Lump in my hamstring

February 16, 2024

During a cold track meet in 2017 I pulled/strained my hamstring in the 200m dash. Rehab took about 6 months until I felt as if I was 100% again but I still had a lump in my hamstring.

In January of 2022, the same injury occurred during sprints resulting in more severe pain. I am currently still in rehab (scraping, cupping, dry needling, exercising, etc.) with no improvement of the lump and being able to return to running, even a light jog. I am able to workout and exercise fine other than any hamstring focused exercise.

I have had three MRI’s of my hamstring and knee focused area. Results had shown that I have 12cm edema, slight tearing of the muscle fibers and fluid buildup where the lump is.

My physical therapists and ortho are unsure as to why I am not able to complete a simple jog by now and by being in the military it’s difficult for my annual PT tests and addition trainings.

I’m seeking help as to what may be going on, why the lump is still present and if I may need surgery at any point.

Thank you!

February 16, 2024

Hi Caleb

This is quite a chunky question – and will have a few variables in answering.

But let’s go through the logical stuff.

So the lump you feel from 2016 or 2022 is scar tissue – that’s non specialised tissue that hasn’t reformed into anything that resembles a muscle. It has no contractile property. It cannot be broken down by cupping, scraping, needling, massage etc. It may (or may not) eventually go over time or you can (but you’d be mad to ) have it surgically removed. It’s inert tissue and very happy sitting there.

Your MRI report is…different. 12cm of edema/swelling is strange as it’s like describing 12cm of water. It doesn’t tell you how deep or wide it is and the edema would clinically correspond to a tear, and hence the lump (rucked up muscle tissue). The MRI also describes a slight tearing, which doesn’t correlate to the clinical picture. I get that you should always treat the man and not the scan, but in your case there should be more parity between signs and symptoms- unless the weakness is not muscular but neural. Hopefully this has been cleared by SLUMP testing and a battery of other neuro testing.

It also might be worth getting another set of eyes on you, and not necessarily your hamstring. For me I’d like to understand how much rotatory control of your lower limb you have, what’s your single leg squat like, how your glutes function under load, what’s been your training program so far and simple things like cadence, stride length and your training schedule – do you have a paced program to return to running to deal with load transference, tissue & functional capacity?

So, leave the lump – I’m sure it’s very happy and with regards to surgery you are right to question this as if you are failing good rehab then surgery is the right next step. However you’ve got to make sure you are doing the right rehab, and not just rehab and the MRI should be indicative for something more invasive, which I’m not sure it is either.

The Guru

Guru Responded
February 16, 2024

I greatly appreciate the response back and help that you have to offer. As for my rehab routine since March of 2022, I have been going to physical therapy once a week on base where they scrape, cup or needle my leg and then I’ll do a variation of single leg RDL’s, pistol squats, side/front lunges, bosa ball bridges, single leg bridges, resistance band work and heel drags. I also go to a place called Myolab once a week as well where I’ll get cold rolled, deep tissue and trigger point therapy, active stretching and game ready machine.

I am able to bear weight and complete squats, lunges, leg extensions, leg press, RDL’s but with a lot of pain in my knee where my hamstring injury took place. For cardio I always use the stair master, rower, bike and hop in the pool but always on exertion it feels like if a take it a step farther or faster my hamstring will “snap or pop” again. The farthest I have made it in a jog (10min mile pace) has been 200-300m until my hamstring cramps, gets tight and feels like a pulled rubber band.

I’ve never seen neuro for this or any other issue either. I’m scheduled for an ultrasound appointment on 19 Feb2023 with my doctor.

February 16, 2024

Thanks for the intel Caleb

The good news is you’re going for an USS where they can dynamically look at the tissues and make sure A and s connected to B and question the grade of tear.

I probably think all the passive therapies are now probably past their sell by date and the rehab element is key, but if you can’t get out the dilemma you are currently in ie running – short distance and controlled then other options need to be explored, and you should get this question answered with the USS.

Do let me know what they say, and also make sure you have a portion of your rehab which is control not just strength focused.

The Guru

guru-profile Guru Responded

Have more questions?

If you're struggling with Feet, Ankles & Lower leg, Knees issues then we'd love to help. We offer appointments within 24 hours whether face to face at one of our London Physio Clinics, virtually or if you’d prefer we can arrange a home visit.

Request An Appointment

We aim to get back to you within an hour

How should we contact you?