Sunday, August 10, 2014

Ultrarunning and High Hamstring Tendinopathy - Part Three

Another update on my progress thus far.  I had my injection last week after the MRI confirmed HHT and ischial bursitis.  I'm sad to report that the injection has had maybe only a minimal effect.  Perhaps my expectation were too high as I had hoped that all pain and discomfort would go away but it did not.  I still have a lot of discomfort when driving for any period of time and I can still kind of feel it nagging me back there.  I was hoping that after over six weeks of not running and after having the injection that I would move to the next phase of recovery.

For me the next phase begins when I no longer feel any pain or discomfort whatsoever.  So I will continue to rest and not do any type of activity (running, biking, elliptical, tennis etc) that could irritate and increase the inflammation in the area.

I've also continued and even increased my daily workouts.  Five times a week I spend about 30 minutes doing core workout (mostly sit ups), light weight lifting and also some physical therapy exercises to strengthen my hips and abductors and other areas that are thought to help more balance the workload required of the hamstring.  But these exercises will do nothing to heal the HHT, from what I understand, they just will help strength other areas so that when and if I get healed, it will reduce the likelihood of the injuring recurring.

I've wanted to begin concentric exercises and have done some lightly but am afraid to push those because my understanding is to not start those until you no longer feel any pain.

On days that I am busy, my conditioning workout is enough to take my mind off the running, biking and tennis but on the weekend when I have more time is when I'm really tempted to run or ride or play tennis.  But if I ever want to be competitive again, I know I must stick strictly to this regiment.

I've also communicated with a cousin of mine who is a doctor and is an expert in this area.  He teaches other doctors how to treat these conditions. He is going to look at my MRI and my history and then give me his opinion.  I am looking forward to that because it gives me hope that he may have a more concrete, solid and proactive approach for recovery.  I will update again after I hear from my cousin and as I've given more time to heal.

I'm almost to the eight week mark now which some say is all that is required to rest.  But I'm thinking the four month range is probably better.   After all, if you've waited two months, what's another two just to be sure.  Better that than to start running again ruin any gains you've already made.

One other thought that has me troubled is that damn RunRabbitRun 100.  I know that I should e-mail and postpone my entry until next year but I'm having trouble actually doing that.  I just don't want to admit defeat and a part of me wants to go to Steamboat Springs and try to finish that damn thing however foolish or foolhearty it may seem.

Tuesday, July 29, 2014

Blessing in Disguise

After two years of suffering from what I thought was Piriformis Syndrome, I finally got MRI results that positively confirm High Hamstring Tendinopathy.  The good news is that at last we know what is causing all of my problems and we can thus begin to treat it.  The bad news is that this treatment means at least four or more months off.  And by off, I mean not just running but no cross training (biking, swimming, tennis).

So gone were my plans to finish my Hardrock Qualifier at the Run Rabbit Run 100 in September.  Gone too were my big dreams of thru hiking the John Muir Trail this July or at least a big segment of the Colorado Trail.  I would not be able to do anything and for me, this is actually be torture.

But I so love the mountains that I thought I would go to the mountains anyway, just minus the intensive physical activity.  A relaxing trip might be nice for a change.  And since I wasn't going to be hiking 25 or 30 miles a day, maybe the kids would want to go.  As it turned out, only my son Jim was excited at the prospect of roughing it for nearly a week.

So what was originally a curse of not getting to do all the things I've wanted to do like hike the rest of the Colorado Trail, turned out to be a blessing in disguise.  My nine year old son Jim and I had the best time!  It was so much fun and so I thought I would include it in my blog.  The trip will also inspire many more such trips in the future!!

We left at 5 pm and drove for about 6 hours before sleeping at a rest stop near Amarillo.  The next morning we drove to Alberquerque where I surprised Jim with a trip in the world's longest Tram to the top of Sandia Peak.  It was great and Jim loved it.

After the tram ride, we had a picnic lunch on the way to Durango.  In Durango we picked up last minute supplies for camping including a new sleeping bag for Jim which he was really excited about.  On to Silverton where we found a nice primitive campsite along mineral creek.  That night we cooked out hot dogs and roasted marshmallows.  A more perfect campsite could not be found and the weather was nice and cold and we both slept soundly.

In the morning we had oatmeal, I had coffee while Jim had hot chocolate.  We packed our day packs and camelbaks and off we went for a hike on the Ice Lake Basin Trail.  I had thought that this would be a nice introductory hike for Jim but as it turned out, I was very wrong.  This was a much more difficult and arduous hike than I had expected.  Though only 8 miles round trip, it has a lot of elevation gain.

Jim did great with the first long climb to the meadow but after about two hours, he was getting fatiqued.  But this hike is deceptive because when you get to the meadow, you can see the basin that you hike to and it seems so close.  So we continued past my self designated 2 1/1 hour turn around point.  It ended up taking another hour and a half to get to the ice lake basin.  But we couldn't bring ourselves to come so far and not see the ice lake.  It was great.  We had lunch and I waded in the ice cold water.  Then we began the long descent back to camp.

It was tough going and the first part of the descent was slow going and tricky, but the further we got, the faster we made progress until at last we were back at the car after nearly 7 1/2 hours.  We were both exhausted and we spent almost two hours just laying in the tent recovering.

Jim started to get real quiet as we drove into town for dinner.  I started to become somewhat concerned.  So I just picked what seemed like a good place to eat in Silverton.  I was so proud of him for persevering on that hike that I told him he could order whatever he wanted.  He ordered a grown up burger and potato skins for appetizers.  He was still very quiet and fatigued until the potato skins arrived.  After only a few bites it quickly revived him and he was a new man.  I know exactly how it feels to be that exhausted and then have food that tastes so good help bring you back to life!

After dinner we found evidence of Bigfoot.  A huge footprint.  Jim has been fascinated by the show on television about Bigfoot and we are quite sure that we did at last find conclusive proof of Bigfoot's existence.  There was even a bumper sticker left at our camp the next morning -

So more marshmallows and another roaring campfire and a sound night's sleep in the mountain air.  The next morning we got up and we were suppose to head back to Durango that night.  While having breakfast I told Jim I didn't want to leave and how would he like to stay another day.  He was excited about that.  So together we decided it would be fun to drive to Ouray and tour a gold mine, soak in the Hot Springs as originally planned but then instead of going back to Silverton, we would drive on another 3 hours to Moab, Utah and tour Arches National Park.

The drive to Moab was great.  It was amazing to watch the scenery unfold from 14,000 peaks, to high plains scattered by huge canyons and then more peaks in the distance as we got closer to Utah.  After getting into Utah, Jim thought it looked a lot like Radiator Springs from the Cars movie.  I think that was spot on.

We found a great campsite along the Colorado River and at dinner at a really nice little place in Moab that had misters to cool off the outdoor seating area.  I think Jim picked the place because he thought the misters looked cool.  Then we rushed to Moab to try to watch the sun set on Delicate Arch.  The landscape was unlike anything I ever saw and pictures can never do it justice.

We didn't quite make it for the sunset on delicate arch but watched the sun set over the other part of the park.  As we were coming back toward campsite around 9 pm, the car thermometer read 105.  It was going to be a rough night of sleep unlike those cool mountain nights.

When we got back to camp it was sultry.  Then the wind picked up and blew bugs all around us.  We decided to just make the best of it and go to bed.  Sometime around 1:30 in the morning it seemed to cool off enough so that sleep was possible.  I'm sure camping in a tent at Moab would be great any other time than summer but in July, best to get a room with AC.

The next morning we were packed up and out of there and ready to tour Arches more thoroughly.  We hiked for a couple of hours through Devil's Garden and the highlight of that is the landscape arch which is just huge.  Then you can boulder on up higher and Jim and I both enjoyed the scramble.  There were also lots of rock tunnels filled with sand to run around in and that was a lot of fun.

But we had to drive five hours to Durango so we went back into Moab where the car got a very needed oil change and then we drove to Durango stopping at Ouray for ice cream.

In Durango, we allowed ourselves the luxury of a cheap motel room and a hot shower and air conditioned room with real beds.  We slept soundly and in the morning our grand finale for this great adventure was a Colorado River Rafting trip.

The lower Animas river was at a low level and so the whitewater wasn't as big as may I had hoped but it was certainly enough to impress Jim.

Done at 12:30, we got back into the car and began the long drive home.  Jim and I talked and laughed the whole way home and talked about the great fun we had on our adventure and planned future adventures as well.

I think the sisters will definitely want to come with us after having heard about all that we did.  And the trip definitely made up for not being able to backpack or run because of the hamstring injury.

Monday, July 28, 2014

Ultrarunning and High Hamstring Tendinopathy - Part Two

So I hope to keep people updated on how my rehabilitation is going and as a way for me to track my own progress and to keep motivated.

I thought I would probably update this blog at least monthly and maybe bi-weekly.

The last entry described how I had finally got a proper diagnosis of high hamstring tendinopathy after years of thinking I had piriformis/sciatic issues.  The HHT had become so severe in the last 18 months that I could no longer race effectively and struggled to complete marathons or ultra marathons.  I had several DNF's and could no longer run even close to what my times were in the past.  I would start on pace and then quickly the pain would reduce me to a shuffle.

I tried to run through the pain as I had done other little injuries and thought this too would go away as all the other aches and pains had gone away.  That in hindsight was a big mistake.  I should have stopped running at least a year ago and by continuing to run that will make recovery much more difficult.

So now it has been almost one month since I have last ran.  Unfortunately I have not noticed much improvement in my condition.  The first week off from running coincidentally was also the time that my family and I were at DisneyWorld and so I would hardly count walking that much as a week off.  On the way to DisneyWorld I was going to run an 8 mile trail race in Alabama and I had to abandon that idea because after 12 hours of driving, I was in a lot pain. This is how I made the decision to stop running altogether and seek a second MRI.  It was really a struggle to get around at DisneyWorld which says a lot about the extent of my injury when an ultramarathoner is struggling just to walk around to the different attractions.  The humidity seems to make things worse.

Also during the last month I had a second MRI done.  This MRI was for the pelvic region.  Doctor Goodman was so kind as to call me personally to inform the indeed I had HHT and he also saw something called ischial bursitis.  Dr. Goodman has been great as you may have read in the last post.  He recommends an injection and 4 months of complete rest.  With the one month already off, that means five months altogether.

The nature of this injury means that anything that could irritate the HHT could interfere with the healing and so that means cross training is out as well.  No running, biking, tennis, swimming or elliptical.  I hope to continue to do core workouts and limited weight training.  Most importantly, I will work on physical therapy that will strengthen some areas that will keep the HHT from recurring.  My plan is then to take off August thru November and then December I will slowly reintroduce elliptical and running very low mileage while paying very close attention to how my body responds.

I think almost equally important is to avoid long periods of sitting as this seems to aggravate things as well.  Having driven 18 hours to Orlando and then a recent 20 hour trip to Colorado in Utah for summer vacation trips, I now think that it will be at least Thanksgiving or even Christmas before I have another long road trip again.

Hopefully I can make a complete comeback but I'm sure I will never again run the mileage I used to run.

If I can get back to where I run 50 to 60 miles a week, I'm confident that that will be enough to be competitive again without stressing the HHT with 80 to 100 mile weeks.

At least that is the plan for now.  It's very early in this recovery process but I am very optimistic and hopeful to return to competition in 2015.  My most important goal is to run a mountain 100 mile race so that I can get a qualifier for Hardrock with hopes of running Hardrock in 2016.  Those dates seem so far away now but it will come soon enough.