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Platelet-Rich Plasma Therapy

Warning: If you can not handle the sight of blood, you probably won’t want to read this because, yes, you will see some blood.

I really wasn’t sure what to expect when I went to the clinic for my PRP injection. How long will it take? Will it hurt? How long will my recovery be? Will this be my only injection? And, most importantly: will it work?

The “blood-sucker” introduced herself, took me into a room and proceeded to withdraw 30 cc of blood from my arm. “Whoa! That’s a big syringe!” I said when I saw it, and I didn’t look at it again until after she had finished taking my blood. “Wow! That’s really purple!” I had forgotten that blood can look purple too,

One Platelet-Rich Plasma Cocktail in the making.

Dr. Bentley, then, put my blood into the centrifuge to spin it around. It only took seconds to see the blood start to separate into its layers: red blood cells on the bottom, then white bloods cells, and the platelets on top. After a minute, the 30 cc that I had given him had been reduced to much less. After that, I really didn’t see much more as I was getting ready for the injection. I caught of glimpse of what I think was a very long needle (the length of a pencil) as Dr. Bentley filled a syringe with my platelets to inject into my hamstring tendon. I lay on the table, face-down and in a quasi-prone position, trying to relax.

Dr. Bentley poked with his finger at my upper hamstring to find the location of the tear before he started using the ultrasound. I wasn’t able to feel any discomfort at first and that made me nervous. “What if there really isn’t a problem?” I thought, only to be followed by my verbalizing, “That’s where it is.” Dr. Bentley started to use the ultrasound and I heard him say to his student “That’s the tear, right there.” I suddenly felt a bit of assurance.

“Get ready for a poke,” he said and that was all I really felt. At one point, I felt like I was in a dentist’s chair as he asked how I was doing a few times. I was fine. “I’m just telling myself that this isn’t going to hurt that much because my legs are so muscular – ha!” There was no real sensation of pain; it was more of a tightening. I later described it to Dr. Bentley as an elastic tightening around your arm until you have a constant throbbing. He replied that the blood being injected into a tendon has no where else to go so it would create that same kind of feeling. As we finished up, he told me that it would feel like I was sitting on a golf ball for a few days.

On the way home, I was glad that Dave drove me to my appointment. Moving my foot from the pedal to the brake and back to the pedal would have been difficult. We hadn’t even left Hamilton when I said to him “I feel like my leg is having a baby.” Painful, but not terrible, and knowing that it would end with something good.

A few hours later, I was able to drive. I took my 13 year old to referee a soccer game and I happily stood for an hour to watch. Walking was difficult and sitting was impossible, so standing had become the position of choice. I could tell that it was going to be for the few days but I had a feeling that it would be worth it.

Whatever It Takes

A few months ago, I hoped to be running again by mid-June. As good luck (and a lot of patience) allowed, my physiotherapist cleared me to start running slowly. “Run for mechanics,” he said, “not for fitness.” He was telling me not to push myself and to just get use to the motion of running again.

My first run was 2 miles at a 9:30 pace. Within two weeks, I was averaging 3 miles just below an 8:30 pace and, just recently, I have been running up to 4 miles with my average pace around 7:50 per mile and a few miles hovering around 7:40. On paper, everything looks great. I’m running more and I am running faster – and I am being careful not to push myself; I’m running at a “feel good” pace. My gait feels good, my hips feel straight, and I feel strong. But the back of my leg just doesn’t feel right.

As the saying goes “Nobody knows your body better than you” and I can tell that I am still not “fixed.” In April, Dr. Bentley (the hip specialist) wanted me to have my pelvis realigned through physiotherapy and it has definitely helped me. But I still have a tightness at the top of my hamstring, close to the tear where the hamstring meets the ischial tuberosity. Nothing feels wrong, so to speak, but it still doesn’t feel right. I feel like Tammy the Hamstring is lurking at the door, waiting to break in and turn my house upside down. After all of the rest, muscle work, rebuilding, realigning and time I have invested in my recovery, I am ready to do whatever it takes to keep her locked out.

Ready for some time off to heal some more.

I went over my concerns with Dr. Bentley and we decided that a platelet-rich plasma (PRP) injection is the next step for me. I have spent months reading about PRP treatments and there is not a lot of evidence to support its effectiveness. I have spoken with two people who had it done: one said it made things worse, and the other said it didn’t really help. But there is a lot of research that supports PRP therapy. My GP, sports med doctor, chiropractor and 2 different physiotherapists all feel that this is a good route for me to follow; when I have a team of professionals who are rallying a PRP injection, I am going to listen. I really have nothing to lose.

Last night, a lady I know told me of a friend who had a PRP injection done. “Her text right after was full of delightful words,” she said, “but she’s finding that it’s helping.” That was the message that I needed – something positive, something to affirm that I am on the right path. I am ready for the pain and I can deal with a bit of time off – whatever it takes to keep me running and let me keep chasing my dreams.

Using Your Head

In Ontario, cycling with the helmet is the law. Anyone under the age of eighteen who rides any type of bicycle must wear a helmet. But something happens when kids suddenly turn 12 and many feel that they are better than the law, so they leave their helmets at home or ride with their helmets dangling from the handlebars. It annoys me that this has not been legalized for adults as there are many who feel that they are invincible and ride bikes without wearing helmets; ironically, I often see this when they are riding with their children, who are wearing theirs. Whether it is the law or not, every cyclist needs to wear a helmet every single time they mount a bike, no matter how old they are, how far they are going or how fast they are riding.

When my oldest was 4, he rode his bike everywhere – and always with a helmet. This was long before the helmet law that came into effect in 2105 but, with parents who cycle and a dad who also rides a motorcycle, not wearing a helmet simply wasn’t an option. One day, when I watched my speedy son zoom down a 4 year old sized hill, lose his balance and crack his helmet, I was grateful that wearing them was part of our lifestyle.

A few weeks ago, a friend of mine, a very experienced cyclist, was riding north of the city, training for an upcoming Ironman competition. The roads were slick that day and, as she crossed a set of train tracks, she lost her balance, slid and hit her head. The damage to her bike was so severe that it needed to be replaced, as did her helmet. She had a concussion but walked away and started training again a few days later. Her helmet saved her.

Why people even think about riding without a helmet is beyond me? Sure, your head might get a little sweaty but wouldn’t you rather have a sweaty head than a crushed skull? Messy hair can be fixed; brains can’t.

Two years ago, one dark Saturday night, I was driving down a particularly poorly lit street to pick up my son at a friend’s. At that last minute, I spotted a couple of boys riding their bikes – no lights, no helmets. My parent instincts took over and I pulled into a parking lot, which I thought they would cut through, got out of my car and waited. When they turned in, I called them over. As it turned out, they were kids from my school, grade 7’s whom I had taught the year before.

“You guys need lights. I could hardly see you. There are parts along that road that are so dark that you could have easily been hit.” Then, I noticed the lack of headwear. “And your helmets need to be on your heads, not on your handlebars.”

They were speechless, but they got it and it wasn’t long before their lights were turned on and helmets were locked into place. Two years later, on their last day of Grade 8, one of them said to me “Thanks for stopping us that night. I always wear my helmet now.”

Yesterday, my own 13 year old left the house wearing his helmet, came back home to change into something warmer and left. Zeda barked at them as they were chatting on the driveway, which drew my attention to them. “Where is your helmet?” I yelled as I ran outside.

“In my room.”

“Go get it. And where is your helmet?” I asked his friend. “I’m pretty sure that you have one too.”

“I don’t have one right now.”

“You don’t have a helmet?” I questioned. I know his mom. He has a helmet.

“It’s at my house.”

“Then you are going to go home to get it and I am going to text your mom that you are on your way.”

And that night both sons were reminded, by their respective moms, that if they are ever caught without a helmet again, they will lose their bike.

Whether young or old, new to bikes or an experienced cyclist, everyone needs to wear a helmet when riding. So be warned: if I see you cycling without one, I will call you out every single time.

When Will They Learn?

This year, the skunk population has jumped. Our neighbour has a den behind its shed and another has a skunk family under its back deck. Since Zeda loves to play with any four-legged creature big or small, and she has had more than one skunk encounter, I am on my guard in the morning and at night, and our walks are typically in the safety zone of busier streets.

A few mornings ago, Zeda woke us up at 4:30. We had walked her at 10:00 so we were fairly certain that she didn’t need to get out – but wanted to get out. By 5:30, I gave up and took her for a walk. Even then, when we got home, she headed straight to the back door and whimpered again. “It’s still too early,” I told her, but she didn’t listen. I showered and was grateful that she settled down by the time I had finished but, sure enough, by 7:00 she had returned to her whining at the door. “The sun’s been up for almost an hour” I thought and I didn’t see any sign of backyard creatures, so I let her out. She bolted towards the fence only to turn around and dart back towards the house.

“Dave! Zeda has been hit by a skunk!” I yelled as Zeda ran towards me. The early morning whining now made sense. I grabbed Zeda by her collar to take her into the garage, but it was too late; Zeda managed to rub her face into the carpet, leaving eau de skunk behind. And as she moved to the garage, she saturated the air with even more and, somehow, permeated our freshly cleaned clothes hanging in the laundry room with that same stink. It was clear that the rest of my day was going to be spent cleaning.

Needless to say, the next few hours were spent bathing the dog in Vagasil (yes, vagasil. You can read about that dog-owner hack here), washing floors, deodorizing the carpet, doing laundry, showering (more than once) and running the diffuser non-stop to purify our home. By noon, things were under control when Dave called me from the kitchen. “Cynthia, look, I caught a skunk. Oh, wow, it’s a big one too. Come look!”

“You caught a skunk?” I actually wasn’t sure if I had heard him correctly and went into the kitchen feeling somewhat perplexed. “What do you mean you caught a skunk?”

“Well, I’ve been trying to catch that squirrel that keeps getting into the bird feed, but I caught a skunk instead.”

“You set a trap in the backyard to catch an animal and you didn’t tell me? We have a dog! It would have been a good idea to tell me!” It quickly became obvious that the skunk was trapped in the middle of the night – most likely around 4:30 a.m. – and sprayed Zeda a few hours later when she went out to play. Then it was Dave’s turn to be confused. “Oh…that’s what happened….” Seriously, I can’t make up this kind of stupid, only to be followed with more. “Wait. Why was Zeda outside for most of the morning, and the skunk was there, but they stayed away from each other?”

“Would you go back if you got skunked?” I asked. “And….just how do you suggest we get rid of the said skunk?”

“Well, I can put it in the car and drive it up north to release it….or….”

After a bit of animated discussion, we decided to call a pest removal company to take the critter away for us. We did have to wait until the next morning but Zeda seemed quite happy to avoid the backyard altogether.

Later that day, I hesitated whether to go to a hot yoga class, worried that the smell had gone into my pores. “I’ll be fine,” I thought. I’ve showered twice and my yoga stuff is clean. Even though I felt somewhat confident that I was clean, as I walked into the studio and placed my gear on the floor, I looked around to see if anyone might be giving me the stink-eye. Then, during class, I tried not to cringe as the instructor put her hands on my back to help me move into a deeper stretch; as she walked away, I peeked to see if she was twitching her nose or wiping her hands on a towel. There was no reaction. Phew! I passed the test.

Exactly a week later, my mind wandered back to the skunk escapades as Zeda and I left for her morning walk. We had just turned onto the sidewalk at the bottom of our driveway and, completely unexpectedly, we came face to to face with another skunk at the bottom of our driveway. The skunk looked perplexed as it had just climbed out of our neighbour’s garbage, tilted its head as it stared at us and didn’t know what to do. I did. I froze and so did my dog but worried about how long Zeda would stay. Would she jump? Would she bark? Did she even realize that this was the same creature that sprayed her the week before?

“No, Zeda,” I said, and we slowly walked away in the other direction while I crossed my fingers and held my breath. By the time we got home, it was gone. And needless to say, Zeda did not go in the backyard that morning no matter how much she whined.

Looking for My Pony

Shell-shocked. There is really no other word to describe my reaction after finally seeing the hip specialist in Hamilton. I waited for 3 months to get to the bottom of what was going on with my hamstring – a tear at the insertion of the ischial tuberosity. I waited another three months for a consultation with Dr. Bentley, whom I thought was going to prescribe platelet-rich plasma therapy to strengthen the tendon. I got more and more excited as the days to that appointment got closer; I felt like a 6 year old hoping to find her pony on Christmas morning. But I left his office feeling dejected. There was no pony waiting for me, not even a stuffed toy that could act as a substitute. Instead, I left with a piece of paper: a prescription for more physiotherapy.

During the examination, Dr. Bentley commented, “I don’t think you need an injection. It won’t help you. I think there is something else going on.” Like most runners who have been off longer than they want to be and are desperate for answers and healing, I tried to pry more details out of him. “Let’s finish the examination. Then we can talk.” But the words “won’t help you” kept my mind spinning. So I am that one in ten who PRP injections aren’t suitable for? I wasted all of this time waiting for nothing? Is there no hope of recovery? Will I ever run again?

During our debrief, Dr. Bentley explained that my pelvis is not aligned properly. I have an anterior pelvic tilt, meaning that my right hip sits forward; in doing so, the right hamstring is stretched and that, he believes, it the root of my problem. This also explains the occasional sciatica discomfort that I get, my tight hip flexors and, most visually obvious, the right leg swing when I run. The treatment, Dr. Bentley said, is pelvis realignment through physiotherapy, and he suggested 10 treatments would correct the problem. “Once a week?” I asked. “Oh no,” he said. “You need twice a week.” Between his words, I imagined hearing “Your pelvis is that messed up.”

“And what if this doesn’t help?” I asked. After all, I have gone through the rounds of chiropractic care, physiotherapy and worked with an osteopath, yet I am still considered injured. Dr. Bentley told me to book another appointment if I felt that the treatments don’t help.

It’s taken me almost a month to emotionally recover from his diagnosis and recommendations for treatment. I am angry that I had to wait so long to get to the root, or what seems to be the root, of the problem. I am frustrated that I have had to go to yet another physiotherapist, one who specializes in pelvic realignment, and explain the events of the past 9 months. And I am confused as to why he wouldn’t want to strengthen the tendon when it is going to remain a “less than 50% tear” for the rest of my life (since tendons don’t repair), especially with osteoporosis-arthritis showing in January’s MRI. But, as with all other wounds, time heals and we move on.

On Wednesday, I am starting my fourth week of treatments. Some days, I leave feeling optimistic and ready to start running again; other days, I leave feeling frustrated and wonder whether this will, in fact, let me return to running. There have been good days and bad, laughter and tears, and longing….a longing for good news, a wish for running health….and hope to find that pony with a pink ribbon around its neck.

Stress Test

Last week, after 15 months of heart tests, I was finally given a thumbs-up. Everything is fine.

The fact that doctors thought there was something wrong with my heart was an enigma. In November 2017, days before I was running Nationals cross-country, an 8k distance, I was scheduled for a routine asthma test at the hospital. During one of the baseline tests, the respirologist stopped the test. “We can’t do it,” she said. “Your heart rate isn’t normal.”

I was completely dumbfounded. How was that even possible? At that point in 2017, I had logged almost 2000 miles for the year and I was racing fast enough to call myself a competitive runner.

How could I possibly have something wrong with my heart? But during the baseline test, my heart rate dropped (spiked down, as she said) so that it was dangerous to proceed with the test. After answering what felt like a gazillion questions (Do you smoke? Do you drink? Do you workout? What do you do for exercise? and so on) and meeting with a cardiologist, they decided that it was safe for me to continue the asthma test. “It’s okay. There is a cardiologist next door if something goes wrong.”

Over the next 6 months, I had bloodwork, an echocardiogram, and an ultrasound of my heart. In simplest words, results showed that my outtake valve is thinner than my intake valve; the valves, by the way, are only 1mm thick, which I find absolutely remarkable. So running is good for me, but it meant that I needed to be monitored.

This past fall, at another asthma appointment with my respirologist, she asked whether I had been showing any symptoms? “Of what?” I asked. “I really don’t know what I am looking for.” My waking up and gasping for air in the middle of the night could be asthma-related, or it could be a symptom of a heart problem. So could the dizziness that I sometimes have during the day (which is likely attributed to a low heart rate). My doctor wanted to “cross the t’s and dot the i’s) so she referred me to a cardiologist. Continue reading “Stress Test”

Let Them Be Kids

In the past six months, Ontario universities have lost students who took their lives. We can’t begin to wonder why or guess the circumstances. But what we can do is find ways to improve. We, the adults, we need to do better.

The stress that our youth face is no joke. Ten years ago, as a teacher, I saw Grade 8 girls put so much pressure on themselves to get marks as close to 100% as possible that I worried that they might have a breakdown before they even got to high school; that was before the pressures of social media. A few years later, I watched a parent criticize a Grade 8 son for his 80% average because “it isn’t good enough for the top universities.” Yes, he was only in Grade 8. And, as a parent, I have watched my son and his friends devour their books so that they can have the 90% averages needed for university entrance while accumulating hundreds of volunteer hours and working part-time. I have read resumes of university students who make my own – a resume of someone who has been in workforce for over 30 years – look dull.

Today, without meaning to, we have put pressure on kids as young as 12 and 13 to start thinking about their career choices. We expect our kids to be well-behaved, have high marks, play a sport or instrument (and often more than one), volunteer at school or in the community, and, if they are able, work at a part-time job. Every parent wants his/her child to be the best, but is the best right for every single kid? And when exactly do our kids get to be kids?

I often feel that, as parents, we have lost touch with what really matters in our children’s lives. We need to let kids play – not an organized soccer practice or robotics club kind of play, but completely unstructured “run around and be silly with your friends” kind of play. Let them complain about being bored because kids can always find something to do; it may not be what we want them to do, but they’re making their own decisions and, if they get in trouble, so be it. Let them face the consequences and help them to understand and accept those consequences. It’s part of growing up. So is failure. By all means, we need to support our children at school so help them with their homework – if they ask for it – but don’t do it for them. And if they don’t get the mark that everyone wanted on a test or assignment, let it go. We need to stop helicoptering around our kids and rescuing them every time things don’t go they way we want. We need to let them fail if we want them to succeed. With our support and encouragement from their teachers and other adults in their lives, our kids will figure it out.

This is what builds resilience in our kids: being independent, making their own mistakes, failing, and using each day to try something new. Resilience is most definitely not gained from larger class sizes. If that happens, we will have taken away time from the second-most important group of people who interact with our children: their teachers. (And let’s be real about this: there are many kids who see their teachers more than their parents.) Increasing class sizes increases the demands and the pressures that we are placing on our youth. The failure that is bound to happen comes from our government’s decision to increase class sizes and, since that decision is not our youth’s control, it is only going to lead to greater stress for our kids through high school and more urgent feelings from their parents who will feel an even greater need to hover around them, protect them and help them get through high school.

As mental health is becoming, if it is not already, a crisis among young adults, whether in the work force or at school, we – the parents, the teachers, the coaches – must prepare our students for this step in their lives. But we do that through the connections that we have for our youth, through our care and understanding of who they are and what they need to succeed. We do not build resilience by creating larger class sizes where kids – yes, kids – become one of too many to teach and get to know. But we can build resilience by letting kids be kids and enjoy their high school years. We build resilience by spending time with them, guiding them and allowing them to see that they have our support, the support that they will carry into the next stage of their lives.

Cautiously Optimistic

This week, I have taken advantage of March Break and booked a few midday appointments at Dr. Elliott’s clinic. It is amazing how good eliminating the stress of getting to appointment before work or rushing to one at the end of the day feels. So I have been there every day this week: for physio, for a massage and to see Dr. Elliott himself. I think that I now deserve my own parking spot.

Better than my own parking spot, though, is the feedback that I have had this week. On Monday, I realized that my hamstring is a lot stronger, so much stronger that we have eliminated the hamstring curl with my toe inwards, the exercise that makes me feel dorky. Now my focus is on the glutes and building more endurance in them.

On Tuesday, on the advice of my physiotherapist and doctor, I had a massage. It probably goes without saying that this was the last thing that I wanted to do. But after thinking about it for weeks and realizing that a gentle rehab type massage could reduce some of the tightness and pain that I have been feeling in my lower back and legs, I decided to give it a go.
I booked one with Cliff, who also works at the clinic, as he has access to all medical files related to my injury. I walked in nervous but left feeling a lot better, physically and mentally. He didn’t touch the area near my Ischial Tuberosity but worked around it, as well as my legs, back, shoulders and neck. It’s now two days later and nothing is bothering me, which is a relief. I will go back in a few weeks to try to help relax the muscles associated with my hips.

Yesterday, I met with Dr. Elliott to get some answers to my questions and squash some of the “what if’s.” Dr. Elliott said that individuals are turned away from a PRP injection if it won’t help them, because they have already healed. “So it doesn’t mean that my tendon won’t heal?” I asked. It just means that it won’t make a difference in their healing. By the time I have my injection, I should be almost healed and the injection will only strengthen the tendon. I felt so much better after speaking with him. All I can do now is wait.

Some days, I have found that it easy to get overwhelmed and start to panic. Staying focussed, being positive: that takes work. But it is work that I am willing to do as I have to believe that I am almost there. Psychologically, it is a lot easier to think about running again than about what will happen if I can’t.

Do I Laugh or Cry?

“There is value in learning to accept gracefully those things that cannot be changed.”

This were the first words that I read in my son’s psychology text on the weekend. He had rushed off to work and left his book on the kitchen table, open to a section on anger and frustration. Being a psych major, I couldn’t help but look at what he was studying and, somewhat appropriately, these words jumped out at me.

The past few months have been a test of my mental strength. How much frustration and disappointment of being injured (July), re-injured (October) and learning that it was way worse than anyone originally thought (January) can I handle? I like to think of myself as a positive person, one who looks for an upside, thinks happy thoughts and believes that “things happen for a reason.” The upside of my hamstring tear is it has given me more time at home with my 13 year old and let me watch him grow as a student, an athlete, and a person. But I am now in my sixth month of healing, almost 3 seasons later, and while I have accepted my injury, my frustration is still there.

I had a glimmer of hope that my weeks of being side-lined are coming to an end when I finally got an appointment date for a PRP injection: April 16th @ 12:00PM DURING HIS LUNCH. I had no idea what was meant by “during his lunch.” Am I suppose to feel extra grateful that he is seeing me at 12:00 rather than make me wait another week or two? Is this a underlying message that I better not be late? Or he is so busy that he is likely to be behind and I better not dare complain because he is seeing me “during his lunch.” Or maybe, just maybe, it is a subtle hint to bring him a coffee, a snack or even a lunch. Well, I am grateful that he is seeing me at this time rather than have me wait for another appointment at a later date so I happily confirmed it, I won’t complain if he is behind and maybe, just maybe, I’ll stop at Tim’s to bring him a snack. I could only laugh.

However, when I called to confirm, I learned that this is not my appointment for the injection; it is a consultation. Since 1 in 10 people are turned away, I have to meet with the doctor first and go in later for the actual injection. I wanted to cry. If my injection is at the end of April, I can assume that I will be off for another 6 to 8 weeks, which means that I still won’t be running until the end of June. And that is only if I need one PRP shot. If I need another, it will obviously be even longer.

This whole process has been frustrating beyond belief and it is now being overshadowed but the occasional fear. What if I am that one in ten? What if I can’t run again. What if? What if? I hate the “what if?” game. “Stay positive. Look for the upside,” I tell myself.

Last night after yoga, I spoke my about thoughts with Kelly-Lynne and I found the positive again. I realized how much fitter I have become in the past 6 months. My leg strength is coming back; I can feel it when I cycle, and I can sit for longer periods of time without being in pain. My core is firm, I can do a lowboat again and my upper body is stronger than it has been in years. I threw myself back into the deep end when I came out of my comfort zone and started swimming. When all things are said and done, I feel like I am in better shape than I have been in years. So even though I still am not running and am quite unhappy about it, I can accept the delay. If it means that my hamstrings are going to be that much stronger and I am going to be that much healthier, then I can absolutely wait a few more weeks.

Many years ago, when making a group decision at work, we voted for acceptance. “Can you live with it?” was the question asked. At school, I teach my students that you don’t have to always like something, but you have to be able to accept it; my Grade 7’s understand that. Well, I do not like this time to heal and this waiting game one little bit, but I can live with it. I have accepted it and, one day, I hope, that will make me a better athlete.

When a Runner is Not a Runner

The past 8 months have been a test of my commitment to running. I have been off since that mid-July massage, intended to help my muscles, resulted in a hamstring tear that sidelined me for the rest of the summer. Now there was probably something brewing anyway but the massage tweaked something and I could not run for the rest of the summer. In September, I made what now seems to be a superhuman rebuild to run Chicago, only to tear my hamstring days before the marathon. In mid-December, I was cleared to run again by 3 medical professionals: my sport medicine doctor, my chiropractor and my physiotherapist. Strength was good and my cardio was fine, but running just didn’t feel right; I had no power. Sure enough, an MRI at the beginning of January showed that I had less than 50% of the hamstring, a tear that meets the Ischial Tuberosity. I pulled myself off the road again on January 15th.

It has been another two months since that diagnosis has been made and it is going to be another 6 weeks (April 16th) until I have a PRP (platelet-rich plasma) injection. Who knows how long my recovery after that will be? I am guessing that it will be another two months, which will bring me to sometime in June – if I am lucky. And if that is the case, that means that it will be almost a year since that first injury, the catalyst that sent me into this dark hole that I just can’t find my way out of, a year since I have really, truly run.

During the past two weeks, I have thought a lot about my status as a runner. Am I? By definition, a runner is “a person who runs” and that is something that I am not doing. I think about running all the time; I dream about running again and chasing my dreams; I read about running, talk about running and support people who are running. But I am not running.

When I finally got my appointment date for the PRP injection, I was thrilled. But the waiting, the recovery time and the uncertainty of knowing whether I will actually help strengthen the tendon have turned to frustration and fear. What if it doesn’t work? What if I won’t be able to run again? What if????

The what if’s are always going to be there. But until I have answers, I have to squash them. I need to focus on the things that I am able to do: keep up my cardio and conditioning: bike, yoga, swim, weights; be a mom, a wife, a dog-mom; coach; love my job. It should be no surprise that every single one of these things connects me to running.

Today, I am not running. I am an injured runner. I am a runner not running. But until I am told otherwise, I will continue to dream about running and racing again and focus my fitness towards the goal of pulling on a running skirt and lacing up my shoes again. I am defined by running and always will be.