Excruciating Hamstring Cramps

author : AMSSM

comments : 0

I'm doing my third IM in a week and a half and right now my hamstrings are a mess--sore, tight, cramping too often. I'm desperate. Is there anything I haven't tried?

Member Question

For the past several years I have suffered from excruciating hamstring cramps--the kind that make me fall down in a heap of pain and cause my hamstring to be very sore for days after. I've tried extra stretching, massages, hydrating until clear urine is coming out of my ears, potassium rich foods and supplements.  I am doing my third IM in a week and a half and right now my hamstrings are a mess--sore, tight, cramping too often. I'm desperate. Is there anything I haven't tried?

Answer from Chris Gee, MD, MPH
Member AMSSM

Dear Excruciating Hamstring Cramps,

This is a really tough issue, as I'm sure you are well aware.  Unfortunately, certain athletes just tend to cramp and this can be very difficult to control.  You have tried the appropriate initial therapies of stretching, massage, hydration, and electrolyte supplements.  Oftentimes the problem is that there is a section of the hamstring that has developed some scar tissue from a previous injury (like a small tear or strain).  That scar tissue is not as strong as regular muscle fibers and therefore continues to get reinjured.  The muscle around the scar will cramp and spasm to compensate and prevent further tearing of the affected area.  Basically, if the routine therapies listed above are not helping, then likely you need to be more aggressive about letting the muscle heal.  I've found that extra stretching and exercise does not allow the muscle to fully heal and repetitively causes small trauma to the affected area.  I would suggest really shutting down your activities for a few weeks and just letting the muscle heal.  As hard as it sounds, that means no stretching, running, weight lifting, jumping, etc.  That will really maximize the healing for the muscle.  

Once that phase is complete, then I'd begin a course of therapy that focuses on eccentric strengthening exercises to stimulate the muscle fibers to rebuild their elastic and tensile strength.  These exercises load the muscle in a shortened state and then the muscle is lengthened while the load is applied.  Once the muscle is fully lengthened, then the load is removed and the exercise can be repeated.  Try using ankle weights while your knee is flexed and hip is at neutral.  Add the weight and then extend the knee.  This will hopefully build a stronger muscle that will resist the temptation to cramp and spasm.

Other treatment options may include PRP or Prolotherapy that may have some benefit in rebuilding damage tissue.  These involve injecting platelet rich plasma or other chemicals into the affected tissue to stimulate growth.

Good luck!  Hope your hammies calm down!

Thanks

Chris Gee, MD, MPH

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date: March 17, 2015