Seven Weeks, Running is Go

Finishing (and winning) the
Sylvania Tri in 2010 may be the last
time I wasn't in pain running

It's been seven weeks since my PRP injection. During this time, the thing I've longed for most is the feeling I get when I'm out on the pavement with only my heartbeat, my running shoes, and my thoughts. I solve problems when I'm running. It's the only time I can let go of the damaging self-critic. It's the only time I can be myself without being terrified of what everyone else thinks. I need to run.

Unlike before, this time off from running has been one of inner reflection and fighting demons. Because I wasn't sure I would be able to run again. That fear was always there. What will I do if I can't run? I turned to introspective stream-of-consciousness drawing - the only other thing that gives me similar peace. But the fear continued. What will I do if I can't run? My physical therapist quoted the medical report ".. you have SEVERE tendinosis .. seriously NOT good" (as though I didn't fully grasp the severity of the injury). He said my hamstring tendon was "breaking down" - made it sound like it was actually disolving. The fear grew. Seriously. What. will. I. do. if. I. can't. run?

The fear made me ok with taking seven weeks off without a single step in a running gait. Sure, I was an emotional wreck (further compounded by a car accident). I became religious about my physical therapy. Heck, I became religious. I prayed. But I never stopped worrying. I frantically searched the internet for hamstring PRP success stories. Six weeks went by with not much improvement. And I had pretty much given up hope.

Then, in what seemed like an overnight miracle, this week the familiar always-there pain faded. And today I got the go-ahead. To run. It's been a rough year so I'm not celebrating just yet. But I will run. And it will not be far. It will not be fast. But there is running in my future. And unfinished business - with a finish line.

All I can do to explain is offer this (and stifle the tears):

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.

Visions of Physical Therapy

I just started seeing a physical therapist to fix whatever is wrong with my left hip. On the referral, my orthopedic doctor wrote "capsulitis"-- according to my PT, this is a very general term identifying inflammation of the "capsule" surrounding the hip joint. I think it sounds like I'm taking too many drugs (capsules?). Either way, I haven't been to PT in almost 20 years. It's been so long that I almost didn't recognize my physical therapist (but it was really great to see him again). I told him I hadn't had a problem since last time he fixed me, but I finally broke everything he did and that's why I was back in his office after all these years. He promised to fix me up again (too bad what's wrong isn't all physical).

The first thing he did was identify a major weakness on my RIGHT side. I was blindingly aware of it -- embarrassingly, every time I tried to balance on my right foot, I must have looked drunk. Who knew? He also did a manipulation to rebalance my pelvis which was rotated on the left side. He told me to go running and note how I felt.

So I went home and ran. And something must have changed because the excruciating pain came flooding back into my left hip. But, as usual, as I ran, it didn't get any worse and it didn't get any better. The rest of my evening was spent sitting on an ice pack and listening to the pain shoot all the way down to my ankle. But, progress has been made. And I can continue with the "pain" drawings.

Here are my latest two -- calling them the "physical therapy drawings." The first one was the day before my visit, the second one was during yesterday's ice-pack recovery.