Thursday, March 29, 2012

Patience and Persistence – Dealing with Injury

Dealing with injury is very similar to running an ultra. To get through it you need to be both patient and persistent. The better you are at this, the more likely you are to heal (or finish) quicker. Since last fall I have been dealing with chronic pain in my lower abs and groin. I would try to train; feel good for a few days and then crash. It progressively got worse to the point that the pain would wake me up from sleep. As my luck would have it, it turns out that this area of the body is one of the hardest to diagnosis for injury. There are so many different muscles, ligaments, tendons, joints and bones all trafficking through the same area and anyone of them can produce similar pain and symptoms as another. After initially thinking it was a sports hernia, I had an MRI that revealed significant edema of the pubic symphysis - a condition known as Osteitis Pubis (I know, great name for an injury). It is a condition commonly seen in rugby/soccer players and occasionally long distance runners. My best guess for what caused it was when I injured by hip at UROC last fall; I did not let it fully heal and the large amount of running/racing I did afterward caused the shearing of the bone leading to the inflammation.

The MRI did not completely rule out a sports hernia as well, but it was likely that this was the cause of all the pain. The recovery time was listed as one month to up to 2 years! I was definitely going to focus on being closer to the one month side. As is my nature, I poured over every piece of information available on the subject from blog posts to advanced medical journal articles. Unfortunately, there is not a whole lot of definitive research on this condition. The best seems to be regarding Australian Football League players. The overwhelming consensus was complete rest, with the goal of getting the inflammation down. Once the inflammation is down, core exercises aimed at strengthening the hip/pelvis to help gap the imbalance between the strong leg muscles and the relatively weaker upper body/core muscles; then a graduated return to activity. Fortunately I have great doctors, who like me, are advocates of active recovery. So with that, I took a layoff from running for almost a month and took NSAIDs for 10 days. I did begrudgingly hop on the bike most days in order to maintain some fitness (I really don’t like to bike).

It may take awhile to get back into shape - and trim up the body hair:) 
The inflammation did go down and the referred pain began to subside. Finally, last Friday I went for an easy run pushing my son Gavin in the stroller. The next day I hit the trails for about 90 minutes and it felt good. I took the next day off as a precaution and have been able to run every day since. I have been supplementing this with plenty of core strength and stretching exercises. I occasionally feel a deep ache, but no real pain. The trick is to continue to progressively and consistently continue activity, while being patient – not doing too much, listening to the body and trying not to get frustrated. It takes a lot of mental strength - at times I was so fed up with the pain that I thought about just giving up running altogether. But just like that feeling of despair 60-70 miles into a 100, you have to put your head down, push through and know that eventually things will get better. It also helps to have a wife that knows when to support you and when to give you a kick in the assJ

I go to the doctor again tomorrow for a checkup; hopefully everything is progressing as well as I feel it is. I still have to build back slowly; taking it one day at a time. Hopefully, I will be back to full strength real soon - healthy and running again.

“Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment.” – The Buddha

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