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.
My layered blood.

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.

 

 

 

 

 

 

 

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.

Good news! Or so I thought.

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

Throwback to warm weather running

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.

One Day At A Time

A few weeks ago, I finally picked up a training journal.  I had just started to run again and I wanted to get back to tracking my running on pen and paper.  Five days after buying it, before I had even opened it, I was pulled from running and was told that it will probably be 3-6 months until I can run again.  Since my MRI was at the beginning of January, this week marks the end of my first month.

At my physio appointment on Friday, Tammy’s power and flexibility were good; I am feeling much stronger in general.  The only indicator that I am not ready to run is my butt aches when I sit down.  Looking back, though, I realize that it has been sore when sitting for the past two or three years, maybe longer, which indicates that my hamstring issue may have been brewing for a long time and I just didn’t recognize it as a problem; instead, I attributed my sore sitbones to a skinnier tush.

These days, I am encouraged by the almost normal feeling that I have.  “Does it really take 3 to 6 months for a hamstring to heal?” I asked my physiotherapist.  “No” was the fast reply.  “It takes 6-8 weeks.”  I laughed. “Then, by the time I have my PRP injection, I should practically be healed.”

In mid-January, Dr. Elliott submitted the referral for me to see the hip specialist but I don’t even have an appoinment yet.  “They’re probably still getting over the backlog from the holidays” was suggested as a reason, which is fine, but I really want to know when I am going to see the doctor.  Will it be a consultation with a second appointment for the actual treatment, or will it all be done at once?  How many treatments does he think I’ll need?  And what about the labrum?  Do I need to worry about surgical repairs?

As the days pass, I get more and more frustrated that I haven’t had my PRP injection, nor any kind of communication from the doctor’s office.   But I am starting to believe that I may be back on the road in the spring as my hamstring seems to healing on its own and the injection will only strengthen it.

Fingers crossed, hopeful thoughts, and dreaming of running again….Believe.