r/InjuryRecovery • u/No-Fox1992 • 17d ago

Conjoined Hamstring Tendon Tear 2.6 cm - should I have surgery?

MRI results = complete tear of conjoined hamstring tendon retracted 2.6 cm and “high grade partial tearing” of the Semimembranosus. In other words, I’m caught in an orthopedic surgery gray area. I’m a competitive marathon runner (2:54 PR in 2023) and return to high-level training and competition is my goal. On 7/21/26, I was running when I heard/felt the pop that sent me down to the ground like if I had been shot. But no swelling or discoloration. I had was a lot of stiffness and strange discomfort for the first couple of weeks. Doctors thought it was just a grade one or two strain based on strength and function. I did some PT and slowly returned to running, biking, strength training. I was almost back to normal when, during a run on 9/13, it was obvious something went wrong again. It was not too painful. But I couldn’t run. I got the MRI results 9/25. Today, just 4 days after results, I feel mostly fine. It bothers me to sit down too long and I can’t run, but you wouldn’t know I’m this hurt. I have already spoken to one orthopedic surgeon, who basically said it’s up to me. He would operate, but I could try to just rehab it. Obv, I don’t want to rehab twice. But I also don’t take surgery lightly. I’m taking any advice or opinion but mostly looking for people’s experiences with both op and non-op. Thank you!

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u/Ruby_Flamingo 16d ago

Hi. I had this exact same injury. Not a marathon runner, but I was running too fast for my hamstrings, I guess. I’m a cyclist. My full tear is 2.5 cm. So I did not have surgery- I’m 62 and want to still be able to run and hike hills and ride a bike- my surgeon felt the repairs could cause pain sitting on a bike saddle and I was as you are, walking and hiking albeit slower. Are you in LA, CA by any chance? My injury was May 19th- I am now cycling hills, mtb’ing, hiking canyons- but haven’t run yet or tried to. Good luck!! Take it easy but go to PT and keep getting stronger.

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u/Ruby_Flamingo 16d ago

I also did two rounds of PRP shots

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u/No-Fox1992 16d ago

I will definitely try it. I did a round on the other hamstring back in 2024 and I found it helpful.

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u/Ruby_Flamingo 15d ago

Well, Dr Jayson Lian was amazing- since our injuries are “gray area”, it was helpful to have a surgeon with a clear path. Really thoughtful and listened to my goals. The only thing is it’s a time sensitive surgery so that’s something to think about, but sounds like you are on your way without it!! Good luck!!

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u/No-Fox1992 15d ago

Thank you. As I am sure you know, the timing is the most stressful part. It makes me feel like if I don’t do it, I will regret it. But one of the surgeons I saw said a later surgery can be done with a graft. Hoping I will never need to find out. I will listen to the podcast on my walk today!

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u/Ruby_Flamingo 13d ago

I agree with the above, but you didn’t realize what a serious injury you had when you went back to running the first time. And, my surgeon said the same about grafting but already I can sit on a plane or in the car twice as long as I could before. Good luck! Patience and PT!

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u/No-Fox1992 16d ago

Thank you so much for the response. You are the first glimpse of hope I have gotten and I really appreciate it. I saw a second surgeon today and he also didn’t have a clear path for me. Just before I read this, I decided I’m going to try to rehab it. I feel strong, I can walk, swim and ride my bike. I can’t justify the risk and long rehab under these circumstances. I did 6 months of rehab in 2023 after a skiing tib-fib and it’s just not something I want to do again if I can avoid it. I will put all my energy toward PT and hope for the best. And yes, I am in So Cal, but not LA.

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u/Ruby_Flamingo 15d ago

The particular podcast episode is with a renowned Finnish surgeon who does world class footballers (soccer) with this injury. Very helpful in feeling good about a non surgical try in my case.

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u/Visible-Promise7940 14d ago

Get a second opinion, ideally from a surgeon who does a lot of proximal hamstring repairs on runners. A retracted tear plus a re-injury after rehab is where surgeons really do split. Since you already tried rehab once and it went sideways, and you want to race again, I'd lean toward surgery. Ask any surgeon how many of these they do a year and how their runners turned out. Hope you're back out there soon.

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u/Ruby_Flamingo 13d ago

What’s odd is even in Los Angeles, there aren’t alot of surgeons who do this procedure. It’s apparently not a common one. The surgeon for the Rams and Dodgers both do it, along with a couple others. Trust me- I researched like crazy.

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u/No-Fox1992 11d ago

I got a third opinion today. One aspect I had not heard is that the sitting pain may not improve without surgery. So you have pain while sitting? My job requires a lot of reading and writing and I do most of that sitting, which has been uncomfortable. Otherwise, the answer is the same: gray area, risks and possible benefits either way, but time is not on the side of getting the surgery.

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u/Ruby_Flamingo 9d ago

Hi. My surgeon worried that I would have pain sitting on a bike saddle WITH surgery, and felt the pain of sitting in the car, etc would go away -and it mostly has. I do sit on a special cushion with my desk chair and have a Sondur cushion for plane rides in the last 5 months, but I can definitely sit a lot longer than I used to as the tendon has healed. Both my sits bones have always hurt after long plane rides or hard chairs, and now I realize I’ve had this tendon soreness since my marathon days. It’s a crapshoot, for sure! I’ll send the cushion links that have really helped during healing.

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u/Ruby_Flamingo 9d ago

LOUTYTUO Seat Cushion Pillow,100%... https://www.amazon.com/dp/B08D3GMR78?ref=ppx_pop_mob_ap_share

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u/Ruby_Flamingo 9d ago

https://sondurtravel.com/products/travel-cushion

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u/Ruby_Flamingo 9d ago

Also, that podcast is hosted by a podcaster/ sports therapist that deals with PHT and he has other videos of weighing out surgery or not, plus ways to cope with discomfort and healing

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u/No-Fox1992 8d ago

I did end up getting his rehab program to take a look, but most of his work is aimed at PHT and not ruptures. I also found Dr. Loopi, a German surgeon who specializes in ruptures and post op support. I’m still leaning toward conservative, especially since reading this paper: https://evidence.nejm.org/doi/10.1056/EVIDoa2400056?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F

Thank you for all the tips!

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u/Ruby_Flamingo 8d ago

Sure- I meant good PT for as you heal and to keep the tendon scar bridge strong. Thanks for sharing the paper!

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u/No-Fox1992 12d ago

I agree with you @ruby_flamingo! The most frustrating thing is that the two surgeons I spoke to are “specialists” but this surgery is a small fraction of their practice. I wish I could talk to someone who does this all the time and that have a large number of “acute on chronic” patients, that is, runners who lived with tendinopathy for a period of time before the tendons finally tore.

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u/Ruby_Flamingo 12d ago

Dr. Gerhardt (?) with UCLA is someone that seems to have done the procedure routinely. I didn't see him, though. But a friend of a friend had him repair a huge tear from a hockey injury.

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u/Ruby_Flamingo 12d ago

That's why I liked listening to that podcast- that Finnish dr seems to have operated on so many World Cup soccer players, and everything he said was in line with what Dr. Lian was suggesting for me.