Hello, friends! After a short hiatus from blogging to tend to things in the real life world, I’m back again this month!
Not without any frustration, pain, highs, and lows, I’ve been battling some nagging injuries since my 100 at Burning River in July — 7 months ago. It is quite the story… with an ending that’s still being written. I’m not fully 100% yet, but working towards it. Here’s what happened:
During and after the 100 mile, I noticed some pretty severe pain around my hip, and I just figured it was some kind of tenditinis from overuse or bad form. Post-race, I couldn’t sit and get up without pain. This hip pain was actually an avulsion (doctor speak: avulsion of the ASIS, anterior superior iliac spine): ligaments attaching my hip-area muscles to bone were so inflamed they were pulling the bone away. On an x-ray, my hip was lit up!
THAT. A runner’s most-dreaded words, “You need to take some time off.”
I had to play by one rule: if it hurts, you shouldn’t be doing it. No walking, limited strength/lifting, and definitely no running. I tested cycling, elliptical, and swimming – and all seemed to aggravate the hip. So, I did absolutely nothing for two and a half months.
I began running again VERY conservatively. An unfortunate run with dogs really aggravated my hip again. I took another 3-4 weeks off.
I distracted myself with other things- cooking, event management, and work was busy. It was still a major disappointment to come back after waiting longer than a broken bone would need to heal… just to injure myself again so easily. With runs always less than 3 miles, I was getting more and more frustrated that patience and running conservatively weren’t making a difference. I wanted to slap anybody who complained about having to take 2 weeks off for an injury!
Began running again – attempt #3 – with a few weeks of decent short, easy runs in when I decided to run a non-competitive Turkey Trot 5 mile on Thanksgiving morning. Partway into mile 4 I felt an ache in my hip that got worse and worse as I ran. I stopped running for a few weeks.
Awesome! I strained my back so badly while shoveling snow that I couldn’t sit, stand, or lay down comfortably. A local chiropractor who-will-not-be-named put me through all the tests, all the quack treatments, multiple x-rays, and told me that I may not be able to run distance again and should take up cycling. Hello? I was there for my injured back. Oh – and because my health insurance quit covering more than 12 chiro visits, I left the place no better off and on the hook for over $500 worth of “treatment” provided. Vomit!
After another few weeks off and feeling hip pain (beyond typical start-up aches and pains) AGAIN on runs < 3 miles, I had had enough. Three miles should not cause an injury. I quit running again altogether for another 4 weeks.
I promise, this isn’t a huge sob story… Sad Sally’s just not me.
Here’s what my running log looked like – pretty sparse, but lucky to be even getting that far!!
Breaking point: After a pretty low low (there were tears), I finally went to see a sports doc. At this point I had taken so much time off that I had no pain, but I was still put-off by the fact he sent me straight to physical therapy with almost zero diagnosis. Physical therapy?! Seriously?! They’re going to tell me I have a weak core (c’mon, the phrase is almost cliche. amiright?!) and clamshell exercises, then send me on my way. Useless!
….At least, that’s what I initially thought.
January 2014 to Present!
I went to my first physical therapy session which was just a diagnostic and intro meeting. I ran for 5 minutes on a treadmill, she did some strength and flexibility tests, and then we chatted. After, I was so excited to get started if they could deliver! We scheduled up for about 4-5 weeks of 2 visits per week.
- My running form is almost textbook. (Thanks! I’ve been working on it for years!) I could stand to have more backswing on my arm swing, but perfect otherwise.
- I have some muscle imbalances. Oh, and I have a weak core. (Thanks for reaffirming my expectation of this visit- ha!)
- I have a limited range of motion/flexibility in hamstrings, hip flexors — even for a runner.
- There is a ton of scar tissue built up over years of running, which could be causing aches, pains, or compensation
- I do have a slight leg length issue, but probably because of tightness elsewhere (back, hips)
Here’s what I especially loved about what my PT said: “We’re going to try something different visit after visit. If you don’t notice an immediate improvement each time I see you, then we’re going to change our plan. You shouldn’t be in here continuously for months on end!”
We tried a bunch of solutions, including:
- Heel lift
- ASTYM (similarly known as graston)
- Taping on the IT band, arches
- Active stretching, foam rolling, and use of trigger point balls
Immediately after my first visit and first round of (ASTYM) “the tools,” as they call them, Marissa instructed me to try running. Guess what? No/less pain! Lo and behold, I ran 9 miles pain-free only three weeks later. That was slightly aggressive for mileage at the time, but I’ve since been able to move back to running every day.
Check out a glimpse of my running logs since I’ve been attending PT – lots more mileage bubbles!
What I learned about physical therapy:
- A ton of new hip & core exercises that have been challenging – none that I’ve ever seen or tried before.
- Just like with running, consistency is really important.
- You CAN see strength improvements in only a week or two!
- You shouldn’t have to accept the idea that you have to constantly return for treatment.
All through treatment, I had pains that jumped around. I had plantar fasciitis, extreme tightness in my IT band (it hurt where it connects near my knee), and hip soreness/tightness. We used “the tools” every time and they helped the most — I’m betting I was perfectly imbalanced and compensating efficiently for years and years of restricted motion, scar tissue, and tightness. We did ASTYM on my plantar and IT bands, calves, and glutes occasionally. I was a little bit of a special case because the amount of scar tissue was SO much and SO built up (from 15 years of running)! How do I know? I could literally hear it sounding gritty as they worked it out.
This was exactly what I needed to get back to running the RIGHT way.
I will gladly eat my words: Physical therapy has been the absolute most effective and lasting treatment method I’ve been through so far, mostly thanks to the ASTYM tools. I’m so happy with all the progress I’ve made since December! I recommend it if you think you’ve tried everything and have had no success, and you’ll enjoy it if you’re tired of hearing the same old exercises you can cheat at anyway!
Pros: Treatment is affordable and covered well by my health insurance. I was matched with a PT who’s a runner. Immediate results or changes are expected, and they don’t want to see me weekly for a year(s). My PT is really accessible and responsive by email. My PT wanted to keep me running not because it was the answer I wanted to hear, but because it’s important for rehab and testing out treatment.
Cons: PTs have to balance multiple patients at a time, but that may be exactly why it’s more affordable. I worked with two different runner-PTs because of this, and occasionally had to repeat my report-out on recent progress.
I have 2 more physical therapy visits to go, and have been cleared to slowly increase my weekly mileage by spreading extra miles out over all of the runs each week. I can still go for 6 or 7 running days a week…. out into the cold…. but with these cuties!
Goals for the next 30 days:
- Keep on with hips/core exercises – some combo of 4 “moves” per day.
- Foam roll daily – IT band, glutes, & hips
- Work through IT band pain by loosening up the shoulders – massage 2x/month (not the ahh-feels-good kind unfortunately), daily foam rolling, attention to form, and exercises – 1x/day
- Be consistent, build up gradually – < 6 miles/day if I’m up to it, 10-12 for a weekly long run.
Now, hold me to ‘em! I’ll check back on how I do next month!