Hindsight

As I look back and reflect on my last year of not running, and as I think about the emotions that I went through and the steps that I took to repair and heal my hamstring, I hope that my experiences will help another who might be dealing with the same kind of injury.

First and foremost, you know your body better than anyone else.  If something doesn’t feel right, it probably isn’t.  Looking back, I realize that I missed the warning signs.  Now, I know that the most prominent signal that something was brewing was the pain that went through my butt every time I sat down.  The ischial tuberosity hides under the glutes so, when you sit, the glutes move and you are on your sit bones, or the ischial tuberosities.  I always attributed the discomfort that I had while sitting to not having a lot of fat.  Similarly, I attributed any tightness or discomfort that I may have had through my hamstrings and butt to finishing a tough run (or race) or to a higher mileage week.  Not once did I imagine that my right hamstring was gradually fraying, which resulted in a 50% tear.

Secondly, stay positive.  In the past 10 months, I have worked with my family doctor, 2 sports medical doctors, an acupuncturist, a massage therapist, a chiropractor and a few physiotherapists.  For the most part, my visits with each of them were positive but there were times when I left feeling down.   Some days, anything from a doctor’s silence to a comment such as “That’s unfortunate” or “I hope this will help you” would scare me or send me into tears and leave me wondering “Will I ever be able to run again?”  I had to believe that I would heal and that any fitness lost would be regained.

And so I followed my gut.  While I knew that my tuberosity would heal, it took months to find the right treatment, primarily because I had to wait almost 4 months for the correct diagnosis. It was my GP, not my sports med doctor, who booked an MRI for me, and that had a 3 month wait.  I had just started to run a week before my appointment and thought about cancelling it, but something still seemed off; my gait just didn’t feel right.   My son convinced me to follow through with the MRI as it would give me more information about my injury.  He was right.  The hamstring tear turned out to be deeper than we originally thought.  It was the MRI that led to one sports medical doctor’s referral to another who specializes in hips and to a different physiotherapist, one who targeted strengthening the glutes and hamstrings, followed by another who realigned my pelvis.  And when the physiotherapists gave me exercises to do, I did them no matter how boring they were or spastic I felt.

During my healing and recovery, I focused on what I could do, not on what I couldn’t.  I spent hours each week on my windtrainer so that I could hold onto my cardio; within a 10 month period, I had ridden more than 3000 miles. I worked on my core and upper body  while strengthening my hamstrings and glutes by heading to the yoga studio 3-4 times a week (sometimes more).  I started swimming again and, by June, I was pool running to start rebuilding the same muscles that I use when I run outside.  I set goals that were achievable and I met them almost every single week.

Separating the platelets in the centrifuge.

But it still wasn’t enough. I had done everything that the doctors and physiotherapists had suggested but my right leg just didn’t feel strong whenever I tried to run.  So I followed my gut again and went back to the hip specialist, who proceeded with platelet rich plasma (PRP) therapy  at the end of June. Ultimately, it was the PRP injection that had the greatest impact on my healing.   The doctor had cleared me to run only 3 weeks after the injection, not after the usual 8 week period, and, for the first time in almost a year, my legs felt strong again.

Back to Chasing My Dreams

In the past year, the most valuable lesson that I have learned is to listen.   I learned how important it is to pay attention to my body, to what feels right and what doesn’t.   I listened to my professionals and followed through with their advice. If my gut told me that things still weren’t right, I went back again and again until I  found the right form of therapy.   I never gave up.  Yes, I got frustrated and, yes, sometimes I cried, but I also believed that I would eventually heal and get back to chasing my dreams.

 

 

 

 

Graduated

It’s been a full year, almost to the date, and it looks like I am finally finished dealing with a torn hamstring.

I had a follow-up visit from the PRP injection with my sports medical doctor yesterday.   He typically wants a gradual return to exercise and a visit 8 weeks after the injection.  But I needed more information.  I was tired of  waiting for answers.  I didn’t want to play any more guessing games.  I needed to know: am I healing as expected or do I need a second injection?  Am I doing too much too soon or is my fitness where it is suppose to be ?  I need guidance because, let’s face it, I don’t do well on my own.  I don’t always recognize the signs of trouble brewing and I certainly do not want to end up back at ground zero.  So I asked, maybe begged, and he agreed to see me after the 4 week point.

I truthfully didn’t know what to expect.  I was a bit worried that he would want to start to treat the left tuberosity, where there were some minor tears, because I am noticing that side more than my right.  So my son drove me to his office – just in case he was wanting to do another PRP injection.   Dr. Bentley asked me a few questions and he examined by strength and movement.

“Your hip is jammed up again,” he commented .  I felt my shoulders sigh.  “You’re going to have to keep up with physio or Chiro care – probably twice a month – to keep your pelvis aligned.” I had already been prepared for that as a life-long need; I know that it has helped and I know that I am going to need regular maintenance.

Then I asked my questions:

(1) Is my left side sore now because my right is stronger and I am just hyper-sensitive to what is going on with my hips?  “You’re in tune with your body,
he said. ” You’re quite aware of what is going on so, yes, it’s a bit of both.”

(2) Is this tightness, the achy-ness that I have just part of aging?  Dr. Bentley smiled.  “You’re getting older.  And you’ve have some issues with your hips.  But it’s not like your severely arthritic and your hip is waiting to shatter.  You’re going to be fine.”  So, yes, I need to get use to feeling sore.  Fortunately, I am in a line of work that doesn’t let me sit for too long; for me, being busy and active is key.

(3) Do you think I’ll be able to get back to distance running?   Dr. Bentley told me that more is better for me, which ties in with the “don’t sit still” approach that I have adopted.  “You’ll have to cut back in intensity,” he said. “You can train the same way during each session but not as often.”  Basically, I need more non-running days to give my body a break from pounding the pavement.  Instead of running 6 days a week, I’ll have to run 4 or 5; double-run days, I’m fairly certain, have become a thing of the past.

“You’ll have to keep up with physio,” he repeated.  “But I don’t think I need to see you again.  If something changes, just call me and set up an appointment.”

When I got back to the car, I said to my son, “I have graduated.  I am all done.  He doesn’t need to see me again.”

Graduated

“You’ve graduated?” he asked.

“Yup.  I suffered, I researched, I did everything I was expected to do, and I have passed. I am done with rehab.  I have graduated.”

When I got home, I celebrated (of course) with an easy 3-mile run.  Last night, I started my plan of training to train and today, I can begin to start chasing my dreams.

 

 

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?