Dear Running Doc:
I did a 5k on Saturday. The gun went off and I got tripped up by someone behind me. I know I pulled a hamstring. I made it about five steps. I tried to stretch it; I walked some and then tried to jog-no good. I was forced to drop out which I have never done in my life-45 years! I was told by friends I should try to run using small steps and keep stretching it. I am not able to run without quite a bit of pain. I'm signed up for the mini-marathon next week and I really hope I can make it. Any suggestions?
— Kathy S. Marlboro, New Jersey.
Your friends may be leading you down the wrong path. I know runners want to run and run pain free but just stretching and running with shorter steps may seem good for you in the near future, it is not a good long term solution. In fact, it is just this strategy that leads to chronic hamstring problems and slower performance! Let me explain…
Hamstrings are muscles made of many many parallel muscle fibers. On any given run, microtears occur between these fibers and if you don’t routinely stretch after each run, they heal back shorter and the next time out, you tear more and more until you have pain and a tear that is visible and painful.
Painful large tears heal back shorter as well. They also heal with scar tissue. If you continue to run with shorter steps, decreased stride length, not only will you encourage shorter healing, but due to decreased stride-length, your times will get longer and longer until you press harder and tear again.
Healing of hamstrings require WORK if you are to heal back at proper pre-tear length. That means strengthening exercises to continue and encourage muscle growth and stretching to encourage length. Strengthening exercises are best carried out under the guidance of a knowledgeable physical therapist that can also do soft tissue work to bring in blood flow and decrease scar tissue. So see your Sports Doctor early and get the right supervision early; it is harder to correct once this condition becomes chronic (breaking scar tissue and encouraging new muscle formation), but not impossible.
PRP has been shown to rapidly heal hamstrings. It’s remarkable how soft tissues heal with this treatment.
This is NOT to say that you can’t run next weekend! Be aware that if you are taking shorter steps, your time will not be as good and if you feel no pain, you still have work to do to repair your hamstring and re-increase your stride-length to normal. And remember the rule of thumb: If the pain becomes such that it changes your running form, STOP and go see your Sports Doc before you do something else to hurt you
Enjoy the ride!
Lewis G. Maharam, MD, FACSM is one of the world’s most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc’s Guide to Healthy Running and past medical director of the NYC Marathon and Rock ‘n’ Roll Marathon series. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
Want your question answered in this column? Write to running doc at email@example.com.