Undoing Disasters: The Injury Rehab

This past Friday was the official beginning of my injury rehab. It's both a relief and agony to finally know exactly what was wrong after three years of gradually-increasing-but-never-bad-enough-to-stop-training pain. It's a relief because I can start to fix it. It's agony because I have to fix it (and therefore take more time off).

After the phone call the day I left for London, I was sure that the pain was coming from two different sources - the findings on my left hip MRI: (1) a labral tear and (2) a hamstring tear. This would most definitely explain why I was getting pain in so many places and at times would hurt all the way down to my ankle. But I found out last week that I was likely wrong. I was wrong about which "tear" was actually causing my pain. My Orthopod, Dr. Patterson and I discussed this in my first visit after returning from London.

It went something like this...

Dr. P: You are seriously messed up.

Me: Tell me something I DON'T know.

Dr. P: (explains how MRI images were taken and then shows me the longitudinal slice images from the outside of my hip inward). The good news is there is no problem with the ball joint, the bone.... (points out the labral tear) and here's the labral tear - it's in the front

Me: But I have no pain in the front...

Dr. P: (continues the slide show)

Me: EEEK! What's that?

I knew there was something seriously wrong with it as soon as I saw what turned out to be my hamstring tendon - the tendon that connects your hamstring to the sit-bone.

The diagnosis was severe tendinosis (I've never heard of that either) and partial-thickness tear of the tendon. It was a chronic condition likely the result of never rehab-ing the first hamstring tendon injury (and who knows how long ago that was?). It had gotten so bad that it would probably not heal on its own. In olden times, surgery would have been my option. But these days, there's a new therapy available: a PRP (Platelet-rich plasma) injection to force the healing components of blood into damaged (connective) tissue. Google it if you're interested in ways doctors are using PRP - it's a pretty promising therapy.

Here's how it works. My own blood would be extracted, then spun in centrifuge to obtain mostly platelets, then injected into my tendon. Because it's my own blood, my body will recognize it, and because it's platelets, it has a high concentration of growth factors. It should start rebuilding my tendon tissue as soon as it gets in there. The post-procedure protocol would have me in physical therapy and back to training in about 4-6 weeks.

There are several issues I can now report on - because I had this done three days ago.

First. IT HURTS!!! Like white hot pain for an instant and then imagine the worst pain that you had from the injury and triple it. The doctor who performed the procedure also confirmed via ultrasound that: "yeah, your tendon is seriously messed up" just as he stuck the needle full of fluid right into it. In his defense, he SAID it would hurt.

His next question was: "does it hurt like the injury did?"

"You bet your sweet bippy it does!"

He said: "good, that's what we want." It was the exact pain I'd been experiencing while running -- except I wasn't doing anything to induce it.

Second. It gets worse before it gets better. By that night, although the initial white-hotness had gone away, I couldn't walk or stand without pain, and I felt like I was sitting on a rock for many hours to come - through the next day, in fact - before things settled down and I wasn't hobbling around. This is supposed to happen.

Third. You must grin and bear it because YOU CAN'T DO ANYTHING FOR THE PAIN. No ice. No NSAIDs. Oh, yeah, Tylenol is ok (like Tylenol works - come on!) Why? Becasue the inflammation is necessary for the healing process. I always prided myself on my ability to tolerate pain, so now it was time to walk the walk.

Three days later, the aching pain has subsided, and I only get pain if I sit on my sit-bone. I've happily become a couch potato in hope that healing is underway. Heck, what I was doing wasn't working. I'm ready to try anything that might mean a pain-free run in my future. It's been way too long.

Finding the Fun: 2013 ITU World Championships in London

It's over. My triathlon season, that is. It ended with a race in my favorite urban green space: Hyde Park in London, England.

It wasn't the fairy tale ending I dreamed about last year when I qualified to race in London. In fact, on another day in another time, I would have considered it a disaster. But based on the situation I found myself in race morning, my last event of the season was actually bittersweet.

The bitter part came in the form of my thoughts of what could have been. What could have been if I wasn't training and racing injured all year. What could have been if they hadn't shortened the swim leg. What could have been if our travel had gone smoother with less stress. And, most importantly, what could have been if I had known in October what I found out the day we left for London: an MRI showed a labral tear in my left hip and a chronic torn hamstring. Had I known THAT, things might have been different in London.

But after I spew out all the things that conspired against me in London, none of them would take from me the thing I was determined to take back - my love for my sport and my love for the city of London - specifically my very favorite running spot in the whole world: Hyde Park. This was the "sweet."

I can't count how many times I've wished to swim in the Serpentine. Or how many times I've run circles in the park and wondered what it would be like to race there. When I watched the Olympics in 2012, biking along the approach to Buckingham Palace looked almost too good to be true. When I got my chance to race in London, I would take it all in and enjoy it - seriously, this WAS a once-in-a-lifetime thing.

I will say that it was easy to adopt that attitude with an injury. My physical therapist said I should have no expectations besides "just finishing." Of course I had expectations. I haven't been working hard while injured for nothing. I hoped for miracle podium finishes just like anyone else out there. And I have friends in England to impress. I also wanted to race well for my team - Team USA.

In the end, I had to settle for smiles and small victories.

It was my first time racing an ITU race. There were endless rules and rigamarole to follow. Uniform rules. Bike helmet rules. Bike racking rules. Transition area rules. Even wetsuit rules. Bike check-in for me was Saturday at 6pm where they read us all the aforementioned rules and went over the transition area layout.

The transitions included 1.8K of running - this was an official measurement made by someone on the Canadian team. We were told not to do anything stupid - i.e., get hurt or injure someone else just for an extra ten seconds - that we would NOT get a personal best time on this course. We were informed of crashes and where to slow down on the bike course. Slippery spots in transition were pointed out - including the place where a competitor fell and broke his hip the day before.

In my mind, the biggest issue facing us was the weather. Several days of rain wreaked havoc on the sprint race (20 people ended up in the hospital from bike crashes) and the women's pro race (top contender Gwen Jorgensen crashed and had to withdraw). In addition to the rain, we would also have to endure the cold (air temperatures in the 40s and water near 60 degrees F). Thank heavens the USA uniform included an ITU-approved jacket (the uniform rules are very strict).

In transition, we were not allowed to have anything except race equipment. All towels and transition mats (including rags to wipe your feet) are outlawed in ITU racing because they are regarded as "markers" for your location. This was hardcore stuff - no unfair advantages allowed.

I racked my bike, walked through the transition routes, and then my husband Jim and I made our way back to our hotel. I didn't get much sleep - travel woes and jet lag were screwing up my entire system. In what seemed like a few moments, we found ourselves hustling to make the half-hour jaunt in the dark down to transition on race morning. Transition closed promptly at 6:30 am for waves starts at 7:00. With about 2.5 hours to wait for my start, the key would be keeping warm as I foolishly forgot gloves and a winter hat. Many athletes were donning their wetsuits early to stay warm.

Keeping warm pre-race

While we waited, we found out the swim leg had been shortened to 750m because of cold water and concerns for hypothermia, and wetsuits were no longer optional. After an icy swim in the serpentine the day before, I was not looking forward to even colder water. But this year, swimming has been my strongest leg, and the shortened swim would likely cost me several places.

By the time my wave was called, I had given up trying to wake up my digestive system in the (flushable with sinks and soap and an endless supply of toilet paper) porta-johns. I grabbed a shower room (did I mention they had portable showers on-site?) to squeezed my huge body into my abnormally-small womens-medium-size Tyr Team-USA tri-suit. On the flip-side, because it was cold, I didn't have to struggle with a sweaty body getting into my wetsuit.

Jim and I said our goodbyes, he told me to have fun, and I joined my age group in the queue.

Time gaps between waves were very generous, but we were able to pass the time by watching finishers (the race was over for some before it even started for others) and talking about how it was "warming up." Miraculously, the sun had stayed out and it was burning bright in a clear sky... in London! We were hustled onto the start dock in what I later learned was (in proper English lingo) "two shakes of a donkey's tail." The in-water start was as fair as could be - everyone held onto the dock until we got the horn.

"Queuing"

I started my watch with "take your mark," and we were off. As soon as I started swimming, it felt just like every other Olympic-distance race - i.e., everyone was relatively civil (unlike Ironman where I get viciously clobbered by non-swimmers). Except something wasn't right - I felt the athlete wristband wrapping around the "heel" of my left hand. The same wristband had been on the opposite side of my watch about ten seconds earlier (when I hit the start button).

Trying not to get distracted, I assumed my watch had slipped a notch and slid down. I felt good in the water (surprisingly the cold was a non-issue) and was mostly alone with no feet to draft. Spotting the very tall buoys was easy even with the sun in our eyes for the longest stretch of water. When I rounded the second-to-last buoy, I almost slammed into the stragglers from the previous wave. I took a second of breaststroke to regroup - and used that second to inspect my left wrist.

Swim exit, sans watch

Horrified, I noticed my watch was gone. In true Disaster Magnet fashion, my new touch-screen watch - a birthday present from Jim - had become a victim of the Serpentine. (My extreme reaction would have much more light-hearted had I known the watch sacrifice would become a running joke for everyone in my circle of English friends for days to come.)

The swim exit was about 20 yards away and there was nothing I could do - short of panic. On the long run to T1, I heard Jim yell "nice swim," to which I replied "I LOST MY WATCH!" Like he could do anything about it.

I kept running. And running. And running. I had no idea what my swim time was, but I found solace in the fact that my bike time didn't require the watch as it would be firmly registered on my bike computer. My wetsuit came off in record time, and I saved more time by deciding it was warm enough to ride without my jacket. Then I foolishly lost time to OCD while trying to tidy up my ground space. The run to bike-out was thankfully short.

The two-loop 40K bike course was nothing short of spectacular. It did a quick out and back through Hyde Park then exited via Hyde Park corner, through Green Park, past Buckingham Palace, along St. James Park, then loosely followed the Thames river to a turnaround near the Tower of London. It was flat as an English pancake (more like a crepe), and the only thing that slowed us down was the wind that kicked up on the second loop.

During the bike leg, several near-crashes kept me alert. A wind gust reminiscent of Kona nearly blew my bike out from under me near Hyde Park Corner, and when I swerved to avoid another competitor who cut me off in Hyde Park, my back wheel caught air. There was also woman with a death wish who disregarded a crossing and had to be pulled out of the way by a crossing guard just in the nick of time - with two female cyclists traveling 25 mph bearing down on her and screaming for her to get out of the way (I was one of them).

Yeah, I'd have to say she was drafting.

A funny thing that happened on the bike was when another competitor passed me near the end of the leg and turned around to yell to a German woman behind me to stop hanging in my slipstream... then she said "you're cheating" in a very matter-of-fact tone. What cracked me up was how politely she said it. I think I might like this ITU thing after all.

The bike course was awesome for spectators - I saw Jim no less than three times, and he never had to leave Hyde Park. It's also worth mentioning that crowd support was phenomenal on the streets of London. The throngs lining the streets cheering was comparable to those of the New York City Marathon.

My bike time was slower than expected - based on speeds I was clocking - but I felt I rode as hard as I could without aggravating my hip. A couple of severe twinges of pain made me step back a bit so that I could (hopefully) run without limping.

I pulled into T2 slightly downtrodden at my slowness but happy only a 10K remained between me and the pub. Again, the run was quite long to the bike racks, and by the time I reached mine, I understood my earlier OCD folly. The transition zone had become a war zone, with equipment carnage everywhere. My running shoes were not where I left them - thankfully they were close by. I was able to get into them despite having muddy frozen blocks of ice where my feet used to be.

During the long trek to run-out, I gave the slip to the draft-guilty German girl - she obviously didn't pay attention to the course talk about the hairpin turn in T2 and tried to cut the course by exiting at bike-out. Some people never learn!

The 10K run was comprised of three loops completely within Hyde Park. The crowd support would blow my mind - people were constantly yelling my name and "U-S-A!" It didn't matter what country we were from - we got cheered.

Now came the real problem of being without my watch - taking run splits. Jim to the rescue! On the back stretch of the first loop, he held out HIS watch and I grabbed it. I was feeling relatively good compared to other races this year. But it was almost useless because there were no distance markers on the run course. Without mile markers, I was forced to do math - I assumed a loop was about two miles, and after the first loop, I started the watch.

The run passed the finish line three times

On the second loop, I stopped trying to figure out who was in my age group - no body marking and numbers worn on front. A British woman who looked about my age passed me at a decent pace, and I decided to hang behind her.

I struggled to stay with her and took a split at the second loop - 14:44. I was doing 7:20s. Not great, but my hip was still working and I actually still felt pretty strong. So I decided I wanted to run down the British chick.

Half way through the second lap I caught her on an uphill and maintained my lead for about 30 seconds, then she re-passed me. I noticed her breathing was more labored than mine, so I hung back for a minute and then made my move. With about a mile to go, the mantra of an old running friend came back to spur me on. He used to tell himself: "You can do anything for a mile.. you can hop on one leg for a mile if you have to."

It was the final mile of my final race, and if I had to go down, I would go down fighting. I passed the Brit and ran with everything I had. I never saw her again. I completely forgot about my time, and as I came to the turn into the finish chute, I was handed an American flag from a spectator. I sprinted for the finish line.

My first race on international soil had ended. It wasn't my best. It wasn't my worst. But it WAS the most fun I've had in years.

By the time I found Jim, the weather had turned foul (rain, cold, and wind), and I quickly packed up my stuff as soon as we could get into transition. Then Jim bought me the coolest new Timex watch ever - it's white with the Union Jack on it.

Monday night we attended an intimate gig with my favorite musicians: Turin Brakes. After they played a brilliant gig showcasing their amazing new album (check 'em out at turinbrakes.com), we spent time catching up. It's been an agonizingly-long three years. The biggest story of the night? How hilarious it was that I would be leaving my watch in London at the bottom of the Serpentine.