weak hamstring??

[jimbo77]

Hi,

I'm now 26 months post-ACL reconstruction. Still having problems walking, and with a general lack of feeling in the hamstring/calf area. I think this may be because my quads are strong (I cycle to work each day), but my hamstring very weak (though much stronger than it was), and it's not pullling the knee back enough. When I swing through, my leg extends very freely (though not quickly!), and it doesn't feel like it's extending at all (even though it is!) (unless I flick the knee out, which can lead to hyperextension). After a while, the top of my calf goes numb (presumably because it is not being contracted sufficiently by the hamstring, or else the hamstring is working too hard?).

If I try to run, my leg doesn't come back quickly, and often get a jolt in the knee. Similarly, I have trouble swimming, as, when kicking, the leg doesn't 'bounce' back up easily. When I'm standing too, the leg always feels like it's being pulled forward. There's also visibly far less tension in the hamstring than my good one.

Been seeing physio regularly in last few months, and working hard on the hamstring, but exercises don't seem to be making huge difference. He also thinks it may be neurological.

Any thoughts/tips?

Many thanks,

James

[ATsoccergirl]

What type of graft did your surgeon use?

[henri]

I have the exact same problem. I have been working on my hammys for a long time now, doing hamstring curls and some exercises with rubber band for about 9 months now, still, i have the exact same feeling. I have also been saying this to my PT and she also claims it might be neurological.
On the other hand, i certainly dont feel the tightness back there as i have on my better knee. When i kick the ball, it might just hyperextend from the kick when i miss the ball , or when i try to stretch , before i get the pulling sensation, it takes alot more stretching than with the other leg. I feel quite vulnerable because of that(specially walking on a slippery ground), as hamstrings are supposed to protect you from hyperextending. I had one incident in the winter where my leg hyperextended due to this, when i slipped, if i had had right hamstring strenght, hamstrings would have protected knee from hyperextention.
What i am doing now, is that i try to do alot hamstring curls and also ride a bike. I am quite sure, my hamstring strenght and quads strenght are out of balance, as i didnt do no hamstring exercises for the first 7 months or so.
i am hoping for the better, working on it, it will get tighter and will start to grow, theres no other choice for him
PS i had a hamstring graft, so loose feeling kinda makes sense

[jimbo77]

yep, had a hammy graft too...

Cheers, Henri - sounds very similar to me. Reassuring I'm not the only one!

Yes, it's very vulnerable for me on slippery ground - have to be very careful in the swimming pool changing rooms/showers. Also find walking on sand difficult. Stretching too, I'm the same - I can easily touch the ground without feeling the pull, which is far more difficult on the good side.

Interesting though - I only really started tackling my hamstring seriously a few months ago (and I remember the surgery absolutely flattened them), and wish so much that someone had told me to work on them from the word go, and/or identified how weak they were (rather than quads, quads, quads, extension, extension, extension!!).

I'm also doing a lot of curls (PT reckons should do high weight, low reps), lots of rubber band work, and also just started Nordic curls. Guess you're right - a matter of keeping going, and hoping it gets tighter!

Doesn't seem to be many other people with this problem - I know I have very supple hamstrings, and have hyperextended kicking a ball in the past. In hindsight, reckon a patella graft would've been better. Still, had I worked on them properly straightaway, would have been fine I reckon, as the quads have just got stronger and stronger.

[Annika]

What is a Nordic curl?

[jimbo77]

Hi Annika,

a Nordic hamstring curl is an alternative to regular curls, but very tough!

you kneel down, with a bar/weight/someone-else holding your ankles down. You then let yourself fall forward, but not all the way to the ground. The hamstrings take the strain. When you do fall on to your chest, use your hamstrings to pull yourself back to the initial position. It's a killer, but I'm assured it really strengthens your hamstrings (eccentrically apparently).

Not sure why they're "Nordic" though?! Must be those crazy scandinavians who invented it!

[Annika]

Certainly does sound like a killer. I'll try and remember it for when I get there. I am a crazy Swede but had never heard of it!

[Linds]

Sounds like you might be having problems with propreoception. The body is loaded with these little "sensors" that kind of tell the brain what is going on in different areas of the body. Your brain doesn't get the message that your leg isn't moving back in time until you've jammed the knee...

Hopefully the PT will help.

[feeny]

Im at 20 onths, and I had a hamstring graft too - two tendons - the semi-tendonosus and gracilis were taken from my injured leg to make the autograft.

Firstly, I recall reading somewhere that a balanced leg has a hamstring with 60-80% the strength of the quads - and that for ACLr people, it would be better advised to aim for 80-100% hamstring strength vs. quads. I never quite clarified what this meant - IE which exercises to use as comparison - so I used leg extension vs. hamstring curl. If I am correct in this (and I think I am) - it means that I ought to be able to hamstring curl 80-100% of the weight I can leg extend.

The main hamstring exercises I do are the hamstring curl and always do it one legged trying to keep both legs balanced. The same goes for the hamstring swiss ball curl - I do these one legged too. Also - an eliptical strider / walker on a high resistance setting will work hamstrings individually.

I dont ever feel loose in the hamstring - but I do feel a bit one sided- kind of like the tendons on the lateral side of the knee are doing more hamstring work than the medial side. This make sense to me, as the two tendons were taken from the medial side. I only ever really feel the hamstring differences when specifically exercising the hamstring. In normal day to day activity or even when playing soccer - I don't feel the hamstring.

If it is neurological - then linds may have hit the nail on the head with her "proprioception" comment. Get on a wobble board for a few mins a day and increase it. I remember during my intense rehab days I would try and balance on a wobble board (both a disc wobble and a vew-do board) whilst watching a movie ned to end without falling down - and whilst balancing would also try to squats, one legged balance, one legged squats etc - all which both helped proprioception and rehab in general!

Lastly, as jimbo says, I think its something that needs to be gotten onto quickly, before bad neurological (and muscular?) habits have a chance to develop. Several team mates of mine who also had ACLR didnt get onto these things quickly, and never returned to sport, have gait issues etc.

[jimbo77]

Thanks Linds and Feeny!

I hadn't heard of propreoception, but sounds similar to what I'm experiencing. I think, along with the weakness, my main issue is simply the lack of 'feel' (numbness really) in my hamstring/top of calf, which I have never had since the ACLR. I have to stretch so much to feel it, or really ram my fingers in there to feel anything.

I definitely feel my lateral hamstring is doing more work than the medial side. With all the strengthening exercises I'm doing on it though it's definintely getting stronger, and always feels much better (though, again, quite numb) after a good workout. Oh well, I'll keep going, and see if my PT can do anything to help get some of the feeling back (which, weak or strong hamstring, I think I should have!).

Thanks!

James

[jimbo77]

Not sure if this is related to my ongoing problems, but when I flex my hamstring, when I get to abut 90 degrees, my lateral tendon always catches on something as it flexes, causing a clunk. If done at high speed, it's not too noticeable, but at slow speed, and especially when doing hamstring curls, it is very noticeable, and, after doing a few times gets quite aggravated. When I extend back beyon 90 degrees, it clicks back.

Anyone else come across this??

[feeny]

I have had various clunks - not in that area - but in other areas.
I had such a huge clunk, I swore it would never go away and people would hear me clunking up to them from miles away.
Both PT and surgeon said it would go - and it did go. I am now clunkless.

It is usually just a bit of scar tissue somewhere that gets ground down - and if you can pinpoint it with your fingers, you can actually "grind it down" with some massage too.
At least - thats the case with adhesion stuff - Im pretty sure it ought work for other clunkers too - but to be sure, ask a PT if its ok to press "there" (whereever there is)

[WJD]

Hi Jimbo

I've got the flexion clunk in my non-op knee. I was cheeky at when I saw the OS about my ACL, asked him to have a look at the clunk. (It can acutually be seen! like the lateral tendon passing over a bit of bone). Anyway, thats what he said it was. Its not painful, just feels a bit grisly, and so I do not flex as much as everyone else when doing squats with weights on a bar on my shoulders. Also feel it a bit on lunges. Apart from that I ignore it.

By the way, sorry to hijack your thread - although it is partly related - does anyone have any experience in training their brain back to using both legs equally? I have been ACL-less for two years, and my good leg has unconsciously been doing 70-80% of the work. I am now trying to train my legs to work equally (lots of one legged cycling and jogging seems to help). Anyone else experience this?

WJD

[jimbo77]

Hi WJD,

yes, that's exactly the clunk I get! strange that it's in your good knee though! That's what my physio says it is too.

on your 2nd point, I'm always trying to get my bad knee to do more work, but difficult! Probably what you're doing is fine though.

Jimbo

[kneeboy]

im bumping this thread!


because i have the same problem!


I just wonder if any of you guy got better???