Saturday, December 12, 2015

Injury Update: Rollercoaster Autumn

The last two months have been quite a rollercoaster.  To give you an idea, I have attempted to start multiple blog posts but just couldn't finish them.  The two that remained in drafts were titled:
  • Latest on Crap Year - Started on September 21, 2015
  • 2015 Ends In Surgery - Started on November 11, 2015


So let's go back a few months to July.  I had just finished IM Muncie 70.3 Swim/Bike with my buddy Erik doing the run.  I then spent the next 5 weeks focusing on physical therapy exercises to see if I can get the hip pain to go away again.  That's what happened back in March and two weeks later I ended up with a Stress Fracture.  So back to the weight room and easy on the running (like 3 to 4 miles a couple times a week).

At this time I put my coaching on hold.  I didn't want to waste Coach Ken's time and I might need to put that money in reserves for anything up coming (like specialists co-pays which are much more than my general physician).

In August I finally talked to my Physical Therapist as the strength exercises weren't helping.  Well, they were but if I stopped for 3 or 4 days, the pain was back.

September I met with my Hip doc who sent me for my second MRI of the year but this time of the hip.  This MRI required getting a dye injection in the hip socket and 50 minutes almost fully in the bore of an MRI machine.  Results indicated a slightly labrum tear.  Ugh.  Next stop is a steroid injection in the hip.

October was waiting to see how well the steroid injection helped.  It did help quite a bit.  I was riding and slowly bringing my running up throughout the month.  After 3.5 weeks my hip pain started coming back.  I went out for a 5 mile run and the shin started to give me pings of pain.  So I stopped after one mile and walked home. The shin, while not painful, did give me discomfort throughout the past few months.  I met with the hip doctor and we scheduled surgery for December 10, 2015.

Quite a rollercoaster, eh?  Not quite.  We haven't even left the starting gate for the ride!  Ugh, why didn’t I hit the chicken exit.

At the end of the meeting with my Orthopedist I asked him a simple question.  While I had planned for a speech noteworthy of an award, it basically turned into this:  I love marathons.  I love triathlons.  I want to get back at them.  Will this surgery put me in a place where my hip and shin no longer hurt.

We’ve started to ascend the first hill.  “clack clack clack”. 

His answer wasn’t very comforting. Basically, I could have had this labrum tear for years and it’s just now bothering me.  

We are cresting the hill!

Then he slipped in this gem: My hip and shin pains are completely unrelated.

We have crashed down the first hill and into the first loop!

UGH!!!  So basically if this tear has been here for a while, I’ve been able to compete without causing any shin pain or stress fracture.  SO WHAT’S CAUSING THE SHIN PAIN!!

This is why I had trouble writing and finishing blog posts.  This one question needed to be answered.  

Back in February, Coach Ken had recommended I see a Sports Medicine doctor when my pains first started.  He does a form analysis session and might find some issues there that could be corrected.  I never did; however, I kept his name in the back of my mind.

I ended up scheduling an appointment with him and sent him all my medical records and MRIs (right shin and left hip) for the past year.  We had a good discussion and he spent quite a bit of time checking out some mechanics and really working over the hip.  

He said one thing to me that made me feel better: Your hip and shin pains aren’t related.  While this wasn’t a second opinion appointment, it kind of was.  So fine, it’s not related.  He then said that I shouldn’t get the surgery.  I should focus on what’s causing the shin pain first.  All the range tests he gave me didn’t hurt.  He said that the test results were so “boring” that it isn’t something to be concerned about yet.

He recommended getting another steroid shot and seeing if that helps again.  The thought being that the first one helped for 3.5 weeks so maybe it just needs a “booster”.  I agreed and he administered it in the office.  If the pain comes back, then consider surgery.  He then was going to refer me to a specialist regarding the shin pain.  

Hitting an inverted loop!

So I left that appointment not feeling too confident.  I am now in a race to Dec 10.  If pain comes back, go for the surgery?  If the pain doesn’t come back, hopefully the shin pain will be resolved and I’m back.

TKB said I should go ahead and talk with my hip doc.  I wanted to spend a few days trying to figure things out to decide my plan.  While going for a four mile treadmill run, I came to the conclusion to cancel the surgery.  The shin is the ONLY thing keeping me from being active.  The hip has never been an issue.  I’ve always been able to swim, bike, and run with the hip.  My shin keeps me from running more than 5 miles. That was just further validated by what my hip doc and the sports med doc said.

Meanwhile the hip pain did come back after a few days.

So I finally scheduled an appointment with my hip doc (1 week before surgery!).  I was nervous.  I basically got a second opinion without giving him much of a heads up.  When he came in, I told him what I did and told him I’d like to figure out the shin pain.  His first words were, “That’s good because surgery is going to make your shin worse”.  

We’re slowing down to re-enter the start gate.

Oddly, that statement made me feel so good.  I was going to be on crutches for 4 weeks, putting more weight and stress on the shin.  

He wanted to do another MRI on the shin to see if maybe there is some more healing to do or if it indicates another issue.  Then we can look into things like chronic compartment syndrome or some other vascular problem.  

For the first time I left my hip doctors office feeling amazing.  I wasn’t scared of the surgery.  I just didn’t want to spend the time recovery, money from insurance, or my doctors time on something he (nor the sports med doc) thought was necessary.  

So instead of surgery on December 10, I had an MRI done.  Now I’m waiting for Tuesday to get the results and go from there!


PS-
So I did have this blog post titled "Injury Update: Rollercoaster Fall".  Probably would have given people a false impression of what this was about.