Do you like to sport? Do you like to exercise? Do you exercise and often times you leave out a thorough and regular stretching and enough time for regeneration after the physical activity? Are you aware of it but you still don’t care? You are hazarding with unpleasant injury of your burdened muscles. With this problem we have usually athletes searching our services, but not only them. This painful complication can happen to anyone during physical activity. We will demonstrate it to you on one of our client. We will show you how we can at our facility, FYZIOklinika, help you quickly and effectively with muscle rupture and help you to return back to a normal life again without any traces of pain left.
THE CASE OF RUPTURED HAMSTRING OF MRS. V
Female client (55 years), Mrs. V., has searched out our services two days after her injury (16.4.2015) of a ruptured hamstring, a muscle that is located on the back of our thigh, which happens quite often during physical activity. In case of Mrs. V. the cause was just an incorrect step on the right leg while wearing high heels. That led to painful rotation in the hip, that is when the client felt sudden muscle stretch around the hip and back of the thigh. She suffered a shock, and from then on she didn’t feel well. She couldn’t step on her leg at all.
During the time she got to us, her condition was already little bit better, however she couldn’t stand with full weight on her right leg. She walked very slowly with short steps because extending the right leg was very painful. She felt even more pain when she had to walk into the stairs, but she was able to walk upstairs.
In this case, the diagnosis was clearly a ruptured attachment of the tendon on the back side of the thigh muscle. As has been already stated above, this injury can occur during excessive force developed on the muscle. Bigger rupture or complete rupture appears rarely and therefore in most cases this injury is not very extensive and serious. However it is still manifested by strong pain and it often causes several other unpleasant complications, which prolong the healing process and regeneration. Injury of this muscle group is in some cases accompanied by formation of ligamentous scar which causes friction and stops you from continuing in any physical activity. There is also a danger that the mentioned scar which is not elastic can rupture again during bigger burden.
First meeting
We performed few entrance examinations on Mrs. V. along with ultrasound. There was a clear hematoma in the affected area. The area of the tendon attachment of the semitendinosus and semimembranosus muscles (located on the back and inner side of the thigh) was painful on touch. The sitting bones of the pelvis seemed to be painful as well as the muscles between the sacrum, tailbone and buttock muscles. The pain would appear in the upper part of the leg during walking, so the client had to do small steps. She also had restricted mobility such as bending forward and stretching out. She was also troubled by standing on one leg, which she was able to withstand but with some pain. All that was accompanied by a light edema on the right leg.
For a fast and effective treatment we decided to choose the focused shock wave therapy, which is concentrating energy deeper into the tissues. We treated the sitting bones like that, trigger points in the buttock muscles and inner side of the thigh. Then we also performed mechanical lymphatic drainage and in the end we applied lymphatic technique with kinesio tape on the hamstrings and buttocks.
Second therapy
Four days later after the first therapy 20.4.2015, had Mrs. V. attended her second therapy. From examination we noticed smaller pain beneath the sitting bone, the thigh was not swollen anymore, but the hematoma was still visible (in size of 20x10 cm) on the back of the thigh. On the calf was a smaller hematoma (about 15x7 cm).
We again applied focused shock wave therapy on the sitting bone, buttocks and inner side of the thigh. Then we performed one hour long mechanical lymphatic drainage, and applied kinesio tape on the hamstrings and calf muscle.
On the photography you can see that the area which was taped up healed much faster, which proves that lymphatic technique and kinesio tape really works.
Third therapy
We continued in the same therapy after three days from last visit 23.4.2015. It was clear that lymphatic drainage worked very well on the hematoma of Mrs. V’s leg. We could again perform a treatment with focused shock wave therapy on the same parts as before. In the end we performed lymphatic drainage and applied kinesio tape again on the affected areas of the body.
Fourth therapy
Five days later we continued with the same process of the treatment. There was still a slight pain on the sitting bone. Client was already able to bend in a 90 degree angle in her hips the big hematoma started to absorb, the one on the calf just started to develop with a bigger expand, but it had lighter color. It was visible how effective kinesio tapes are.
Last - Fifth therapy
On the last therapy 4.5.2015 it was examined that the hematoma on the thigh is completely gone, and the one on the calf was still there, but almost healed as well. The client was able to walk swiftly, hike, and by a slight running she still felt a slight pain, but that would eventually fade out. Mrs. V. was therefore recommended at the end of the treatment to exercise specific exercises for stretching the hamstrings.
From the case situation above you can see that focused shock wave therapy in combination with kinesio tape is appearing to be very effective treatment. The shock wave therapy speeded up the process of recovery, and the kinesio tape worked very well on the hematoma.
Lymphatic kinesio tape technique works on the principle, when the receptors leads the impulse into central nervous system, from where the nerves lead the information. It’s always 3 kinds of informations:
- Motor control = muscle is moving
- Vegetative = blood vessels are opening in order for the muscles to have oxygen and nutritions
- Sensitive = feeling that your muscle is stiff
In this case the vegetative information is very important for us, that is when the lymphatic nodes and lymph vessels are released. Lymphocytes, subtypes of white blood cells with protective function, can consequently deal with the hematoma and at the same time lower the muscle tension and speed up the metabolism of the tissue, treat the swelling, accelerate the recovery of the injured tissue and in result lower the pain.
Stretching the back of your thigh
We present you here short exercise tutorials of how you can stretch the back of your thigh (hamstrings) and prevent that way any unpleasant and painful injuries.
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Clinical experience in private practice and physiotherapeutic field, FYZIOklinika