Sunday, March 29, 2015

Boston and Injury Update

When I started this blog in 2011 I didn't really know how it would turn out.  One thing it has done is turned into a place where I can relive those races that I really enjoyed.  It also turned into a reference for others planning the same race.  Even Beach2Battleship has reposted my 140.6 race report.  Pretty cool.

As much as I want to continue posting positive things, you must take the bad with the good.  And this is going to be a post I don't want to relive.

With all the positives that I've been seeing in the last few weeks, my shin issue hit an all time high.  I set out for my 18 mile run with the Saturday Ultramax Store group run.  I started with a couple other triathletes I know.  Everything was going well. Chatting with people sure helps take the mind off of things.  About mile 3 the limp showed up.  By mile 4 my right leg was sore from the bottom of my foot up through the quad.  Around mile 4.5 my coach caught up with me and suggested walking breaks, which I did at mile 5.

I never started running again.

Luckily, the route brought us back by the store at that point.  I got in my car and drove home.

After hopping around in the shower, I laid down in bed and told Tricia that Boston was over.  There's no possible way.  My sub-par training would lead to a sub-par Boston and give me a feeling that I'd be leaving that race with a chip on my shoulder... assuming I could finish it in the first place.

I couldn't fight back the tears.  All I wanted to do was go to sleep so this pain would go away.  But the caffeine from my pre-run coffee was still coursing its way through my veins.

Eventually I did drift off.  When I woke up, it was like a new day.  I've been dealing with pain over two months.  Sure, I was still going to endure some but the path to recovery had been paved.  I'm ready to be normal again.  I'm ready to refocus for Ironman Muncie 70.3 and Ironman Louisville 140.6.  The decision was actually a bit of a relief.

I had to convey the bad news to my brother, parents, and friends.  My brother and parents were planning to make the trip out to Boston.  I didn't want anyone to make any further financial outlays on my part.

So now the question is should I get the MRI?  The money I'm going to save from hotel cost, dining, and race merchandise will more than cover that.  It will help figure out how to plan the recovery.  I'll talk with my doctor on Monday to discuss.

Maybe in a few years when I'm preparing for my next first Boston Marathon, I'll see this post and feel a level of appreciation and not sadness.

Wednesday, March 25, 2015

ScottyTris, MD

I'm getting tired of talking about medical issues here but that's my life right now, sadly.

So I continued with my foam rolling.  Monday I was doing better.  I decided to wait until Tuesday to see if it still helped.  Tuesday I was feeling even better.  PT Ross gave me the go ahead to run/ride.  So I decided to ride and call him on Wednesday to see how I'm doing.  Wednesday wasn't better but wasn't worse, so he green lighted running.  I did 2 miles on the treadmill and 1 mile on the track.  I wanted to use the treadmill to keep pace and a softer landing.  This SUCKED because I was staring out the window at the first warm weather day.

Thursday it was time to see Ross again... and I wasn't feeling any better.  Maybe a bit worse.  Again, I had to be honest.  This time I could point out exactly where it was sore.  As soon as I did this a light came on and Ross diagnosed a tight Iliopsoas.  Basically the same muscle group known as the Hip Flexor.

He showed me a couple stretches and some strength training exercises and sent me on my way.  As I was heading out he said to keep on "running, biking, and swimming"!  SWEET!

One of the stretches involved a BOSU ball.  I didn't exactly want to go to the gym multiple times a day to do this stretch, so I found a brand new one on Craigslist.  Friday morning I went to the gym and did my stretching and weights.  During the gym session, I planned out a meeting point for the BOSU ball and by 7:30am I had it and was on my merry way to work.

Interestingly enough, the hip was feeling pretty good.  I did a 5 mile run at lunch.  Did more stretching after.  Before noon I had already showered twice, at two different YMCAs.  That's a pretty good day!  I even snuck in a bike ride that evening.  Was I doing too much?

Saturday I hit the pool in the morning and then did a High Five Station at the Big 12 12k Run on KC Sports Commissions request.  I did have a two hour bike planned that afternoon.  Even though it was OK outside, I did it on the trainer.  I've been having some trouble getting my Power Meter to read correctly on my Tri Bike, so I ended up hosing up most of the ride by hopping on and off the bike tweaking it.  Eventually I just wasn't into the ride and cut it after 90 minutes.  My legs were pretty sore from the strength training the day before... but my hip felt great!

Sunday I met up with Kristen and the Sunday Runday group and ran 14 miles.  It went pretty well.  It wasn't the fastest, which is good because I wanted to keep the pace slow.  I did run about 1/2 a mile with the organizer, Donny, and we hit some 7:30-ish paces and, while it felt great to hit that pace, I knew it wasn't wise.

So after recording 19 miles running, 2.5 hours riding, and 1 hour of swimming, by Monday morning my hip was feeling... great!  I ended up calling Ross on Friday after a few more workouts (which included an 8 mile threshold run) and told him I was doing quite well BUT was concerned with a shin splint.  He agreed to see me the next Thursday and would tape me up with some KT tape.  By doing this I would be taped for my 18 mile run on Sunday.  According to Ross, if I watched the wrong video to tape it, I could end up doing something really bad.  He was being honest and wasn't trying to rip me off for another $40.  I didn't care, he fixed my hip.  He can have that plus more.

Saturday came and I rode outside for 2 hours.  It felt awesome.  That evening my hip and shin splint were both feeling good.  I met up with Kristen again on Sunday morning for my 16 miles.  She ran with me for four miles before heading back.  I did the following 8 miles on my own.  While my hip was feeling good, my shin was cranky.  I had four miles left when a girl who was running Boston as well caught up with me and we ran together for the final 4 miles.  She had told me how she missed her first Boston with an injury.  So she understood my situation.  After running with her for two miles, I realized we were kicking 7:30 - 7:45s instead of the 8:15 - 8:30 that I should have been running.  Finish strong, right?

By the time I got home, my shin was yelling at me.  It was bad.  I managed to get around but was not pretty.  Monday morning I could barely walk.  I knew this wasn't right.  I've had shin splints before but NOTHING like this.  I called my general physician as soon as they opened and scheduled an appointment at 10:30am.  Fortunately for me, TKB took the day off and could take me into the office.  Yes, I could drive but stretching my foot to push on the gas was quite uncomfortable.  Unfortunately for TKB, she had to spend the morning of her day off dealing with me at the Doctor's office.

Doc did some "point" tests and other range tests.  His gut feeling was it was a bad shin splint and not a stress fracture.  Until an MRI was taken, it wouldn't be possible to know.  So he did something that I thought was interesting.  He asked me what I wanted to do!  He knew I wanted to remain active.  So we came up with a plan:

  • Get in with the PT as soon as possible to do the KT tape now so it would help just walking around.
  • Take the remaining Meloxicam for inflammation the he prescribed me bake in early February.  He prescribed me 30 pills but directed me to only take 10 of them back then.
  • Hold off on running for a bit but when I do, hit the treadmill.
  • Start talking to the health insurance about doing an MRI.  This was just for the approval, not that I would actually do it.

I talked to Ross and was going to see him Tuesday morning and started the meds.  I made it into work around noon and went immediately into about 7 hours of meetings.  I got home, still in pain, and basically went to bed at 8:30pm.  The two days of bad shin splint pain and two months of dealing with all this crap had caught up to me.

Tuesday morning it was still very very uncomfortable.  I couldn't tell if it had gotten better.  I manage to shave the bottom third of my right leg to help the KT tape adhere.  Ross showed me how to put on the tape and gave me some stretches and a few strength things to do.

Meet my new sock for the next 3 weeks.

 Similar to my physician, he asked me what I wanted to do.  I didn't go to medical school!  I discussed the same plan with him as I did my physician and he liked it.  I wouldn't say I felt immediately better but there is always something comforting with a plan.

Another long day of meetings but when I got home, I could tell a difference.  It was good.  Wednesday morning (today), I was still sore but better.  Much better.  While I still had pain, it wasn't quite the same as what had been coming on over the previous weeks.  That could be the tape, or the stretching, or the meloxicam... or my new found medical profession.

I rode my bike tonight and did some hard intervals.  It wasn't irritated when I was pushing the 500 watts for 30 seconds or when I unclipped.  I'm hoping things feel even better tomorrow as I will plan to hit the treadmill for 4 or 5 miles tomorrow night.

I've never worked so hard to run a marathon and not refer to the training.

Sunday, March 8, 2015

Injury Update

When I left you last time I had just scheduled an appointment with a bone/joint specialist. That week I put up 23 miles, which included 12 miles at the gym (11 miles on the treadmill and 1 on the track) on Sunday.  I guess I wanted the hip nice and visible for the doc the next day.

Before I continue, I just want to remind you that I never really have a pain in my left hip.  I have discomfort like a dull ache if I sit or lay down for a long period of time.  I do not have an issue, standing, walking, or running; however, I do have a slight limp.  It causes my form to change slightly give me shin splint concerns on my right leg when I run.

On Monday I arrived at the medical center and they sent me directly to x-rays.  I had three photos of my man hips and off to wait for the hip doc.  He came in and did some odd tests (hold your arms over head, look left/right, do the Macarena).  I figured these were mostly to confirm that I'm willing to follow directions in the event he tells me to do something really stupid... like stop running.

He said I had a femoral acetabular impingement (FAI).  Basically the head of my femur has a bit of a bump on it and it can cause irritation to the tissue around it.  It's something that I grew up with.  Based off of the always-truthful-internet-medical websites, having an active lifestyle can cause it to cause pain much earlier in life or it might not be a problem at all.

According to the doc, the only permanent solution is surgery to remove the 'bump' but he didn't recommend it.  He asked me to convert to water running for the next 4 to 6 weeks, pick up more strength training, go to Physical Therapy, take prescribed steroids, daily Ibuprofen, and then check back in with him.

Uh....  Boston Marathon is "4 to 6 weeks".  I told him that and so he modified the 'script.  Go to PT, iburprofen, and water running for 2 to 3 weeks.  Then convert to track running.. blah.

So I left feeling lost.  Seriously lost.  How in the hell is water running going to truly prepare me for -Boston?  It's not.  How am I going to run 26.2 with very little pre-pounding on my legs?  Sure.  Track running will help but doing 80 laps on a track?  Probably not what he had in mind anyway.  I was pretty bummed.  I decided not to go into the office that afternoon and work from home.  My mind was having trouble focusing though.

I called the PT to setup an appointment and then talked to my coach.  I told him I still want to run Boston. I didn't quite gauge his response to that but we already know it's not going to be a PR.  In fact, it's going to be a PW (personal worst).  Frankly, I'm mostly fine with that; although, I'm sure I will fly home knowing I have unfinished business.

That night I went to Masters Swim class.  A fellow swimmer was a family physician and when I told him what I had, he said he had one too and dealt with it.  He said "FAI" is a popular diagnosis.  That didn't exactly make me feel any better but gave me the confidence I can manage it when I'm through with this bout.  In fact, my friend Jill had one but had it dealt with surgically while she had hip surgery for a torn labrum.

Luckily, my PT appointment was the next day (Tuesday) at 4:30pm.  I had high hopes. I also had a full slate of meetings that afternoon.  My last one for the day was a few blocks away, so I left a bit early so I could move my truck right next to the building in order to leave right after it was over.  When I got to the truck, the battery was dead.  Just my freaking luck.  I was not parked in a place conducive for jumping with all the other vehicles parked around.  I was stuck.  I didn't have any time to get a jump and make my appointment.  CRAP!  I didn't want to miss it and delay anything!

My knight-ess in shining armor saved me.  TKB was able to cut out of the office early and pick me up in plenty of time.  That actually worked out quite well to have her at the appointment too.

Once I got to meet the PT, Ross, he immediately did an assessment. My left leg was shorter than my right leg.  Finally, something made sense!!  Up to this point, it seemed like every medical professional I talked to was just following some script and pushed me off to the next person.

So my left leg was shorter, which was causing a slight limp. That translates to a shin splint on my right leg. Along with having something that made sense, he had me do this particular PT exercise.  It took 1 minute.  He did the assessment again and, viola, leg length normal.  So I had a muscle imbalance, not shorter bones, that needed to be corrected.

He asked me to continue doing this exercise every couple hours and come back on Thursday.  He also told me what I didn't want to hear: No running.  To put icing on the cake, no cycling either.  He didn't want anything that could jeopardize pinpointing the exact cause of the muscle imbalance. Fine.  Swimming was approved though. After two days of bad news and my truck giving me a slight heart attack early that day, I needed a win.  I needed something.  So TKB took me to Freddy's Frozen Custard and Steakburgers for dinner.  It was delicious and, yes, so worth it.

My next appointment was two days later, on Thursday.  I had to be honest with him.  My hip wasn't doing any better.  It was still sore when sitting and laying down.  To say it didn't feel as bad was difficult because it never hurts that bad.  In fact, he did the hip length assessment and my left leg had gotten even shorter!  WTF!  He had me do the weird exercise and, viola, normal.  Argh!

So he gave me some more exercises to do.  He has me foam roll for 20 minutes on my left quad and hamstring to loosen up the muscles and then a quad strengthening exercise.  All in all, it takes about 30 minutes.  Knowing that I have a $40 out of pocket expense for every session, he asked me to call him on Monday or Tuesday to see how things are progressing.  If things are doing better, he would green light some running.  I'm not sure if he told me that to motivate me through 20 minutes of foam rolling hell or what.  This also gives me a mental struggle to figure out how to objectively determine if I'm truly getting better.  That's so difficult when sometimes it's hard to tell if it is sore because I'm sitting down all freaking day or it truly isn't healed.

So it is Sunday night and I'm about to do my 30 minutes of fun.  Here's to hoping it helps kick this issue!