Health Blog

by Mark Pitcairn-Knowles (Osteopath)

One of my other roles is as an Athletics Coach at Tonbridge Athletics Club, where I am involved in the Senior (over 18’s) distance running group.

At a recent training session which involved some faster shorter reps towards the end, I noticed one of the relatively experienced athletes feeling the back of her thigh and stretching her hamstring. She said that she had felt a twinge but thought it was cramp and would be ok to do another rep. My advice to her was to stop! This is a classic case of an athlete who does not want to accept that they have an injury that will result in a period of rest. However, by ignoring that first indication they are highly likely to end up lengthening the eventual period of rest required.

In my opinion, the way this started as a sudden onset during intense activity is clearly an indication of muscle or fascial tear. The fascia is a fibrous connective tissue that wraps around the muscle in the body. When this happens, with the correct treatment/management, a period of 14-17 days is normally the minimum time required to allow for repair and a return to activity.

In the case of this athlete, trying to continue would have stretched a fresh injury, effectively pulling the tear further apart and would certainly have been the wrong thing to do. This incident prompted me to write this post as it struck me that clear advice is always helpful in trying to prevent more long-term damage.

In the case of this type of injury, my best advice is …

Accept that you must stop the activity!
This is often the hardest thing to do!!

Apply ice within the first few hours.
This is to reduce bleeding into the tissue – blood causes irritation when it is in the wrong place. It will also reduce the time required to re-absorb the blood.

DON’T stretch for the first 2-3 days.

Start to apply warmth and massage gently on about day 3 post injury.
Slowly increase the massage and use a foam roller.

After a week you may feel quite pain free and be tempted to restart running again – DON’T!
It is almost guaranteed that you will cause a relapse and prolong the period of recovery. However, you can start to stretch the affected muscle and walking should be fine.

If all is feeling good at day 14, start with a run/walk over a short distance. Take a day off, then a slow run, then a day off. If all is fine at this stage you should be able to resume normal training.

Rather than just feeling fed up, try to see this period of rest as a chance to concentrate on other aspects of your training such as core work.

Obviously, you should also question why the injury happened in the first place and try to learn from the experience. Was this a new activity? Increased intensity or distance? Did you feel generally fatigued or had you done other strenuous activities such as hedge cutting or a long walk prior? Considering these things may help with prevention in the first place.