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.

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