong. If you feel any pain, stop im­me­di­ately and con­sult your physi­cian. For more ex­er­cises on keep­ing your legs healthy, visit Shawn’s daily blog at www. shawn­farm­ers­ese.com.

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