Biceps femoris injury

Hi -

Was hoping someone might have some advice dealing with injury to biceps femorous (behind knee on the outside). Been feeling pain in my TR workouts and running (recently started up again). Yesterday did 100 mile indoor ride and was in pain entire time (probably over did it). Struggling to walk today. Painful to bend or straighten leg. Any advice for recovery / treatment. Just bought a foam roller and figure working from home and sitting more has caused strain on top of starting to run again. Much appreciated. Hope everyone staying safe. Thanks.

I have had a lot of knee and leg related injuries lately. The one thing I learned is dont force things and recover properly before starting again. Your recovery time will eventually be longer if you keep going while you shouldnt. Go visit a doctor asap and accept this takes time. On the injury itself - a lot of stretching only worked for me, but it may take some time before you can.

Stop cycling…I’m not sure why anybody would train if they are constantly in pain you are just making it worse (I’m not sure why anybody does 100miles on a trainer either but that’s a different story). If you can’t walk you have done some serious damage (I often have been unable to run from injury but rarely unable to cycle) You need to ice it, rest, get to a physio specialising in soft tissue work and get it assessed. If it was a mild strain you could get away with rest, stretching and foam rolling but it sounds like you have a serious injury. One point you could check is that sometimes hamstring pain is referred down the leg by active trigger points in the glute medius and minimus or compression of the sciatic nerve due to a tight pyriformis. You can address trigger points with a lacrosse ball…however it looks like a good old fashioned muscle tear - which will need lots of rest. Hamstrings are really tricky to heal and have ended the career of many an elite sportsman - take it very carefully - this will not go away and you can’t train through it…which looks like what you have been trying to do!

Had this injury last September, caused by overuse + clipless for the first time.

Complete rest for 2-4 weeks. Ibuprofen,ice, feet up while watching telly.

Give yourself a medal/hard slap for cycling 100 miles while your knee was screaming to you that you were doing serious damage.

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Yep - I would still go and see a physio as well to see if the hard slap has retrospectively come to late :smile:

First of all, despite what many posters on this thread are saying, pain DOES NOT equal tissue damage. Anyone who says that fundamentally misunderstands what pain is, what causes it (and what doesn’t), and how to deal with it. So don’t worry or beat yourself up about pushing through on your 100-miler. You most likely did yourself no harm whatsoever.

The bottom line is that almost universally the best thing you can do for pain is exercise. Do it intelligently, modify your intensity and duration based on what your body is telling you, find a way to train that is tolerable and doesn’t exacerbate it. But the worst thing you could do is to stop training.

Furthermore, in almost all cases other than acute tissue damage (i.e. you’ve been shot) there is no discernible biomechanical cause for soft tissue pain. And in almost all cases, the pain resolves itself over time regardless of the treatment protocol undertaken and it does so faster when the individual experiencing the pain continues to be physically active and excercises appropriately.

Here are some excellent sources/resources for learning about pain in general and pain in the context of exercise and athletic training in particular.






Good luck.

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Really so there is no tissue damage from straining or tearing your hamstring and then continuing to exercise…well every time I have had running injury there has been as it is the muscle fibres that are tearing under excessive strain (I have never injured myself cycling) and all the physios I’ve seen to deal with it have advised that initially you follow the RICE protocol. Yes once healing starts you return to exercise and you always look to other forms of exercise to maintain blood flow to the area to facilitate healing but you can’t just keep exercising - it won’t resolve itself - but then obviously apparently I misunderstand where my pain is coming from. I’ll stick to the advice I have been offered over the years thanks.

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It would be nice if you actually engaged with what I said and not with some straw man argument.

I said “pain does not equal tissue damage”.

I did NOT say that “there is no tissue damage from…tearing your hamstring”. You did. Obviously, tearing, by definition, is tissue damage.

Getting shot is tissue damage. Cutting yourself is tissue damage. Muscle belly tears are tissue damage. And yes, tissue damage is frequently, but not always, accompanied by pain.

But, once again, just to be clear since we’re having trouble following the logic: pain does not equal tissue damage. And to go one step further, even if there is tissue damage, pain does not necessarily indicate ongoing, continuing, or increasing tissue damage.

Pain is NOT an input to the brain from the tissues. It is an output of the brain that may or may not be related to tissue damage.

If you want to know more about it then I suggest you go read some of the source material I referenced in the earlier post. If you’re not interested in the actual science and research and just want to believe whatever you want - or what you’re being told by people with a financial interest in your pain therapy - you’re certainly free to do so.

And since you mentioned the RICE protocol, here’s an extract of a paper from the Journal of Athletic Training regarding the actual evidence for the effectiveness of RICE:

And another research review from the Belgian Red Cross:
https://abstracts.cochrane.org/2015-vienna/rice-or-ice-what-does-evidence-say-evidence-base-first-aid-treatment-sprains-and-strains

From the University of British Columbia:

I was engaging with what was said because we were specifically talking about a muscle injury to the hamstring not a general argument about the origins of pain - of course not all pain originates from tissue damage but that was the origins of the original posters issues so that is what I was discussing. I am always interested in actually science and I don’t have a problem following logic as I think a 30 year career as a post graduate scientist and now as teacher of Physics and Maths will attest to. I just considered it more relevant to stick to what the OP might have done to his hamstring and how that could be addressed rather than wading through a large amount of additional reading material (I’m sure it’s very enlightening and I’m not suggesting it is not accurate by the way). Also although you obviously pay for physio on an injury it has actually worked so the outlay was worth it. Finally moving an injury is great for rehab - just not straight away …that is why a joint swells after a sprain to protect you from additional damage - as was mentioned at the start the OP has just injured themselves so they need to start with immediate remedial measures and then - yes - sure move onto all the ideas mentioned in your post but it is not the immediate response suggested by most health professionals. I’m sure you can always find minority articles suggesting alternative regimes and as I tell my students regularly the oil industry and Trump can wheel out the odd scientist who suggest that climate change is not due to man made CO2/CH4 emissions (well cow made in the case of methane) - doesn’t mean they are right. :laughing:

You specifically were NOT engaging with what was said. You were engaging with your own straw man argument. And claiming the opposite is pointless when your post is there to see.

Also I find it amusing that someone will claim adherence to science and logic without bothering to either present their own evidence or review the supporting material presented by the other side.

But we’re getting off-topic from the original poster’s question so I’ll abandon this line of argument with just two points.

First, considering that you’re proposing diagnosing and treating a condition over the internet, based on some vague statements made by the OP, I think taking the alternative perspective of providing that individual with tools they can use to increase their self-efficacy and better understand and address the condition themselves (and issues they face in the future) without being over specific is preferable to blithely giving them specific and likely inaccurate or unhelpful anecdotal advice.

Secondly, to the accusation that I’m “finding minority articles suggesting alternative regimes” I will include the following series of articles and the note that lobotomies were widely used in “modern” medicine for over two decades as late as the 1980s and are now considered “a disparaged procedure, a byword for medical barbarism and an exemplary instance of the medical trampling of patients’ rights”. Science moves on. Medicine moves on. And the fact that “physio’s” are doing something is not prima facia evidence that is is a useful or even valid medical procedure.






I think you’ll find that my first suggestion was that they go and see a medical professional who can access them as nobody knows what the actual condition is until it is accessed. I just suggested stopping cycling until they are sure what is wrong. TBO I have better things to do with my time (like going for ride in the UK sun…which is what I am about to do) than upload loads of articles from the internet - as you say it wouldn’t really be needed as my view is the majority view that (unlike lobotomies) has yet to be replaced and thus is well known to most. Some radical ideas will stand the test of time …some will not - until shown otherwise I will continue to advocate strategies that have worked for me in the past and have the largest body of research behind them. For example I have had a whole host of calf strains when I ran marathons - they only resolved when I stopped running and used a massage ball to realign the scar tissue that formed over the soleus achilles tendon junction. Continuing would have just caused injury after injury and calf muscle like hamstring issues can be really tricky to fix and have ended many a football career in the UK. Admittedly I don’t live in the USA but in this country none of the sports injury professionals I have used have been using techniques which don’t work. In fact the place I use (not much now as cycling is less traumatic than running provided you stay upright) will only see you 3 times as after that they suggest it should be fixed if you continue to follow the exercise/stretching regime or further treatment will not be effective. You and I are entitled to have differing reviews - I will trust my life experiences, athletic background and university education and you can do the same. Since we are unlikely to ever meet it won’t matter - Best wishes :grin:

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“First of all, despite what many posters on this thread are saying, pain DOES NOT equal tissue damage. Anyone who says that fundamentally misunderstands what pain is, what causes it (and what doesn’t), and how to deal with it. So don’t worry or beat yourself up about pushing through on your 100-miler. You most likely did yourself no harm whatsoever.”

This is some of the absolute worst and dangerous advice I’ve ever read on this forum and you have actually presented it in a reasonable way, which makes it even more dangerous.

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A more succinct rebuttal than I managed but basically yes! :smiley: