Dear Running Doc:
I was tripped at the start of a 5K and pulled my hamstring, and now I can’t run without pain. Friends tell me to try to run as usual. I want to return to running as soon as possible, as I’m preparing for a fall marathon. Any suggestions?
Kevin P., Staten Island
Thanks for this important question, Kevin.
If your long-term goal is to keep running and racing without pain and constant re-injury, ignore your friends’ advice. Running in pain can make an injury worse, or lead to another injury if the pain is causing you to alter your form. You also run the risk of permanently reducing your performance potential by preventing proper healing of the muscle fibers.
When you pull or tear a hamstring, the healing process shortens the muscle fibers and causes scar tissue to form. Yes, you can run taking small steps (shorten your stride length), but as soon as you try to extend to your normal stride length you’ll risk another pull. As long as you can maintain your form you can run realizing it is for training, not to set new records!
To properly heal your pulled hamstring, you must stretch and strengthen the muscles with exercises carried out under the guidance of a knowledgeable physical therapist. This treatment will encourage the muscles to retain their pre-injury strength and length — or even become stronger and longer. A good physical therapist can also perform soft-tissue work to bring in blood flow — which promotes healing — and break up scar tissue. Realize this may take 4-6 weeks.
I suggest you visit a sports medicine doctor to have your injury evaluated and get a referral for physical therapy. You will most likely be able to run during this treatment, though it’s wise to avoid racing and speed training. If you are in a real hurry, PRP has had fantastic results healing a tear in 3-7 days.
To reduce your risk of re-injury, take time to stretch the hamstrings after every run. Running causes microtears between the hamstrings’ muscle fibers, and without stretching the fibers heal back shorter. Over time this decreases your stride length — so you run slower — and makes the hamstring vulnerable to a serious pull or tear.
Kevin, let us know how you are doing and when you get back to regular training.
Enjoy the ride!
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Lewis G. Maharam, MD, FACSM is one of the world’s most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc’s Guide to Healthy Running and past medical director of the NYC Marathon and Rock ‘n’ Roll Marathon series. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
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