Once diagnosed and home I was keen to explore 🤓 more about this injury. I went straight to Google only to discover it was limited in this regard. Particularly the NHS website which states “grade 3 – a complete muscle tear. Severe hamstring tears will usually be very painful, tender, swollen and bruised. There may have been a “popping” sensation at the time of the injury and you’ll be unable to use the affected leg.”
According to the much more detailed Wikipedia “A grade 3 hamstring strain is a severe injury. There is an immediate burning 🔥or stabbing pain ⚡️and the individual is unable to walk without pain. The muscle is completely torn and after a few days a large bruise 🌑 may appear below the injury site caused by the bleeding within the tissues.”
The Wikipedia description is more akin to my own experience. My report on my initial visit to A&E was that the muscle was burning, on fire 🔥, it felt like a dead leg and I was unable to walk or sit. Although not evident at this presentation, the bruising 🌑 appeared when we were in Harrogate 3 days after the event and was certainly visible on the second visit. I felt I had made the correct representation of my symptoms but it had not resulted in a diagnosis at either of these visits to A&E and I’m still not sure why that was the case.
There were also a couple of blogs 📄 from doctors or physio’s who had also sustained a hamstring strain but most of the information related to lesser injuries sustained as a result of training or sports 🏋️♂️ and threw no light on my situation.
However I did find some academic studies that reported sufficiently on Grade 3 injuries to suggest a diagnosis was possible. Grade 3s were more commonly associated with slips 🤸♂️ and falls (caused by block heel boots). Individuals aged between 40-60 👵🏼 (I just made that) were more at risk and women 👧 (definitely made that) were approximately 3 times more likely to suffer hamstring strain than males with the majority of these being from non-sporting scenarios. (again those block heel boots) Yep, it was all out there, but I’m guessing Wikipedia is not on the trainee doctor reading list.😨
And, with the absence of diagnosis, of course comes the guaranteed lack of treatment. 🔬The recommended treatment for this injury is the RICE protocol — rest, ice, compression and elevation. This treatment is the same regardless of the severity of the injury, and should be commenced within the first five days. RICE is primarily used to reduce bleeding and damage within the muscle tissue. Of course this would have been useful if that was what I had been advised but the first and second visit to A&E failed to even identify the problem. 😳
In the immediate aftermath I needed to know this. Instead of going to Harrogate I should have been home with my hamstring rested in an elevated position with an ice pack applied for twenty minutes every two hours. Lower grade strains can easily become worse if the hamstring is not rested properly. Bleeding needs to be reduced but in my case this had not been addressed and my blood loss was significant. 🤭 Complete ruptures require surgical repair and rehabilitation but as I had not had my diagnosis for over a week the window for repair had apparently weakened and surgery was less likely.
On this evidence an apology from the consultant does seem appropriate, but I have also raised this as a concern with the NHS so that others with the same problem get the right help when its needed…….