April 14, 2017

One massive, complex & confusing jigsaw puzzle

Firstly, please ignore if you are looking for a post with scenic trail pics or race reports.  I appreciate the injury updates can be pretty boring stuff for most folks out there but it's a month since my last update so I figured it was time to update again on my progress ... or lack thereof ...

When I last updated I was in the middle of a series of prolotherapy injections to try stabilise my lax sacroiliac (SI joint).  This involved a weekly visit to the doctor for six consecutive weeks to have 60 injections at a time into my SI and lower back area.  Luckily I got local anaesthetic injections each time too so it felt like not much more than an intense session of IMS, and Dr. Gillies - an older British woman - regaled me with stories of cycling in Thailand to distract me.  Many folks react quite strongly to the injections and have limited mobility for a few days, but I found I didn't react too badly and was fairly mobile after each session - but that doesn't indicate that the injections (which are dextrose and tighten ligaments) aren't working and in fact they did.  After six weeks Dr. Gillies was very pleased that my SI was much more stable, though I will be going back for a booster session in a few weeks time to increase chances that it stays that way.

Throughout the course of prolotherapy I was not allowed to do anything that might make the SI shift so that basically meant to activity - no running, no gym work, no hiking, no biking, no swimming.  I knew I was getting desperate when I asked if I was allowed to do yoga or not - I'm not sure if I was relieved or not when I was told that that was not allowed either.  I was allowed to walk for 2 x 15 minutes day, oh well - at least I could go grocery shopping then!  After six weeks of zero activity and much over eating and youtube video watching (I don't have a TV) I was allowed to try a 30 min jog.  Man oh man, I can't tell you how terrible that felt.  I'm super out of shape right now (but that's the least of my concerns) but everything just hurt - I was tight, tense and my legs were sore to touch.  I knew that a lot of this was because I was simply deconditioned to running (or really any movement) and even after a few days of 30 minute shuffles I began to feel a little more human again - my shoulders and back had loosened up and with thanks to the foam roller my legs were beginning to feel a little less like concrete blocks.  I wouldn't exactly call it progress but I was getting back to not feeling much worse than before the prolotherapy so that was a positive.

My doctor has been checking my SI most weeks since the completion of the six weeks of prolotherapy and so far it is (almost) as good as it was right after prolotherapy, despite a slight increase in activity.  So far I have been allowed to try some easy hiking, easy cycling and easy runs, all wearing an SI belt as an insurance policy to hold the SI in place.  There's nothing better than wearing a tight band around your hips when you already feel pretty chunky ;)  But the basic problem remains that my left leg just doesn't work like my right leg does.  This is pretty darn frustrating as I was hoping either the prolo or the six weeks of total rest would really help (and I wasn't too fussy which would help, so long as one did).  Don't get me wrong, having a stable SI is pretty much essential for an ultra runner, but getting that tightened up has not really resolved the underlying issues of my original injury at all.  The original pain in my groin of a year ago is not there (for now) but my adductor is constantly overworked, my left glute refuses to do any work and since around Christmas time my hamstrings have been shouting and so far have not piped down much.  Of course with being injured for this long it becomes pretty obvious that it's unlikely fixing one thing will solve the puzzle or that the puzzle will be solved overnight - there are many components at play and it's trying to get them all lined up at the same time that is proving the tricky part.

For now I am running a small amount every other day.  I really have to emphasize that it is a little - so far 8km/ 5 miles is a long run for me and I don't plan going over that sort of distance any time soon.  It's not pain free but it's tolerable and it's keeping me sane - some folks might under estimate that but if a short jog is only slightly uncomfy but keeps my overall body feeling ok and gives me 30 minutes of enjoyment then I feel that is important.  For now, SI stability permitting, I'm easing in some other activities to try just maintain my minimal fitness and to get outside, these privileges will be revoked by my doctor at anytime she feels my SI is getting worse.  I've been a little scared off strength work for now (a gym incident in January truly showed that my body was fragile) but I'd like to get back at that when I can as I know I have lost pretty much any strength I had, but that's what six weeks of lying on the sofa on the back of 10 months of curtailed activity does to you.

I'll be seeing, yet another, physio next week to check out a new angle and I'm waiting to get an MRI (which could be a few months) just to double check the hip area again (I had one back in July but worth re-checking and this should be a contrast MRI which can show more detail).  I made two goals at the start of the year - 1, that by December I hope to have run a 10k race (I don't care how slow but at a proper race effort) and 2, that by December I would also run a local trail route that's about 15kms (Headwaters to Norvan Falls for any locals reading).  Now we're in mid-April  I'm not sure if these are realstic goals but there's still a few months to start making progress.

At this stage I am truly grateful for both my sponsors and the medical folks who have helped me along the way.  I am also super proud and grateful to my coaching clients - I currently have about 35 clients all over the world training for anything from a half marathon to a 200 mile race, I absolutely love my coaching work and it's always a pleasure to help guide folks to achieve their dreams and personal goals.  Whilst my own personal running goals might be on hold for now, I'll never tire of talking about running and helping others to weave their running ambitions around family commitments, busy jobs and sometimes far from ideal training grounds.

Special thanks go to:

Salomon Running
CLIF bar
Drymax Socks
Sundog Eyewear
Flora Health


Dr. Jim Bovard (he says he's getting stubborn, I'm glad because I sometimes feel like giving up).
Dr. Jean Gillies (prolo treatment)
Bobby Crudo RMT (especially for saving me at 4pm on a Friday when my SI gave out in the gym that morning).
Chris Napier, Marylou Lamy, Carolyn Bliss (physios)
Joe Uhan (physio and gait analysis)

 Happy trails,

I helped iRunFar with race coverage at Chuckanut 50k.  It was a fast and furious race to watch!

Hiking in the rain.

25% off sunnies til end of April!

It's not really been great cycling weather but hoping for more sun for more skinny tyre miles.

Fun times hanging out with CLIF bar in Whistler.

Trail conditions in North Van, April 10th.