The Results Are In....

And it's not pretty. I actually got the results over the phone late last week and have been mourning processing ever since. I have a "superior lateral and posterior acetabular labral tear", which is a fancy medical way of saying that the labrum (the thing that goes around your hip socket that keeps your thigh or femur in place) is torn. But that's not all! Oh no, there is more fun to be had here. I also have "significant tendinopathy at the hamstring attachment"....which is fairly self explanatory. The tendons attach your hamstring to your pelvis, and when they get angry and inflamed, it's called tendonitis or tendiopathy (essentially the same thing)....

So first emotion here was relief. As I mentioned before, I have some experience with joint injuries, specifically, significant joint injuries that don't show up on scans. So I was relieved that whatever is causing me pain was evident on the MRI. I've heard of people having hamstring tendon issues that don't and know exactly what that frustration feels like and I didn't want to go through that again. Second emotion was a lot of sadness. For several weeks now, I've been mentally preparing myself for the inevitability that I wouldn't be doing the Portland Marathon next month or my Ragnar Ultra Relay in Las Vegas in November. But that doesn't stop me from being really really sad whenever I remember all over again.

Treatment and how long recovery will last largely depend on how much healing I can promote in the tendon with total rest. The labral tear will heal on it's own provided there is no further stress on it, surgery isn't warranted as it's not a big enough tear and there doesn't seem to be any cartilage that is just hanging out there that might prevent healing. Once the pain and symptoms aren't present when at rest any longer, I can start PT, working on strengthening and stabilizing the hip so that it can withstand the load bearing and the shock of running.

As for the hamstring tendinopathy, that is a bit trickier. These particular tendons don't get a lot of blood flow, which is essential in healing. And once it's been a few months, you start to wander into chronic territory, which isn't good at all. Unfortunately, there was nothing visible in the MRI that tells whether there has been any healing so far.....since this injury is 3 months old now, that isn't really that helpful. I had hoped to gain an understanding on whether the damage looked new or older...in other words, have I been making it worse? Or was it just really bad and it taking a long time to heal? I suspect the former....even though I cut way back in July, continuing to train really hampered the initial healing that should have been happening at that point. And the off and on rest since I started PT also didn't help much.

Right now, I am at 3 full weeks of rest and counting. At least 4 more weeks of it and then at that point, if I am asymptomatic when resting, then I can start PT again. Once I start PT, massage, strength training exercises and perhaps some utlrasound might help. As for drug treatment, the best thing for me right now is anti-inflammatory meds....I've been taking some twice a day for a couple weeks now and it seems to help. I did ask about steroid shots, as that came up some in my research, but he thinks that a cortizone/steroid shot might hurt more than it would help....After starting PT, and working through the tight hamstring and tendons (which are part and parcel to the injury), I can try to gradually ease my way back into running, under the guidance of my PT. Really, the one helpful thing he did say was that once I get back into PT, there will be soreness and pain and that finding the right balance of moving through that and pulling back when necessary is going to be key....

I officially told my Ragnar team that we need to find a replacement for me today. And I'm really sad about it....so to make myself feel better, I'm already recruiting them to form a team for Ragnar SoCal for next April. I think that will help with the injury blues - and give me something to look forward to!

Make Yourself Monday

A much needed quality right now....

Well that was fun....

Yeah. Not really. Really glad I decided to head home after the MRI today, instead of going back to work and trying to sit in a chair for the rest of the day. My hip hurts and feels weirder than I thought it would. I am still sort of confused as to what this whole thing is called- Dr.'s orders called it an arthogram - but essentially, they injected some iodine and MRI contrast fluid into my hip joint using an X-ray as a guide. And then did an MRI.

The appointment started off in utter confusion and ended with a bang- literally. I went to the front desk at the hospital (where the radiology department for the group of physicians I see is located) exactly where they told me to check in. She says 'oh no, you just go straight down to the MRI waiting room and check in there'. So I walk all the way down this super long hall, down a floor and that lady tells me that I am having the arthogram somewhere else and she can't check me in here....not sure where I should go, let me call someone, etc etc. Whoever she calls tells her to send me all the way to the other wing of the hospital and up to the 6th floor. Which is totally suspect - when I get all the way over there, it's imaging alright but cardiovascular...clearly not where I am supposed to be. I went in anyway and the lady was very nice in finding out where I was supposed to go; which incidentally, was main patient registration...where I started.

So we started off with a bang. I finally got to the right place and checked in but of course we were 30 minutes behind because I spent my planned 'registration' time traipsing all over the stupid place. I had to change into gowns and they had me lay on a table where there was a big X-ray thing hovering over it. They took a bunch of pictures and then the radiology guy that was injecting me came in. He was super nice and very chatty and made an uncomfortable procedure go by quickly. The needle was larger than a shot needle but not super huge. He had to inject the fluid into the joint just so, so he used the X-ray machine to guide the needle. I didn't watch this. I was numbed up so I didn't feel anything more than a pinchy pressure.

Once that was done, they had me get in a wheelchair and took me off to the MRI area. So I was asked a few times if I was claustrophobic but no one asked if I loud clanking and rumbling noises for an entire 40 minutes would make me crazy. Seriously. I feel like I was prepared for every aspect of that but the god awful racket. For reals. It was crazy and I am really glad I didn't have a headache! My sister has had one and the place she went to was fancier apparently, b/c they gave her headphones with music to listen to during and I just got disposable earplugs. Heh.

So that was it. The hip felt super stiff and weird for the first couple hours and then it started hurting. A lot. I've been icing off and on since I got home and that is helping a bit. I'll probably be pretty sore tomorrow as well. And now I wait. It takes them 24-48 hours to send the images back to my Dr. but he's out on Friday, so the soonest I can see him is first thing Monday morning. Holding out hope that it'll come Thursday some time and I can pop over and see him, since his office is right across the street from my office. Terribly convenient, I know.

Am not entirely sure what to expect. My running buddy Jess has also been battling a hip injury since Ragnar and had her MRI last week. Results today - she has a labral tear...which is the cartilage around her hip socket. On cruches for a couple weeks but her Dr. says he's ok with her walking PDX...the idea of walking 26 miles with no training is also scary but it would be better to do it with someone. So depending on the results of my MRI and what my Dr. thinks is actually going on here...I am hoping to walk it too...at least start and get as far as I can, right? With the goal of both of us being able to run Ragnar....fingers crossed.

Make Yourself Monday

Trying very hard...I feel a bit destructable at the moment....

I'm Alive - I Swear

Just sinking into a spiraling circle of depression and just an overall blah feeling. I really miss running. A lot. It's been weeks now. I had my x-ray on the 7th. It didn't show any obvious signs of a stress fracture so an MRI was next. Took almost a week to get word back from my insurance company on preauthorization, but I finally heard back today and was able to schedule an appointment. He ordered an arthogram contrast MRI so I have to show up for a hip injection of some sort of dye and sit for an hour, while I guess it spreads out through the hip or something. Once the hour is up, they do the actual MRI. Hopefully they'll be able to tell exactly what is wrong right away. It will be very discouraging to have nothing show up. I've had that happen before.

I worked for Starbucks all through my 20's. In 2004, I tore the cartilage in my right wrist. Nothing showed up on x-rays or the MRI and I was misdiagnosed and treated for tendonitis for 16 months. 10 months of physical therapy and lots of different drugs and treatments, all to no avail. I finally wised up and switched doctors about a year in and after a bit, they became convinced I'd torn the cartilage on the outside of my wrist. They did surgery and sure enough, torn right off practically. Long recovery - probably the most painful and difficult time I've ever had physically.

That experience most definitely colors my perception on this whole hip-pain-not-going-away-thing. I have missed running and can't wait to get back to it. But who knows when that will be. My Dr. says no full marathon in Portland next month for sure...and most likely no ultra Ragnar either. I am extremely heartbroken about that. That whole waiting, not sure what is going on thing, has made me very bitchy and sad. I really want to run....

The start of school has kept me busy for sure. My beautiful baby girl has started high school and she's growing up. First Friday night of the school year found me staying up on the couch waiting for her to get home from the Girls Vollyball game she went to watch with her friends. God I remember those days...going to the game on Friday nights...football, basketball...lots of fun memories. The first of many nights like that over the next four years to be sure.

Promise I'll keep checking in, even though I don't have any running news to report. Sad face. To keep you entertained, like it's keeping me, check out this Tumblr....Suri's Burn Book. "A study in Suri and the people who disappoint he". It's a hilarious gal who lives in DC, works in policy by day, and blogs as her alter-ego, Suri Cruise at night. It's mainly snarky commentary on celebrity children's sartorial choices and I can't get enough of it. It's funny as schmidt. Go there. Immediately. You're welcome.

Make Yourself Monday - on Tuesday!

Yep....and patient.

August: In Which I Start PT and Feel Sorry for Myself

I can hear that 'timberrrr....' sound effect 

from cartoons in my head looking at these stats.

I began the month super excited about switching my focus to full marathon training. I revamped my plan and was getting mentally prepared. I was still running on fairly normal schedule, but was still in a lot of pain. I was also in a great deal of denial.....

I sort of limped through the first week of August; even got in an 11 miler. I celebrated my 1 year Runniversary in style - researching my insurance requirements for PT coverage and finding a good one near my work.

I found a great PT and started seeing her twice a week. I've had 7 visits so far and it was clear after the first that my pelvis wasn't aligned. She's been doing correction techniques at every visit and we've been working on strength - exercises to make the hips, glutes and hamstrings stronger so that it keeps the pelvis in place. I've gone on a few 'runs' to test out how it makes me feel - and see if there is pain. They've been walk/runs - 3 mins alternating and the running has most definitely shifted the pelvis back each time. Walking is ok - things stay in place pretty well and there is minimal pain.

It was a good thing the Olympics were on so I could distract myself from all that non-running and making no progress on my training schedule. At this point, I am still operating under the assumption that I will be doing PDX. Which freaks me out b/c it's going to be painful and I'll likely end up walking a good portion of it. 

The last few weeks have been tough. I am beating myself up on account of not being able to train, I feel like crap - some days I'm in a lot of pain; some days I feel much better. I feel like there are three steps forward followed by two steps back. I am discouraged and bummed that this isn't healing as quickly as I'd have liked.

My last appointment with my PT, she said it's time to bring in my Dr. -- she wants to rule out a pelvic stress fracture so I've got an appointment set up this week. We'll see what comes of it. So I've definitely felt sorry for myself this month. I miss running and it's hard seeing people out there and hearing about friends runs and races. Trying to keep myself busy and distracted. Easy to do right now...we are spending the long weekend getting ready for school to start. My little baby girl is going to be a freshman. And then turn 15 next month. I am so not ready for this! But we are heading into my very favorite season of all....Fall is perfect. It's pretty, the return of boots and sweaters is my absolute favorite, and it's my favorite weather to run in. Hope I can start doing that again soon!

Time to See the Dr.

I saw my super awesome PT yesterday and reported that not only did I not get in the run I was supposed to do, I was in more pain. Sitting at work is getting to be really painful and makes each day feel like it's so very very long. But anyway....she said I should have started to feel better by now and that even though clinically, this is really presenting as a stubborn hamstring issue, we'd better rule out a stress fracture of the pelvis just to be on the safe side.

Which is good...because I had planned to ask her when she thought I should bring my Dr. into this. This stupid hip just feels too pinchy and sore. So I was able to get an apt with one of the other Docs in the clinic since mine is on vacation next week and we'll start with an X-ray. According to Dr. Internet, you can't always see a stress fracture on a x-ray....most of the time it takes an MRI. But since it happened several weeks ago, there is a chance that if there was a stress fracture, there would be some calcification visible.

No running until after the appointment. I'll see my PT the day after so we'll talk then and figure out what our next steps are. More waiting....hummpfff. Good thing there is a ton of political theater going on right now to keep me distracted! RNC over, DNC up next -- which I suspect will not be as entertaining. Unless Mr. Eastwood shows up in NC! Heh.