The Achilles Hamstring

Unlike its more famous cousin the Achilles tendon, the hamstring is not instantly familiar as a symbol of mortal vulnerability. In fact, hamstring injuries -- like bad backs -- often seem elusive, their severity uncertain and ill-reported. People even make fun of professional athletes who complain too often of a "bad hammy" (Manny Ramirez). Bill Parcells famously mocked then Patriots receiver Terry Glenn, saying that it took Glenn longer to recover from a bad hamstring than it took Parcells to recover from his heart attack.

But for anyone who has suffered with a chronic hamstring injury, it is one of the most frustrating, discouraging, soul-sapping conditions imaginable. You never know from day-to-day where you stand, and how you're doing. If a hamstring injury is a metaphor for anything, it's a metaphor for the way the wonderful running machine can be completely ruined by the malfunction of one link in the power chain.

Hamstring injuries are extremely common, but poorly understood. Most of us figure that we get hamstring injuries when we run too fast before we have warmed up, and that we will cure them by being more conscientious about stretching and warming up. This is fairly simplistic, but sometimes it works.

But other times, an initial hamstring injury becomes chronic. An initial injury becomes a trigger point -- a small area that is permanently knotted by errant nerve signals. The muscle tissue around the trigger point is affected, and feels sore, and yet stretching does nothing to alleviate the problem. Using a roller, stick, or even a tennis ball to massage the area can help, but sometimes it doesn't, and the weakness continues. Anything faster than jogging feels mechanically awkward. It's impossible to generate power. Speed suffers, of course, but so does any semblance of fluid stride. The athlete loses confidence, over-compensates by using other muscles in ways they are not used to (possibly developing a secondary injury).

At some point, the injury to the body infects the mind, and the athlete becomes afraid to test him or herself with anything close to full speed. Hamstring injuries can go on for months or years. A pattern of discomfort takes hold and becomes difficult to break.

So what to do?

Well, I think dealing with a chronic hamstring injury requires first that someone competent locate the actual area of the problem, not just the area that feels uncomfortable. Trigger points can refer pain elsewhere in the muscle, making it hard to identify the true problem spot. A good massage therapist can relive the complex of tight muscle fibers, opening up the area for healing. This hurts, by the way, but it is necessary.

The next requirement is patience. Easier said than practice, unfortunately, especially after a long period of suffering with the injury. And yes, patience applies not only to having reasonable goals day-to-day, but also taking the time to develop a good warm-up routine, with or without stretching. (I am not a fan of extensive pre-run stretching, feeling that you are as likely to re-injure yourself with too aggresive stretching, as you are to do any good.)

The final ingredient after therapy and patient rehabilitation is to get your confidence back. I wish I had an easy answer for that one!