Recurrence of old true injury (torn hamstring) or TMS pain?

How do I determine whether pain at the site of an old injury is due to TMS or a recurrent injury?

I am a 25 year old pretty active female who is very TMS personality. I had been experiencing a multitude of different pains that started last November 2020 (left hip, lower back, neck, tingling in fingers, but had had GI symptoms for years). I had all sorts of imaging for these things and nothing came back besides a little scoliosis which is a really mild degree. I realized around July of this year that TMS was the cause and have been working on my mental health and old wounds ever since. I've had some minor flares that I didn't give much mental space to and they eased up. I've been getting back into weightlifting and kickboxing, two of the things that I love to do and was scared of doing when I was having hip/neck pain, etc. However, a couple days ago I have a new pain that hasn't cropped up in a while.

In February of 2020 (about 9 mos before hip/neck TMS symptoms started) I tore my hamstring kickboxing. MRI confirmed, 25% proximal avulsion. I had PRP (platelet rich plasma) injection after about 4 months of gingering it with multiple re-pulls and it healed up really nicely with PT and strengthening. Around October of 2021 I was back in the gym and feeling awesome. Around the time that my hip started acting up in November (TMS), I started getting the same pain in my hamstring that I had when I had injured it earlier that year. I figured I was just re-pulling the hammy since it usually happened after I exercised, and would rest it for a few days and it would be pretty much okay. It's been on and off with the hamstring but I haven't really experienced the hammy issues since I started leaning into the TMS diagnosis for my other pains (which makes me think that this convenient recurrent re-pulling that started towards the end of last year was TMS as well!).

Sorry this is so long but here's where I need advice - A couple days ago I was kickboxing and maybe kicked a littllleeee higher than I should have (the way my hamstring tore in the first place) and I freaked myself out because I felt a stretch. Not an audible pop and swelling, but just a stretch. Anyways I finished my session without much issue but after the workout my hamstring just felt tight and swollen like it did when I would "re-pull" it in the past. Its been off and on for the last few days and I'm like 75% sure this is TMS because I also have been somewhat down and stressed about other things this week, but a little part of my brain wants to say "hey, you tore that hamstring before so you physically re-injured it." I went to the gym today and was jumping around without much issue, but afterwards and all this afternoon it has been achy and sore. I tried to do a few of the anatomical tests that the ortho did when it was torn, and there doesn't seem to be any physical weakness (I couldn't support my weight on one leg when it first happened) but I do feel a little "twinge" when I test the hamstring. I don't know if that twinge is real, or if its my head trying to make this seem real.

I have no problem with resting it if it truly is just a little muscle strain that will heal up in a week or so, but also I dont want to give into that possibility and feed the cycle by stopping my activity if this is TMS. I know pain on top of an old injury is grounds for TMS to manifest since its learned neural pathways, but what is the consensus on "re-injury" in a muscle that should have healed (and did, I thought) long ago. I know people with hamstring injuries tend to have recurrent issues (which could be TMS in a lot of people!) so idk. I basically am just looking for some reassurance that this is common and likely TMS.

Thank you so much!!

 

Hey Trapeezy,

Glad to see you've been fighting TMS and winning!

What I have done in the past when I was not sure if it was TMS or an actual injury, I rested the injured part for 3-4 days and then gradually started testing it by doing more and more every day. Usually after a couple of weeks I was back to my normal activities. After that if I felt any pain, I knew it was either conditioning or TMS.

Take care,

 

@FredAmir Thank you so much!! It hasn't really gotten better the past few days and has been off and on, with more soreness near the upper tendon of my hamstring and nerve symptoms that go down to the bottom of my foot and inner ankle. I've spent so much time worrying about this the past few days and haven't done much in terms of activity that would have made it worse if it was anatomical, so thusly I think TMS is rearing its stupid ugly head again this one is harder though because I know there is an anatomical injury that once was there and the idea of scar tissue and all of that can cloud my ability to just be like "my body is fine because this is an area that I know is not injured and has never been hurt!"