Sunday, October 30, 2016

Big Recovery News

I had a little bit of a bombshell on Thursday regarding my injury. The radiologist who interpreted my MRI posted his notes to my Patient Portal and I learned that rather than two stress fractures, I have two stress REACTIONS (no breaks, but weakened and swollen), along with the previously diagnosed osteitis pubis, a partially torn adductor longus on the left side and strained adductors on both sides. Here is more on stress reactions, aka bone stress injuries (BSIs).

BSIs are much less severe than fractures, but the symptoms are the same and immediate treatment won't change - still four weeks of limited activity and then a followup. The only difference is that I'll be able to start with a physical therapist on fixing the causes to the osteitis pubis and (hopefully) be back to full activity a few weeks sooner.

For a week I was operating under the belief I had essentially two broken hips. I visualized the broken ends fitting together like a cracked coffee cup waiting to be glued From the time I woke up until I went to bed, every move was modulated to keep those ends snug against each other, not grating or twisting or pulling apart.  Suddenly my hips were no longer broken - the twinge in spin class was not bone rubbing bone but cranky, worn (or torn) tendons reminding me to back off.

Saturday Kathryn and I went for our usual bike ride - this time starting at the Chickahominy Riverfront Park, east to the end of the Capital Trail, 13 miles on the Colonial Parkway along the James, through Williamsburg and out to Yorktown Naval Weapons Station, and then back after a snack at the Jones Millpond parking lot.  This is one of the older parts of the Cap Trail and the pavement is getting cracked and buckled, but it felt heavenly silky smooth after the jarring composite surface of the Colonial Parkway.

It was a beautiful ride - mist rose off the river and tributaries, and the rising sun caught the misting of dew on the reeds and grass - but mostly I no longer felt broken.  Was this because I've been relatively sedate since my last two mile run/walk on October 17 and I'm starting to heal, or was it mental? I believe it's a combination of the two. I'm much less tentative, but I'm also healing.

Exercise Log

10/22 - Walked 4-5 miles with Christina and took lots of pictures. We walked to Maymont but it had just closed, so we walked along the fenceline and down to the Nickel Bridge and back home. My hips were getting pretty tight the last couple of miles and my left leg started to hurt quite a lot towards the end. I talked later with Dr Lauren and she believes this is because swelling is putting pressure on my sciatic nerve. Hips were pretty sore that night and on waking the next morning.

10/23 - Bike ride with Kathryn - 40 miles on the Cap Trail, from Charles City Courthouse out to the Chickahominy Bridge and back. Minimal pain but not much strength. The ride back was pretty slow - first my left quad was burning and then both quads, and then both legs overall. I was tentative pushing on the hills, and dismounting proved to be quite challenging. Christina came along and rode on her own for 20 miles - new 2x distance PR for her! Both of them made fun of my wobbly gait at the end because they're mean and nasty people.

10/25 - Spin class with Kathryn. I was a bit nervous about this. I've done spin a couple of times before and it was a sufferfest - drenched with sweat, quivering with muscle failure after 45 minutes. It seemed like a lot of stress on my (I believed) broken bones. I decided I could do it if I held back some and didn't push 10/10ths.  Turns out that's easier said than done.  My hips were kind of tender the rest of the day, but they didn't hurt at night.

10/27 - Spin class with Kathryn. Different instructor this time, and a much more specific and varied workout.  I held it back a little more than the previous class - slow cadence on the standing portions, focusing on only applying force on the downstroke - and I wasn't sore afterwards

10/30 - Bike ride with Kathryn - 40 miles of Cap Trail and Colonial Parkway. No problems dismounting this time and .5 MPH faster overall than the previous week's ride. No nerve pain during the ride and just the normal achy quads after. No pain at night or this morning.

Friends and support

It's critical to have a circle of good, trusted friends. I went many years without any, and I discovered that if you wait until you need them, it's too late.

If you have a circle like this, let them know today how much you appreciate them. Give them a hug if you can. If not, call them, text them, anything. Let them know.

If you don't have a good circle you can trust, please PLEASE think about what you need to change to make it so you do. Open yourself up. Trust enough to be vulnerable, and keep the trust of those who make themselves vulnerable to you. Be the person you would want to be friends with. We're social animals. We need each other.

Friday, October 21, 2016


Part I

It's 5:30AM. I'll be leaving for my MRI appointment and followup with Dr Cutter in an hour. My giant melon head is chock full of emotions.

I'm nervous, anxious, worried. What if he tells me no activity at all? What if I can't run for months? What if I find out I'll never again be able to run like I could a year ago? What if I lose all my running friends during the time I'm out and after when I can't keep up with them?

These are all absolute worst-case scenarios. From the research I've done, my case is fairly mild. The logical, rational part of my brain knows this. And I have faith that my running friends won't abandon me. They're my friends first and foremost, and my running friends after that.

But still.

I'm optimistic. This injury didn't suddenly happen at Erie Marathon Mile 8. My hips have been tight and sore for months. Various feelings and symptoms from the summer make a lot of sense in hindsight. This has been slowing me down for months. Fixing it will fix a lot of what has been bothering me. Even without the PT that I'm sure is coming, a few weeks off from running will give me a chance to heal, an opportunity I haven't taken since I started this BQ quest early last year.

I'm relieved. All week I've been in suspense. I just want to know what's happening, what I need to do, what I can expect. For the most part I function well in uncertainty and ambiguity, but this is a little different. I'm very fortunate that my followup with Dr Cutter is immediately after my MRI session. I don't know if I could wait another week.

My friends are wonderful. Everybody checked on me last night, offered well wishes and encouragement. There is a lot of positive energy floating around out there on my behalf this morning.

Anyway, time for a shower and to head off to Shortpump and then HCA Sports Med.

Part II

Two stress fractures - one on each side of the pubic symphysis. The one on the left is bad, the one on the right is not as bad.  This put a tremendous about of strain on the muscles attached, so they're pretty damaged as well.

For four weeks I have to avoid anything that causes pain, which is basically anything that uses my abs or involves kicking. Aquajogging and elliptical are out. Cycling last week didn't hurt, although I'm worried that it will now that the hip tightness that was holding everything together has loosened up.

This is not completely worst-case scenario, but it's pretty close.

I'm still working through this. I don't have any good prose today. Maybe later.

Wednesday, October 19, 2016

Injury post #1

Two days ago on Monday October 17th, 2016, I was diagnosed with osteitis pubis. I'm starting this blog for a couple of reasons, but mainly because next month when I'm all depressed because I still can't run, I want to be able to look back and see how far I've come.  There will also be some longer stuff and some of the pictures I've been taking.

10/17/16 - 2.74 miles of run/walk with Kathryn and Greg, total of two miles running. This was likely my last run for a while. Kathryn is recovering from a really nasty case of acute plantar fasciitis and this was her fourth run/walk session since Tenex surgery last month. It was a good last run for me - she's optimistic and getting stronger with every session, and we stopped before my groin started hurting too much. She went off to work and I went to see Dr Cutter.

Osteitis pubis is degeneration or inflammation of the pelvic bone around the pubic symphysis, which is the cartilage that sits in the middle of your groin and separates the two sides of your pelvis. It's caused (in athletes) by a muscle injury or stress fracture. In my case, the x-ray shows problems on my left side.  I'll be posting more about this later.

His tech recommended no exercise at all, but any runners out there will understand why this was not an option. She amended her recommendation to avoid anything that hurts. I will need clarification on this when I go for a follow up Friday. Distance runners have their own scale and definitions for what hurts.

10/18/16 - 40 minutes of aquajogging at SwimRVA. I got myself a 10-visit pass. I'm hoping I'll be able to go once a week, but it's possible that after Friday's MRI and followup that I'll find I need to hold off on this for a while.

I did aquajogging once before - I was at peak fitness a few weeks before Erie Marathon, and honestly it didn't feel like much of a workout. My fitness level now is much lower now after five weeks of very limited running. It was a much better workout this time.

Back to the runner's definition of pain - I could feel some discomfort when I used a full range of motion in my legs. Is that what the tech meant by pain? I stayed conservative and kept my kicks much smaller and tighter.

10/19/16 - Strength workout with Kathryn at the Y. She went to Munford beforehand for her run/walk session (up to three miles total in 30 minutes! Woohoo!!) while I slept in a bit.

For the last few months my hips have been really tight. I haven't run now (except for Monday's run/walk) for four days. My hips are much looser than they've been for a long time. The downside is that all that tightness was keeping my groin from moving around much, and now that it's moving it's a lot more sore. It woke me up last night every time I rolled over.

There are a lot of exercises I'm assuming are a bad idea right now - anything with lateral stress on my hips, anything that activates my deep abs and anything where my legs move independently. This rules out side planks, Russian twists and leg lifts. Kathryn has others she can't do yet, so we're on the lookout for exercises that don't overly stress the heel or the groin.

Right now I'm alternating between optimism - this has been building for a while and I'm pretty sure it has affected my performance for most of the summer. Fixing it will fix a bunch of stuff that's been bothering me for a long time - and feeling really down. Down has been winning lately, and having to wait until Friday to learn more has been really tough.