The hamstring that keeps pulling
StemWave plus ultrasound-guided PRP at FirstCall DPC, Santa Rosa Beach
See if I'm a candidateFor a hamstring, that means we find where the problem actually is: the tendon at the sit bone, the muscle belly, or the junction between them. Each heals differently and each has a different answer. We also look for scar tissue from old pulls, which is usually why the new ones keep happening.
Is this you?
- You get back to sprinting, feel good for two weeks, and then it goes again.
- There is a deep ache right where you sit, worse driving or on a hard chair.
- Sitting through a long meeting or a flight is the worst part of your day.
- You have done the stretches. You are flexible. It still pulls.
- You are in season, or you want to be, and rest has not worked.
If this is a fresh pull from last weekend, you need a good rehab program and a few weeks, not PRP. If the ultrasound shows a full tendon tear off the bone, that is a surgical conversation and we will set it up.
How it works
1.Exam and ultrasound
I test the hamstring at different lengths, then scan from the sit bone down the muscle. We are looking for a worn tendon at the top, a partial tear, or scar in the muscle from old injuries.
2.StemWave sessions
Three StemWave sessions over about two weeks before the injection, aimed at the tendon or the scarred muscle we mapped on ultrasound. Fifteen minutes with Ronna, no downtime, keep training lightly between sessions.
3.PRP under ultrasound
We draw your blood, spin it, and place the platelet layer into the tendon or the tear while watching the needle. The proximal hamstring tendon sits right next to the sciatic nerve. Nobody should be injecting there without ultrasound.
4.Loading plan
Heavy, slow hamstring work starts within a week and progresses to speed. Recurrent pulls almost always come from a hamstring that was never loaded back to strength. The injection helps the tissue. The program is what keeps you on the field.
For a chronic proximal hamstring tendon or a strain that keeps recurring we use the Reset package: three StemWave sessions, then one ultrasound-guided PRP injection within two or three days of the last session, then the return-to-speed program. A partial tear moves you to Rebuild. Count on eight to twelve weeks before full sprinting.
What the evidence says
This is the condition where I am most careful about what I promise. For proximal hamstring tendinopathy the studies are small and mostly positive. For acute muscle strains the best trials found PRP did not speed up return to play compared with a good rehab program. So for a fresh pull, the program is the treatment. For the chronic tendon or the pull that keeps recurring, PRP earns a place.
“If I ever have to exaggerate the evidence to justify offering something, I probably shouldn't be offering it.”Dr. Petersen
What it costs
- Rebuild6 StemWave sessions + 1 ultrasound-guided PRP injection$1,895
- Elite Recovery10 StemWave sessions + 2 ultrasound-guided PRP injections$2,995
FirstCall DPC members get 15% off every package.
The exam and the ultrasound are included. HSA and FSA accepted. Financing available.
Dr. Petersen chooses the package at the exam based on what the ultrasound shows. If a single ultrasound-guided PRP injection without StemWave is the right call for you, that is offered through the main practice and he will say so.
The hamstring that keeps pulling is almost never a flexibility problem. It is a strength problem, usually with a tendon or a scar that has not been dealt with. Stretching it more does not fix that.
I will tell you plainly: if you pulled it last weekend, PRP is not what you need. If you have pulled it four times this year, or there is a deep ache at the sit bone that has been there for months, that is when we look at it on ultrasound and talk about it.
Meet the physicians
Erik Petersen, DO
Board-certified in Internal Medicine. Twenty years of emergency medicine, and the person holding the ultrasound probe.
Co-founder of FirstCall DPC. Former All-American football player who still thinks a loading program beats a shortcut.
Will Carlson, MD
Board-certified in Internal Medicine. Emergency medicine experience, and the slower, more careful half of this partnership.
Co-founder of FirstCall DPC. He is the one who asks what happens if we are wrong, which is why we rarely are.