Finding Strength

12 days post-PRP.  12 days of not being being able to bike or swim.  Those were my saving graces in the 13 weeks that I wasn't able to run.  I spent the first three days after my injection trying to be as immobile as possible.  According to my doctor and what I read online, those days are most critical for healing to occur.  It wasn't easy to be still but I knew it was important.  I used the time to rest, cuddle with the kitties, and finally get back to reading Born to Run, which I started reading about 4 years ago.  Now that I know a lot more about running, I'm finding it much more interesting and enjoyable than when I started reading it.

I knew I was healing and tried to remain positive; however, sitting around for 3 days with little movement started to mentally wear on me.  I started to panic.  If I was going this stir-crazy after only three days, what was I going to do for two weeks?  Sure I could use weights for my upper body but I was craving some heart-pumping cardio.  That's when I remembered the machine at the gym that is rarely used but would be perfect for me: the arm bike!

My spirits lifted when I thought of this!  It isn't the cardio I'm used to but it's something.  Since last Saturday, I've been at the gym every day, pedaling away for 30 minutes on the arm bike.  It's harder than it looks!  I get some cardio benefit while working my chest, shoulders, back, arms and core.  I increase the watts to make it more challenging and sometimes try one arm at a time for variety.  I found an article about arm bike benefits here.

I've also been working on strength training.  At home I use my dumbbells for biceps, triceps, and shoulders.  I have to be careful with core moves but can do crunches and Russian twists (feet on floor).  Yesterday I went to Mechanics at Detroit Tough and Coach Terra put me through a rigorous arm workout.  I did 4 circuits of biceps, triceps, chest, wall pushups, crunches, Russian twists, and shoulders (Y and T raises). My warm-up was 5 minutes of wall angels.  I'm feeling those today!

I know a lot of people get injured and can't run.  When that happens there are cross-training options - bike, swim, elliptical.  I never imagined I'd see the day when I couldn't do any of the above.  Instead of feeling sorry for myself (even though it was tempting to do so) I chose to embrace this opportunity to focus on strengthening my upper body.  

I may not get to run.  I may not get to bike or swim.  But I get to use to arm bike!  

Embrace your strength.  Focus on what you get to do.

Maya Kaimal Indian Simmer Sauces

I love to cook but I also like convenience.  To be perfectly honest, I don't have the time or inclination (mostly the latter) to make my own sauces.  If I can find a jarred sauce with a short list of pronounceable ingredients, I'm going to use it.  I discovered Maya Kaimal Indian Simmer Sauces at my local Westborn Market.  There are 6 flavors (4 are vegan, the other 2 contain milk).  Without question, Kashmiri Curry is my favorite.  I like to mix it up sometimes and get other flavors but when I do I sometimes get sad that I didn't just get the Kashmiri Curry.  

You can whip up the easiest comfort meal with one of these sauces.  I've already posted a recipe using for Easy Eggplant Curry, using a different brand of sauce.  You can use make that recipe with a Maya Kaimal sauce (or any simmer sauce you can find).  Lately I've just been throwing a bag of frozen cauliflower, a bag of frozen peas/carrots, and a can of chickpeas in a big skillet along with the jar of sauce and a tiny bit of water to rinse out the jar.  Bring it to a boil, then turn it down, cover, and simmer for about 10 minutes.  Done!  Serve over your favorite rice.  Mine is brown basmati.  

The Jalfrezi Curry is good but not as flavorful as the Kashmiri Curry.  I also had some leftover fresh green beans that I added to the mix.

Simple and delicious!

Post-PRP

I'm sitting here with a whole day stretching out ahead of me.  My plans include sitting or lying on the couch most of the day and moving slowly around when necessary.  The pain isn't too bad but I'm definitely uncomfortable.  Squatting, bending, sitting down, and getting in and out of the car is hard.  I'm not going upstairs until I go to bed.  Basically once I get into a position I'm okay but the actual getting there isn't easy.  

The PRP (platelet-rich plasma) procedure went very well.  First I had an ultrasound, performed by Dr. Bouffard, a DMC diagnostic radiologist.  This gave a more detailed picture of what is going on with my injury than the MRI did.  My injury is on the right side so the radiologist took images of my right IT band, piriformis, glute medius and minimus.  Although it's my hamstring that is actually injured, due to compensation I sometimes have pain in my hip and he was able to see thickening/inflammation in these other areas, as well.  

Next he moved onto the hamstrings.  For comparison, he took images of both the left (healthy) and right (injured) hams.  Dr. Bouffard kept marveling at what he saw, telling me I was "textbook!"  I'm guessing he must not see runners too often!  My left side looked great but on the right he saw a problem at the the tuberosity (insertion point where I have pain) and definite thickening of the tendon.  Even though I was confident I'd made the right choice before this, I was relieved to hear Dr. Bouffard tell me there was a reason for my pain and that PRP was the right choice for me.  

After the ultrasound I moved to another room where a nurse drew my blood.  It was a pretty big syringe/plunger she took.  I should have asked how much but it was a good amount.  Next she spun it in a centrifuge for 15 minutes to extract the platelet-rich plasma. which ended up being a relatively small vial.

When my doctor - Dr. Haque, DMC sports medicine - was ready, he and Dr. Bouffard came in with the ultrasound machine again.  They used that to guide the needle to the right spot before injecting the PRP.  The needle had to be directly on the bone - on the ischial tuberosity - but it kept slipping off.  Dr. Haque said due to the tendinosis my hamstring is thickened, which was making it difficult for the needle to get through to the bone.  It was a lot of poking and moving the needle around while Dr. Bouffard monitored it's placement and positioning with the ultrasound.  It took a while but I was grateful that the doctors took all the time needed to make sure it was in the exact right spot.  Once it was on the tuberosity, Dr. Haque injected the PRP and that was that.  

I should expect to be sore for a while.  I'm hoping in a few days I'll be a lot less sore.  I have a follow-up appointment with Dr. Haque on February 16th.  No lower body work until then.  As I said in my last post, that's going to be hard but I'm thinking about the big picture.  I was reminded of these words that you often see at construction sites and roll your eyes at, wondering what "short-term" really means.  

This time, I know that short-term means only 2 weeks and that the relief at the end is going to be oh so sweet.

Read previous injury posts here: 

Injury Update - Hope in Sight

Injury Update - 7.5 Weeks

Injury Update - Still a Pain in the Butt

Injury Update - On the Run Again!

Video Analysis - Taking a Closer Look at My Injury 

Injury Update: Hope in Sight

This hamstring injury of mine has been a long, drawn out process.  The onset of pain was May 2nd and it has never gone away.  I've had better days and worse but the pain has been there for 9 months.  Running, walking, sitting, bending over to put on my shoes.  It's become one of the constants in my life.  

Just as stressful as the pain have been the appointments to try and get a clear diagnosis and proper treatment. First was my family doctor who finally referred me out to an orthopedic.  I had video analysis done with a physical therapist to check for weakness and imbalances.  Then there were the three rounds of physical therapy.  I took three cortisone dose packs.  Other anti-inflammatories.  I tried massage, yoga, and acupuncture.

Somewhere in there I took a 2-week break from running.  I still trained for the Detroit Free Press Marathon, albeit on reduced mileage and speed.  And I ran that damn race, even though it about killed me to do so.  After that I really scaled back, running one last 5k a few weeks later for fun, until I stopped running altogether.  For 12 weeks.

The first day I didn't run I had a meltdown.  It felt like my world was crumbling around me and I burst into tears.  My whole body shook as I grieved the loss of what is so much more than exercise - it's my release, my joy, my freedom, my peace.  I didn't know how I would live without it for an indeterminate amount of time.

Getting through the first week was the hardest but it got easier.  It helped that I could bike.  I rode that damn stationary bike every day, challenging myself to up the resistance and ride more miles (whatever that even means on those things).  

I also started going to Detroit Tough, where Coach Terra helped me gain strength and balance in her Mechanics class.  Thanks to her I can do solid pistol squats, real sit-ups, and a seriously good bird dog.  More importantly, she helped me remember to look at the big picture and got me through the tough days when I missed running the most.  

Coach Terra also taught me to be BOLD.  I never learned to swim as a child so I took 5 lessons and practiced on my own every Sunday morning.  I moved from the kick board to a buoy and flotation belt to finally swimming full laps across the pool with only the aid of fins.  They help my hamstring in a huge way, giving me a stronger kick and allowing me to glide through the water more easily.  I can swim without them but not nearly as well.

After 9 months my orthopedic doctor finally ordered an MRI for me.  It showed small tears in my hamstring, which is consistent with an overuse injury - high hamstring tendinopathy or tendinosis.  Because it is not tendonitis (inflammation), traditional therapies haven't worked for me.  Instead of being a nice smooth tendon, mine is grisled and gnarly.  It isn't getting good blood flow to the area and healing time is very slow.  Because this is been going on for so long, I need to speed up the healing process.  

Tomorrow I am going to have a procedure done called Platelet-Rich Plasma (PRP). Basically, the doctor will take my own blood, spin it in a centrifuge, and extract the platelet-rich plasma.  That will then be injected into my hamstring using ultrasound imaging to ensure it goes into just the right spot.  

This is still not exactly a quick fix.  After the procedure I have to rest completely from any activity involving the hamstring (other than walking).  Shut it down.  I'll have a 2-week follow-up and if all looks good I should be able to slowly start up again.  There will be 6-week and 3-month follow-up appointments.  The whole healing process should be complete by the end of 3 months but I'll be able to run before that.  Yes you read that correctly!  Barring any unforeseen circumstances I'll be running again!

To be honest, 2 weeks without any cardio scares the crap out of me.  Although riding that bike day after day got old, it was something.  But when I look back, I never thought I'd make it 2 days without running, let alone 12 weeks and counting.  If I could do that, I can do this too.  It's all about the big picture, which is getting healthy so I can be back out there doing what I love most - running.   

Read previous injury posts here: 

Injury Update - 7.5 Weeks

Injury Update - Still a Pain in the Butt

Injury Update - On the Run Again!

Video Analysis - Taking a Closer Look at My Injury