Fitness

Out of the darkness

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I am fast approaching the one year anniversary of my hamstring avulsion repair surgery and I wanted to document where I’m at with it – especially as there are a large number of people that have emailed me in desperation, trying to find information about hamstring avulsion repairs, the success rates, whether you can return to previous levels of performance etc etc. The biggest problem with this injury is that it’s relatively uncommon and there seem to be few documented experiences about the subject and precious little about everyday people getting back doing what they love. When I was doing my research that was probably the hardest part about facing the surgery – it did seem like I faced a long dark journey into the unknown.

In Australia, the bulk of surgeries seem to be performed in Sydney (Dr David Wood) and Melbourne (Orthosports Victoria). I saw a few surgeons in Brisbane who were loath to operate on it, simply from an inexperience point of view. I visited both David Wood in Sydney and Andrew Oppy in Melbourne – and really connected with Andrew, who cheerfully stated that he was pretty confident he could repair it, but given the length of time between accident and diagnosis, there were to be no guarantees. At the time of surgery, I could not walk properly, squat or climb hills on my bike and as a result I was starting to slide into the long goodnight of depression.

The surgery went well. Andrew complimented me on the “clean break” of the three tendons and told me that due to this, the repair procedure had been surgically pretty simple. Even as I came out of the anaesthetic, my leg felt different (in a good way) and I was discharged to our long stay apartment in Melbourne the next day. By the sixth day, I was beginning to make little strides without my crutches – which apparently happens to some patients, yet the overall recovery period is the same – which is exactly what has happened in my case. I didn’t bother with a Shewee, recommended by several runners, but hired one of those over toilet seat aids so I didn’t have to do any deep sitting/squatting.

I started physiotherapy at approximately 8 weeks post surgery. This involved pelvic stabilisation drills and gentle bridges and at 12 weeks post surgery, I was cleared to start doing exercises that also involved hamstring strengthening.

At 12 weeks post surgery, I got back on my bike again and started the long and arduous process of regaining fitness and strength. To be honest, I don’t think I was in any way prepared for how hard this journey was going to be. Nothing felt good. I developed wrist tenosynovitis and everything was a struggle. As I’ve documented in previous blogs, I gained a lot of weight (try 15kg on for size) and fell into a black hole of depression and anxiety. I found going back to work difficult – not only was I having a ton of trouble demonstrating exercises, the weight I had gained hung like a heavy noose around my neck. Here I was, a health and wellness professional, looking and feeling far from well.

I don’t know why, but I persisted. I joined the University of Queensland adult swim squad. I signed up for some sprint distance triathlons and a fun run – six months post surgery. The hamstring rehabilitation appeared to be dismally slow. I tried to run and I couldn’t. I stood at the start of the Twilight Run in September, crying at the start line, ashamed of my weight gain, filled with feelings of incompetence and embarrassment – this chick that used to run sub five minute kilometres for a 5km run was going to struggle to walk over the starting line! However my hamstring was not prepared for my will and despite the odds being firmly stacked against me, I ran the whole way.

I repeated the same cycle over and over again at the next couple of sprint triathlons I participated in. Each race would see me in a corner, reduced to a pile of tears. My heart wanted to compete, but it was all I could do to complete the event. I tried to remain upbeat and cheery to those around me, but at this stage it felt like I was losing the battle on all fronts. My hamstring hurt and I dreaded doing the rehabilitation sessions in the gym. Finally a heartfelt email to the specialist hamstring physio did the trick – I was paired up with another physio in her practise who devised all sorts of ways to get the hamstring activated with minimal pain. Suddenly I began to improve and there was a little bit of light at the end of the tunnel. I rejoined my coach and started on a cycling program. At that stage (December) I was beginning to give up hope that I’d ever be remotely athletic again. The first couple of rides were brutal. There were often tears as I quietly made my way along the road, which would then later subside when I conquered a hill that I’d been panicking about. By the end of that month, I was starting to become a little bit fitter, though still unable to climb very well.

In January, I revisited the physio, who progressed my hamstring exercises and I began to get ready for an Olympic distance triathlon. Running was beginning to become limited by a lack of fitness, rather than an onset of hamstring pain and the week before the triathlon, the strength of my left hamstring was 80% of my right one, which in surgical terms is a good outcome. At this time, I also started seeing a psychologist and dietitian to assist me with the psychological trauma surrounding the accident, amongst other things.

Unfortunately I was not able to complete the triathlon two weekends ago due to my quad cramping on the way home on the bike. Subsequently when I ran I sustained a mild tear and had to stop. After an in-depth discussion with my physio, we came to the conclusion that I still need a lot more strength to be able to compete at the same level I used to. For somebody that’s not particularly involved with sport, where I am now may be a satisfactory outcome but I’m pretty sure that I can continue to improve over the next six months or so – so I am paying more attention to strengthening this leg and look forward to reporting back again in a few months’ time. At this stage on the bike, after having a good old debrief with my coach and deciding to take off some self imposed pressure by not doing any major racing until next year, I am finally enjoying finding some improvements on my climbing, which is just such a lovely feeling after what has been a pretty rotten year.

To sum up, at a year out – I’m 80% better and at a more than acceptable level of fitness and strength for daily living. However, as I love getting and staying fit, I want to continue to improve and be the very best that I can be – and I’m confident I can do this. If I had any advice or sage words to impart they would be –

1) If you’re prone to depression or mental health issues and you’ve just had your stress outlet (exercise) taken away from you, seek professional help. It has made all the difference to me – and unsurprisingly, my performance.

2) Expect that you’ll likely need ongoing physiotherapy for the better part of 18 months or so.

3) Imagine a reasonable time frame to an athletic goal – then double it – that’s about how long it takes to regain lost fitness and strength.

4) Don’t give up. Recovery is possible. I’m sharing the dark times so that you know that you’re not alone. Take your time recovering. Lower your expectations. Don’t beat yourself up that you’re not getting better fast enough. It just doesn’t work like that.

5) It’s a major surgery/trauma. Mick Fanning, famous Aussie surfer, took 18 months out of his career to rehabilitate from this surgery. As we all know, he’s still a force to be reckoned with in the surfing world – but when I think I’m not progressing, I think of Mick. Reading Mick’s autobiography helped me as he describes his hamstring avulsions as one of his most traumatic life experiences to that point.

6) Keep working at hamstring strength/endurance 🙂

It’s very nice to have moved out of the darkness and finally back into the light.

6 thoughts on “Out of the darkness

  1. Thank you, Liz – The detail and honesty in describing your recovery is so helpful. I’m nearly 4 months post-op (injury was 8 days old) after a complete hamstring avulsion (all tendons and the Adductor Magnus torn off the bone with severe retraction). I could not walk at all. My surgeon was Dr. David Wood in Sydney. After 43 years of running without injury, this has been both an emotional and a physical struggle. Your shared experience brought me much needed hope and inspiration. Good luck in your recovery and making strides on that last 20%.

  2. Hi Liz
    I have just got results of a hamstring avulsion . Searching for info and coming across your story is very helpful . It is interesting and hopeful reading about your honest progress.
    Thank you. Grant.

  3. Hi Liz,
    Thank you for sharing your story. Wow, it sounds like your surgery went well but the post op recovery process is quite an ordeal.
    On January 1, 2018, I suffered a full avulsion tear of my left hamstring Both my conjoint and my semimembranosus tendons. Conjoint retracted 1.3 cm and semimembranosus retracted 7mm. I am six weeks into recovery with no surgery. I have been researching and trying to find surgeons who perform proximal hamstring repair in Hawaii, but it is not a procedure performed here very much. I have found a great surgeon in Los Angeles, California who can perform the surgery on me.
    Meanwhile, I am nearly pain free and walk normally and can go up and down stairs no problem. I have started mellow PT but I am an athlete so I have started pushing the envelope on my own. I’m not cycling, running or surfing yet but I can jump rope and do agility type exercises carefully but with no pain. I feel like it is pretty stable and healing, but not strong enough for any ballistic type activities or training.
    My question to you is do you think it’s worth the difficult post-op for me to go through this procedure? Do you remember what you could do, before your surgery, at 1 month or 6 weeks after your injury? I’m assuming that at those time marks you had not had surgery yet. How are you doing now?

    1. Hi Rick, if you are an athlete, I would have the surgery without question. I could do things after my injury but my tell tale issue that things just weren’t right was I couldn’t run, nor walk properly, even though I was training for a big cycling event. I am 3 years post surgery in April and while my hamstring will never be the same, I am competitive within my chosen sport and can surf etc.

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