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 

Lessons Learned: Marathon #2

Unfortunately, marathon recovery isn't going as quickly or as smoothly as I'd hoped. After the race my IT band and shins were really sore.  Initially I thought it was just due to running the faster pace for the longer distance, which I'm sure was the biggest part of it. Now that it's been 2 weeks since the race and I've had more time to reflect, I've realized a few other things probably came into play. 

I keep thinking back to the weeks and days leading up to the race, even race day itself, and all the little things I might have done differently.  Would have, could have, should have. Then I think of the things I did post-race that prolonged my injury.  I get frustrated that I didn't do things differently.  Would have, could have, should have.  I can't change any of that now so I can only move forward and learn from my mistakes.  

Lessons Learned

Pre-Race:

• Don't neglect strength training - For years I've consistently strength trained 2-3 days a week.  During the summer when I was increasing my mileage for Marquette I kept up with it, even if it was only 1-2 days a week.  Once the school year started and time was limited, something had to give and unfortunately strength training fell to the wayside. On cross training days (Monday) I opted for cycling to flush out lactic acid after long Sunday runs.  While this was important, so is strength training and come race day, I paid the price in my ITB.
• Foam roll and stretch during taper week - My muscles were definitely tighter than they should have been and thinking back, I probably only used the roller twice in the week before the race.  I didn't go to a yoga class or even do much yoga on my own.  
• Warm up before the race - Other than my running/jumping/pushing/ swearing to get to the start of the race (you can read about it in my race report), I didn't get in an actual warm-up run.  That means I started the race on a chilly morning at a 7:26/mile pace without being properly warmed up.  And then ran a marathon.  No wonder I felt ITB pain at mile 16!
• Be sure your shoes aren't worn down - I don't do well with tracking the mileage on my shoes because I have two pairs of Brooks Adrenalines that I alternate between.  In choosing which pair to wear on race day, I should have looked at the treads (rather than picking my favorite purple pair which I'd already run one marathon in).  I didn't even look at the treads until one week post-race at RUNdetroit when I showed them to Alia, one of the store owners.  The look on her face said it all.  Yes, another likely reason for ITB pain.  I left the store with a new pair of shoes tucked under my arm.  (NOTE: When I got home and looked at my green Brooks, the treads were just fine.  Well sh*t.)

Post-Race:

• Get a sports massage ASAP - I thought I was being smart by scheduling a deep-tissue massage a couple of days after the race.  I went to a spa that provides all types of services.  I told the massage therapist what to focus on and she did; however, I didn't feel she spent enough time on my problem areas.  A week later I went to a place that does ONLY massage and had a sports massage.  The massage therapist not only massaged but also stretched my legs and used organic oils specific for pain.  She spent an hour just on my legs!  It was the most painful massage of my life but I also felt about 90% better afterwards.  I will never have a massage at the spa again!
• Rest - By rest I mean not only rest from running but also SLEEP.  I didn't get enough sleep after the marathon and the cold that I had during the race turned into a terrible cough.  Maybe that would have happened anyway but more sleep wouldn't have hurt. 
• Listen to your body - I was hearing from a lot of people about when I should run again after the marathon.  Some people think you should wait two weeks.  Other people don't understand why you aren't ready to run in two days!  I took the first week off and thought I was ready to go back but then I jumped back in too far and too fast.  I was back at square one.  So on week two I took it much slower.  Yoga, stretching, easy cycle. That painful sports massage.  After Marquette I was ready after about 3 days without any problems.  Initially I felt this race recovery would be the same but with so many different factors, that wasn't possible.  Treat every race individually.  Don't compare.  

A wise man recently told me, "A good lumberjack only has one scar."  Don't be afraid to take a risk but don't be stupid and make the same mistake twice.  One injury is enough.  Heal properly before easing back in.  I've learned my lessons and now I will move on, a little smarter and more realistic than I was before.  

No more would haves, could haves, or should haves.  I'll run forward, perhaps a little more slowly at first.  One mile at a time.  In my sweet new shoes.

Have you been injured after a race?  Needed a longer recovery time than expected?  Share your story!

Sidelined - But Not Benched

I told you how I hurt my tailbone 2 weeks ago at Tough Mudder on the Slip 'N Slide.  (At least that's what I self-diagnosed the injury as.)  It didn't hurt to sit unless I leaned back on it but as long as I was careful, sitting was fine.  No, what mostly hurt was running or walking too fast.  It was the impact that really bothered me.  And taking big strides.  Ugh, it was killing me!  Not to be able to run, I mean.

Since I'm a runner, and slightly um, OCD if you will, that first week back I tried to ignore the pain and run on it anyway.  I went for short, slow runs but they were excruciatingly painful.  I tried taking Aleve and icing it but it made absolutely no difference.  By the end of the week I finally came to my senses and decided I would just have to give myself a break.  We were in Denver for the weekend so that was a good chance to rest.  No only was there no time but I was also not prepared to run in the high temps and altitude!  So, I rested.  Completely.  I didn't even use the hotel gym.  (It was not easy - trust me!)

I thought after a weekend of resting I would be ready to go so I tried running Monday morning.  Bad idea.  It was a very short run.  That was my last run for the week.  

But it was not my last workout.  That's where my gym membership comes in quite handy!  Most of my other workouts are non-impact so I was able to keep up with all of my cross-training.  I just increased my time in the gym a bit, which was okay since temps climbed into the upper 90's again this week and running outside didn't sound too pleasant anyway. 

These are the things that worked for my tailbone injury*:

• Indoor cycle (being careful getting in/out of the saddle)
• Stair Master
• Elliptical
• Yoga (standing poses were best)
• Weight machines (no inner/outer leg press)
• Boot Camp (avoiding running, squat jumps, high jacks, etc.)

Today I laced up my running shoes and decided to give it another go.  I've given my tailbone almost a week of rest so I thought why not?  Amazingly enough, it was not sore at all!  I ran 3.7 miles and felt great!  I wanted to run farther but also didn't want to push my luck.  I can do more tomorrow. 

Lesson learned?  When you are injured it isn't worth it to try and power through if it's only going to delay your recovery.  Or potentially make your injury worse.  Take the time you need to let your body rest and heal.  It might not be easy - TRUST ME - but in the end it's the best thing you can do.

But on the flip side, unless you need a total-body recovery, don't use an injury as an excuse to sit on your ass and do nothing!  Find exercises that you CAN do while your injured parts heal. 

*NOTE: Obviously, I do not have a degree in sports medicine and every injury is different so please consult your doctor and use your best judgement when deciding which exercises are best to engage in when you have an injury!

Have you been sidelined from an injury?  Were you still able to workout?