Friday, March 24, 2017

Visit to Boston Doc

As I mentioned in my last post, I really haven't been having much luck in getting any better and I just can't stop thinking that there has to be something else I can do.  I just don't feel like I have a clear path to getting better and that is very frustrating.   So, now I am a couple of weeks into rest and strength training and still no real changes.  It just doesn't seem right that it should still hurt as much as it does.  So I decided to get another opinion, maybe someone in Boston would have some different insight.  So, I did some research and ended up finding this guy -  He is a sports medicine doctor at Brigham and Women's Orthopedic Center and has a focus on runners so it seemed like it might be a good fit.  I was able to get an appointment quickly which was a bonus so I decided to give him a try.

The appointment was very detailed.  He was attentive and interested in listening to what I had to say but in the end I feel like he came to the same conclusion as everyone else.  There is nothing really structurally wrong, it is all just muscular weakness and poor functional movement patterns that need to be corrected.  Basically, he said I need to improve my lumbopelvic control, core strength, lower extremity kinetic chain, and foot strength.  I'm not even sure what all that is but it sounds like pretty much everything. He did provide a very detailed note summary of the visit which I was impressed with considering most places just say something like hip pain and knee pain in the notes.

So what did he recommend that I do?  He suggested I start with this Cycling Medicine Center  -  This starts with a bike fit which I have already had quite a few of.   I doubt they will really find anything major as I think I have had pretty good work done on that.  But then they work with you to develop a treatment plan to target and address your issues.  My biggest concern is that they are located in Wellesley and I don't know how I will be able to fit going there into my work schedule.  I have already taken off a ton of time to deal with this so I am trying to be really careful about this at work.  So, I am going to go for the initial evaluation and bike fit and see what they have to say and then figure out if I can make it work.

The other recommendation was to go to the Spaulding National Running Center - where they would do similar stuff but targeted at my running form.  Again, I have already had a running gait analysis done but supposedly this place offers a super high tech one and then a 16 week (or maybe it was 16 session?) plan to address and fix your weaknesses.  The problem is they have a 4 month wait list!! So that means I won't get an appointment until maybe August and then have to start the 16 weeks/sessions (which again would be in Cambridge so that location won't be any more convenient).  So now, I'm thinking well there goes my whole year!  I did ask him if that meant I wouldn't be able to run again for 4 at least months.  He said we can follow-up after I start working with the cycling PT to review and discuss when I could start running again.   And that I should achieve initial pain-free walking and cycling before he'd recommend it.  That sounds like it is going to be a while.  :(  I also didn't really discuss how he felt about other activities like swimming or aqua jogging.  So at this point I'm still not sure what my plan is for those. I guess I'll discuss it with him at the follow up.

So for now I have an evaluation with the cycling center on 4/5 and we will see where that goes.  If anyone has any experience with either of these two places feel free to leave me a comment.

Wednesday, March 15, 2017

Another Break :(

In 2015, I was at the peak of my fitness journey that had started the prior year.  I had completed many non triathlon races, including my first marathon, and I think I felt a little bit invincible and that "anything is possible".  But last year, it felt like a lot of that came crashing down as the aches and pains just kept piling on.  Maybe I tried to take on too much and then I was just too stubborn to acknowledge that and back down and now it is taking longer than I ever would have examined to recover. 

After my last race in August, my coach and I decided that I needed to take at least 1-2 months completely off. I was okay with this because I knew that my body needed the time off and figured if I put in the time then, I would be good to go in 2 mths max.  I took 6 weeks off and did nothing and I mean nothing except for maybe a few walks at lunchtime.  I went to a sports medicine doctor and had MRI done on my hip and it only showed some tendonisis in my glutes.  He said it just needed time and I could keep training as long as the pain was tolerable.  After the 6 weeks, I slowly started to add back in a few things – I took an 8 week strength classes designed for runners and I started swimming again. But still nothing was really any different and I really couldn’t run or bike yet. 

So, I went to a chiropractor/PT to get a second opinion. He worked with me for a couple of weeks and everything felt very tight to him and nothing was getting better with any of his soft tissue work and he didn’t think it felt right.  So he sent me to a different sports medicine doctor for another look.  They looked at my x-rays and MRI and thought maybe I had some impingement in my hip so they gave me a cortisone shot in the joint to see if that would provide any relief but it didn’t so the conclusion was that the problem is not in the hip joint itself.  They sent me back to PT to try to work on it when I was not training for anything.  I had been going to PT for basically all of last year -  I think they thought I was going to move in.   But since I was still training all of the time, it was just keeping me going rather than making any actual recovery progress.  I also had them look at my knee which had been bothering me all along as well.  So after more PT, shots, x-rays, and MRIs (another one was done on my knee and back to look for referred nerve pain for my hip- nothing there either) the bottom line was some mild arthritis in my knee and still just must be tight muscles causing the hip pain and no real progress.

So, while things have gotten better since August, I still can’t train in a meaningful way.  While, I have made some good progress on my swimming, I can't focus too much time on that either as it will hurt my shoulder (and that's how this whole thing got started in the first place).  I can’t run or bike for any decent period of time or with any speed or power.  So, I agreed with my coach again to take another 2 months off (March/April) and focus on rest and recovery.  I will continue to work on stretching and start some additional strength training to go back to the basics and try to rebuild.  But that’s it - no swimming, biking or running.  It is really hard for me to take this much time off again.   I'm an active person and have a really hard time doing nothing.  Last time, I think I was more mentally prepared to take the break.  The season was winding down and I knew that there would be plenty of time for next season.  But now, it is different.   It is the next season now and I am slowly crossing off events from my plan that I wanted to do.  I find myself just hoping I will be able to do anything this year.

So where does that leave me now? I have started to work with a strength trainer and I am certainly a little skeptical that it will produce results that are any different than what I have been doing already.  We are working on stretching the tight muscles and strengthening the opposing weak muscles.  But it seems like a lot of been there, done that already to me.  So, I'm going to give this a few weeks and see how it goes.  In the mean time, I need to find some other things to do that aren't particularly active to help me pass the time.  Anyway, one thing that seems to becoming clear, is that in order to move forward, I might need to take a few steps backwards.