Friday, December 12, 2014

Ultrarunning and High Hamstring Tendinopathy - Part V - PRP Baby!

After finally exhausting all other options, today I finally went ahead and got a bilateral plasma rich platelet (prp) injection at the ischial bursitis insertional point of the proximal hamstring tendinopathy.  Say that five times fast.  It took me four months to memorize that diagnosis.

A little update on my progress since my last blog.  I have returned to running two to three times a week.  The really good news is that my gait and stride have returned to normal after nearly five months of relative rest (I still played tennis and had one or two runs per week of 3 or 4 miles and they were very slow).  The fact that my gait has returned to normal and my right foot has stopped flaying out I take to be a good sign that the rest is helping albeit very slowly.

In the past two weeks leading up to the injection today things really improved.  I had two runs of about five miles each where I felt only a little discomfort and during the first run I through in a seven minute mile and then during the second run a couple of days later, I was able to somewhat comfortably run a 6:35 mile.  That is the first time that I have been able to do that in 8 months!

Then yesterday I went for a six mile run hoping to maybe even throw in a 5k speed work.  If I could successfully do that, then I was going to forego the PRP.  But as it would turn out, I really struggled.  It was humid that day and humidity definitely seems to make my condition worse.  The good thing about that run was it sealed the deal for me as I knew I needed the PRP because quite frankly I could tell that this was nothing near normal in spite of a few good miles.

As for the injection.  I had read a few blogs and reports that the injections were painful.  Not so, it was surprisingly easy with just a few needle injections.  Actually four for me.  Two to get blood out, and two to put blood in.  Dr. Stanley did mention that the needle is not long enough because the company doesn't make a 2 1/2 inch needle and that makes it more difficult to get to the place that the prp needs to go.  I asked what effect that might have and now that I think about it, didn't really get an answer.  As I understand it, the prp will still be where it needs to be in the tendon and the ischial tuberosity or at least that's what I hope.

One caveat for other sufferers who are going to get PRP, a few hours after the injection, you will become very sore.  I have trouble just bending over and picking things up because I am so sore.  This is suppose to only last for a couple of days.

So now the wait begins.  Dr. Stanley ordered four weeks of no running and I will certainly oblige because prp ain't cheap and I do not want to do it again.  After that, I am hoping to start trying it out and hopefully it will be even more improved than it was right before the injection.

At times I have hope that I will be 100% again and can be a competitive marathon and ultra runner again.  But sometimes I feel that the reality might be that I am limited to slow running and hiking in which case, 50 miles would probably be the furthest distance I would be capable of.  Only time will tell. I will certainly continue to up date my blog.  I will let you know how the first run post prp goes one month from now.

But with my gait and stride returning to normal and continued and steady improvement, I may yet be running as I used to.

As always, if you are a fellow runner and sufferer of HHT, share your experiences.  Together we may be able to beat this thing.

Saturday, October 11, 2014

Ultrarunning and High Hamstring Tendinopathy - Part IV

Hard to believe that it has been 3 1/2 months since I've last run.  Truth be told, I have done gone for 4 four or five mile runs in the last two or three weeks.  I've also started playing tennis again for the last month or so.  My healing has been very slow with many ups and downs but I think I can say that I am getting better.  Each of the runs I went on was a little better than the last one but I am still only going once or twice a week.

In addition to the HHT, I also had achilles tendonitis that was really bad and that is almost healed now.  I also had tennis elbow and that is mostly better but all three of these injuries are very stubborn to heal.

The big one of course is the HHT.  I just absolutely cannot compete in ultras again until that is healed.  The four mile runs that I have been on are a struggle and there is a lot of discomfort and I definitely cannot go fast.  Only something close to 10 minute miles and if I try to pick up the pace, the discomfort returns which I am trying to avoid so that I can heal.

My goal is to get well enough so that I can eventually run four to five times a week with no pain and then work toward being able to do a speed workout on the track and then a 5K.  If I can get to where I can run a 5K again at maximum effort, then I know I will be ready for ultras again.

On the bright side, I have learned quite a few things over the last three plus months.  (1)Running is not THAT important, it's not everything.  (2)I will never again run every day, I can take days off and still maintain my fitness.  I do not need 70 to 100 mile weeks every week of the year.  If I can ever get healed again, I'm thinking 50 mile weeks max will be just fine.  In this way I can hopefully avoid the HHT from coming back.  (3)I also really love running and really miss it.  I must get back to it because it brings so much joy.

For those that are searching as I was and still am - for some type of magic cure for HHT - here is my experience thus far.  Nothing works.  That's about the sum of it.  The injections did nothing for me.  Rest seemed to actually make it worse.  The first run I went on a couple of weeks ago, my legs were very stiff.  It felt like the tendons had not been stretch and I think that is why a few runs every so often will actually help rather than hurt.

My next step is to go back to Dr Chris Barnes in Tulsa.  He really helped me 2 - 3 years ago and I was able to complete Leadville after seeing him.  But I think the HHT was just beginning back then.  This is much, much worse.  Back then I could still run and compete and now I cannot.  So Dr. Barnes will probably be doing some ART and dry needling as he did last time.  I know it will have to be better than the injections because unfortunately, they did not seem to help.  The one good part of spending all of that money is that the MRI gave a confirmed diagnosis that what I have is indeed HHT and ischial tuberosity (inflammation?).  So I can continue to focus efforts on those areas.

My goal is to just continue to heal in 2014 with an eye on the summer of 2015 for some big advenutres.  Some of the things I'm considering are:  Jemez 50 Miler, San Juan Solstice 50 or Bighorn 100, Alpine to Slickrock in Moab 50, a 50 mile race in the swiss alps, and then I'm signed up to do Run Rabbit Run 100 in September because I had to postpone my entry due to injury this year.  So those are my dreams if only I can get rid of this problem.

For those struggling with the same trouble, feel free to post and best of luck to you!

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.