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.

 

 

 

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.

Bridge Work

I think everyone knows that lunge workouts have become one of my training habits. We have a love-hate relationship. I started doing them in late August and, by the end of October, I could feel my quads getting stronger; another month later, the physical definition in them was more obvious. My lunge workout takes time (30-40 minutes) and effort, but it is good for me.

When Izzy was finally diagnosed with a tear, Dr. Sajko added bridge work to my regime.  I initially wondered where the extra time to do them was going to come from, but I listened to his instructions.  Sandy has earned my trust; if he wants me to do something, I do it.  Besides, I like bridges.  It is one of my favourite holds at yoga.  

When Sandy saw that I could do the typical bridge pose, he challenged me.  “This time, lift your core, then lift one leg so that it is parallel to the other.”  I did, and Sandy stepped back.  “Wow, you have a strong core.” Suddenly, I felt jacked. 

After working through a set of those, we bumped it up again.  “This time, start with your feet together, lift your leg like you did before (parallel to the other), then lift your body up.” Basically, I was lifting myself into a bridge position with one leg.  They were harder but I could do them.

I was a bit relieved to hear I only had to do 3 sets: 10 of the typical bridge, 5 (each side) of the single-leg bridge, and 5 (each side) of the lifting single-leg bridge.  Finding 15 minutes is easier: before school, before yoga, even before the dog realizes that I am on the floor and tries to lick my face.  

It’s been three weeks since I have added bridge work and I can feel my glutes and hamstrings getting stronger.  There is still more work to be done, but this is a good start, especially when I can sense that they are forcing Tammy and Izzy to pack their bags and head out for good.  

I know that working with weights to build and maintain muscle mass is in my future.  Until I am 100%, though, and physically ready to start, I am happy to keep up with my lunges, bridges and whatever other rehab exercises are thrown my way.

 

The Waiting Game

I like to think of myself as a patient person.  As a teacher, working with kids, I have to be; patience and understanding are parts of the job.  And as a mom of two teenage boys, patience absolutely has to be at my side.  But when it comes to me, I have always felt that Patience is not my friend. But over the past 9 weeks, I have learned to accept that “it is what it is” and to do what is right, not what I want.

When I saw Dr. Elliott in November, he suggested that it could be a while before Tammy and Izzy move out for good.  “Hamstrings can take a while.  It could be 8 weeks; in a worst case scenario, we’re looking at 6 months.”  We talked about my starting to run again when things feel right and made a follow-up appointment for next week, which happens to be 10 weeks after Izzy the Ischial Tuberosity was torn.

Meanwhile, I have continued ART twice a week with my chiropractor.   Two weeks ago, Sandy and I noticed that I wasn’t wincing when he was working on my hip and leg.  At one session, he dug into the muscle so deeply that he broke a blood vessel on his thumb, which he described as a badge of honour; I felt nothing.  Before I left, we talked about my returning to running as I appeared to be clinically fine, but I wasn’t mentally ready.   Taking the time off to heal has been difficult and, while I felt that  I was stronger and Tammy and Izzy were under control, I hesitated.  I was willing to wait until my follow-up with Dr.Elliott.

But after another week of pain free treatments, I was ready.  Nervous, but confident about being able to run.  I waited a few days for the right conditions – daylight, warmer, and dry roads.  Last Wednesday afternoon, Mother Nature was on my side and I headed out for 3 miles.  And guess what?  It was painless!   I ran slowly but comfortably, averaging an 8:43 pace.  By no means were things perfect; after all, I hadn’t run since the beginning of October.  But I ran continuously, my stride felt good, my hips felt strong, and I was running.  It was a start.

Happy to be running again.

Today, ten days later, I have run four times with each being better than the one before.  When I saw my chiropractor on Thursday, he said my hip was “perfect” and booked my next appointment for a week later.  I am optimistic, but cautious.  As excited as I am to be running again, I do not want to jeopardize the time and effort that I have put into healing, only to make a rash decision that could sideline me again.

Since October, there have been moments of frustration and there have been tears, but tears are a part of recovery.   Keeping Patience at my side and accepting my injury have also been a part of my healing.   Over the next few weeks, I need to continue to focus on doing the right thing while I start to build my mileage again – with Patience.  Together, we will get to where I want to be: running, running fast, and chasing my dreams.

 

Introducing Izzy

After 6 weeks of waiting, I finally have an answer; it’s a tear and, yes, it is a real pain in the butt.

My official diagnosis is a partial tear of the tendon at the ischial tuberosity.  In October, when that first came up as a possibility, I asked, “The what?  Did you just make that name up?”  It is real.  There are three hamstring muscles and one leads to the ischial tuberosity, which is at the top of the femur but under the gluteus Maximus – basically, at the sitbone.  When we sit, the glutes pull up and leave the sitbone to dig down.  With the tear that I have, sitting kills.  This week, I almost feel like I could start to run, but with sitting bring as painful as it is, I know I can’t run yet.

3mm deep – between the height of 2 dimes and 2 nickels

It is obvious that I tore my ischial tuberosity at the beginning of October. After 6 weeks of healing, it currently measures 6mm by 4mm by 3mm; I wish that I could tell how big it was when I first started.

The first thing I did when I got home was text my kinesiology student, who replied with “LOL. The old tuberosity, eh.  I literally had my hands on one an hour ago.”  After a few messages back and forth, I decided to name it – something with a harsh sound, but one that Tammy the Hamstring would like.  I decided on “Izzy, the Ischial Tuberosity.”  Can’t you imagine Tammy and Izzy hanging out together?

Model of the tear: 6mm by 3mm

Messaging my son gave me another idea.  I had to make a model of the tear so that I could understand it better.  Suddenly, the pain I have had makes sense as I imagine a gap or a hole in my tendon that needs to be filled.

Dr. Elliott, my sports medical doctor, said that healing can take up to 6 months, but he doesn’t think it will take that long.  “You’re in a lot better shape than most people at this point,” he said. “It will probably be another month.”  I don’t need surgery, which is great.  Dr.  Elliott suggested a cortisone shot, but I want to stay away from that as cortisone can break down tissue.  PRP (platelet rich plasma) therapy is another option, but it won’t speed up healing; it does, though, strengthen the tendon.  While that still sounds appealing, it comes with a hefty price tag (up to $2000) and there isn’t enough evidence to prove its effectiveness.  I will continue to research that, though, and sit on it (haha!) for a while.  At this point, my answer is ‘no’.

Meanwhile, I will continue to do what I am as it is obviously helping.  And now that I know exactly what the problem is, I can work with my chiropractor and coach to get me running again and, hopefully, ready to race in a few months.

 

Tammy Gets An Ultrasound

After weeks of waiting, I finally got some imaging done, not the MRI that the hospital’s doc and my GP recommended, but an ultrasound.  It’s a start.

During the summer, it was obvious that Tammy the Hamstring was the problem.  Time off and a lot of treatments helped her to heal, but while I  evicting Tammy, she started to move north and enlisted the help of her friends.  Some days, my piriformis was acting up; other days, my glutes were joining her attack.   Injuries can be like that.  As the epicentre starts to heal, the pain shifts, but it comes back under control.  Tammy and her friends followed this pattern.

When my right side gave way on the Wednesday before Chicago, though, it was a totally different feeling.  My hip buckled under me, and Tammy and her friends joined the party.  I felt as if my entire right side was being invaded.  My chiropractor, acupuncture and I counter-attacked, but my hip went down again during the first mile in Chicago.

Everyone wanted imaging and, five weeks after that first battle, it finally happened.  Is it Tammy, my piriformis, my right adductor, my femur , my hip, bursitis, a tear, a fracture….it could be anything.  All we do know is this is not an isolated pain because all of those bones and muscle groups are interconnected.  The instigator remains a mystery.

By the end of the week, I will have the results and, as the days get closer,  I feel more and more like a child waiting for Christmas morning.  Hopefully, they will shed some light on what is happening inside; two more sleeps.

 

The Butt-nut

Since I have been injured, one of the hardest things to do (aside from running, which is still impossible) is driving.  My sitbone being crushed into the car seat can send an excruciating pain through my body.   But, unlike running, as a working mom with busy kids, I can’t just say “I’m not driving today.”  As the expression goes, I have places to go and things to do.

Last weekend, my son and his friends went to Wonderland for the Halloween Haunt and I won the task of driving them home.   That same afternoon, as I made a shorter 20 minute trip to Burlington and whined to myself about the havoc that Tammy the Hamstring was still causing, I started to think of supports and devices that might ease the agony of sitting in a car.  I lifted my butt, shifted positions, lifted my cheek again and had a “Eureka!” moment.  “I need a donut to lift my butt and surround the sit-bone so that it doesn’t dig into the car seat!”

After dinner, before venturing to Wonderland, I began my DIY butt-nut project.  I ripped strips of fabric from an old pillowcase, wound them into a donut shape, fastened it with duct tape and created my prototype.
Dave  could only laugh and walk away when I demonstrated how to use it properly.  But I was proud; my butt-nut felt good and seemed like it would help me survive the 60 minute drive.  The real test was about to happen.

In the car, it took a while for me to find the exact spot for my creation, and I did have to readjust it every now and then.   I waited for the 13 year old boy comments about it when my kiddo and his friends got in the car; what teen boy wouldn’t turn “butt-nut” into something?  But, instead, I got “That’s awesome!” or “You can go on Dragon’s Den and sell these!  You can retire!” If I can impress a crowd of critical teens with these, maybe I have come up with the next great Canadian invention.

When I got home, after a total of 2 1/2 hours of driving, I felt surprisingly good.  I was sore, yes, but no more sore than I was when I got in the car.  In fact, I felt the best after driving that I have in a long, long time.

So remember: you read about it here first.  The butt-nut, a donut with duct tape, personally fitted, designed for comfort.   What could be more Canadian?

Chiropractic Care and Running Injuries

I use to have a chiropractor who helped me with running aches and pains, usually my left SI joint or my right hamstring.   When I had trouble with my back three years ago, though, he wasn’t able to help me at all; yet, he kept wanting me to go back for treatments.  I turned to a physiotherapist who had a different approach and it ended up being the right one.  I never did go back to that chiropractor.

This summer, I went through the reverse when Tammy the Hamstring acted up.  I started with physiotherapy which just didn’t seem to be making any difference in how I felt.  I called a friend to ask for her acupuncturist’s name, but she suggested that I see her chiropractor.  “He’s really good,” she said.  He knows muscles too.”  So I took his name, googled him, read that he specializes in running and hockey injuries and had treated some high profile athletes including an Olympian sprinter.  I picked up the phone and made an appointment to see him that week.

Lunging with company is always better.

That Friday, Sandy treated me and gave me orders to run over the weekend, with a long warm-up and a gazillion lunges.  And, since the run/walk combination had been too painful, he told me to just run very slowly.   After my third visit with Sandy, my husband decided that he would run with me that night but he watched while I did my 6 sets of 60 lunges.

A rare run together!

On the run home, Dave exclaimed, “Your form has completely changed!”  I waited for the negative comments to follow, about how sore and lop-sided I looked, but instead he said, “It’s unbelievable!  You are completely symmetrical!  You’ve lost your funny kick.  It’s absolutely incredible!  Whatever you’re doing, keep it up.”

“Even though I am so slow?” I asked.

“You look great!  It’s unreal!”

My husband is not one to hand out compliments, so I was shocked by his enthusiasm and support, as well as blown away by the almost instantaneous change that resulted from just a few chiropractic treatments.  It was clear that this was the right therapy for me.

In the past week, I have had a setback, but Sandy’s treatments and fitness plan for me have been effective.  I am in this for the long haul and am going to do whatever it takes to heal.  Between Sandy and my coach, I know that I will be able to come back stronger and faster than before.

To anyone with an injury, this is my advice: don’t fixate on one type of treatment.  What worked before may not another time so it is important to be open to new ideas.  I went in for my first visit with a “let’s see how it goes” attitude and, to my surprise, it was the right solution.  While I feel like I am back at square one, I have every confidence that chiropractic care will help me get to where I want to be.

It Just Wasn’t Meant To Be

Weeks ago, I took on the “whatever it takes attitude” in the hope that I would be able to toe the line at the Chicago Marathon.  I saw an osteopath who worked some magic.  I spent time with an acupuncturist who lessened the pain and improved the circulation in my glutes and hamstring.  And I found a chiropractor who is a gift to runners.

Within weeks, my Chiro got me running from 2 miles a week at the end of August to ending my training with 40+ mile weeks.  When I first saw him, it hurt to walk.  Last Sunday, and the one before, I ran 18 miles relatively painfree.  I had put in the time running, stretching, and strengthening, and I was ready for Chicago – not for a fast time but to finish what I started.

But you can’t underestimate the power of the marathon.  During the final days of my taper, Tammy the Hamstring came back to visit and she was angry.  On Wednesday night, Kelly-Lynne and I went out for an easy 6 mile run and, half-way through, I felt like my back thigh was bleeding internally.  A bit later, I thought a knife ripped through my piriformis.  Minutes later, Kelly-Lynne and I walked Tammy back home, with me holding back tears.

After two more visits to the chiropractor, who felt I was just having a muscle spasm, and an acupuncture treatment, all I could do was hold my breath and hope that I would be able to run.  Tammy needed to settle down.

By last night, I felt much better.  My leg had loosened up, and I made the decision to run slowly for the first six miles of today’s marathon and take it from there. I felt confident that I was going to be able to finish.

So this morning, I left my sleeping husband and boys at the hotel at 6:00 as I walked to the start.  Tammy the Hamstring felt relaxed; she was back under control.  At 8:00, we started to move to the start line and began our marathon.  But just past the one mile point, I felt a twinge.  Tammy had resurfaced.

It was only a few minutes longer before I realized that I wasn’t going to finish.  I was prepared to walk the back end of the course but not 25 miles, and I knew that I wasn’t going to be able to run.  So I called it a day.

It took almost an hour to get back to the hotel because of the road closures, and I watched runners and walkers of different sizes and speeds pass me.  That was hard.  I wondered whether I made the right decision until I hobbled back into the hotel lobby.   It was clear that I made the best choice.

A nap, a snack and a lot of tears later, I am comfortable with my decision.  I gave Chicago my best shot but finishing today just wasn’t in the cards.  For whatever reason, this just wasn’t meant to be.

I am grateful for the optimism of my youngest who said, “Ya, but we’re in Chicago.  At least, we get a holiday together.”  And he is right.  It is Canada’s Thanksgiving and I am thankful to be here with my husband and boys.  In the end, this time together is what matters the most.