To break or not to break

[sps]

Fellow physios,

here is the case.

an athletic 42 year old man, who runs a hotel, plays tennis in his spare time.

about a month ago he had a hastring <<pull>> while playing. people, who was playing with and had nothing to do with medicine or physical therapy, offered him a deep tissue massage in order to let the blood flow, as they said. He got bruised but better day after day until he got back to play when he had another episode, milder this time. he did almost the same, himself this time, and got another strain 5 days ago.

it was then that he decided to see someone specialist.Now, he has a great mass <<lump>> between middle and lower third of biceps femoris on his left leg. he is painless on contraction and stretching. he insists in using hot mediums and deep massage.

i believe that the scar tissue formed is too delicate to deep massage and on top of that we need to strengthen and stretch it rather than break it.

so, the question is:To break or not to break?

[karen.hankey]

It all depends opn what you mean by 'pull'. If the hamstring was just tight then a massage and heat would probably be the best option. However if fibres were torn the you have entered the phases of healing - so the use of ice would be best.

You obviously need to scar tissue to bridge any area of damage. If you massage or stretch too quickly you may damage this new scar tissue and therefore the injury may not heal. However if you leave it too long then you may not be able to mould the scar tissue to use effectively.