“I am 70 years old and since 1972 have run over 100 marathons. 5 weeks ago I slipped whilst walking down some stairs and pulled my hamstring. It is the first time I have had this injury and am concerned as 5 weeks on I can walk ok but still not run, Daily icing shows no improvement. Any advice?”
Reader’s email to Matt Phillips, in-house Injury Specialist for UK magazine Running.
Two marathons a year for the last forty years? A huge inspiration for many of our readers I am sure! Sorry to hear about your hamstring strain, very frustrating I am sure. Without examining you I can obviously not give you personalised advice but here are a few general points about hamstring rehab that I hope may be of use.
Though rest, ice, compression, elevation and massage can help reduce pain, performance of a suitably graded, progressive strengthening program is what is required to get you back to running. It can help to look at it like this: the moment you fell, your brain went into protective mode to reduce the risk of any further damage. This is a natural response and a very successful defence mechanism. However, you will not be ‘allowed’ to run again until you have ‘proven’ that you have the strength to cope with the demands of running.
Successful rehab is all about finding what load you can currently handle and then gradually increasing it. This will depend on the severity of the injury but you could initially start by seeing how you cope with a two legged bridge: Lying on your back with feet on the floor and knees bent to about 40 degrees, lift your hips upwards towards the ceiling (as in this video: static bridge). Can you hold it for 30 seconds? Does your symptomatic leg feel weaker / more painful? If the pain is less than 3 out of 10 (where 10 is the worst pain you have ever felt) and you can manage 30 seconds a few times in a row, you can progress to a more challenging task, e.g. a single leg bridge for 30 seconds. Once this is achievable, we could go back to double leg bridge and add movement, or maybe enough weight to stop you from managing over 15 repetitions.
In effect, rehab is about creating a ladder of exercises (the static bridge is just one example) with each rung challenging you a little more over time (e.g. progressing to the dynamic bridge and single leg deadlift) until eventually you are able to run a short, flat, easy paced run without pain. At that point, running becomes part of the rehab.
A sports therapist or physiotherapist should be able to assess you and provide you with a suitable rehab ladder, monitor your development and help you back to running. It will be important to continue the strengthening exercises even after you have returned to running and are pain free as once you have had a hamstring injury the chance of re-injury is significantly higher, especially for the mature athlete – which includes me!
Good luck and let me know how it goes!
Ever struggled with hamstring injury? How did you get over it? Whether you are a therapist or a runner, we would love to hear from you in the Facebook Comments section below!