Monthly Archives: September 2012

Healing to Healed to Heeling

And then JUST LIKE THAT…something started working. I don’t know if it was the alignment work I am doing, the strengthening, the rest or a combination of all three, but SOMETHING has turned around inside my leg and I’ve noticed significant progress in healing. The deep-seated pain is minimal and sporadic. The tightness continues to melt away with each passing day. My gait is not hindered by a limp and strains and stresses are not aggravating. Just. Like. That.

I suppose since the injury came on so suddenly that it should leave in the same manner. Unfortunately, the window of time created during this setback has swallowed the fitness I had built to that point and the PR I was hoping to run at the marathon this November is now no more. The time needed to both ramp up fitness and then scale back for the race is too short for success and so I’ll just have to cheer on my teammates and look towards the Spring, or a winter destination race. 🙂

You know what though, I’m just happy to be on the verge of running again. Measured success, goal races and a climactic endpoint to so much training is all part of the fun, but ultimately, in it’s most purest form, the success and the joy are embodied by the actual effort itself. No one can sustain the amount of mileage and strain we put our bodies through if not for a seemingly absent reward in the act itself. We love running and so we do it. When it hurts, we do it. When we can’t breathe, we do it. When it’s cold, dark, hot, windy, freezing, raining, etc., we do it. All that effort may get us to race day, but come what may in that relatively short span of time it takes to complete the course, all the work up until that point is what we look back upon as the true value, the true reward.

So I can’t wait it out, because in the meantime I’ll be running. Again, finally. And believe me, at this point in my life, I need it more than ever. (subtly alluded to back story not included)

Digression to Hope

I wanted to post about how great it feels to get assessed by a sports-specific physical therapist (Science!), how I diligently followed his plan and, seemingly miraculously, started running just four days later like he said I would. But that obviously isn’t the case. Let me catch you up.

After my last post about going to an acupuncturist in a state of desperation and, expectedly, coming up completely short, I then made a more rational decision to visit one of the best (the best?) sports massage therapists in Indy, Terry Fletcher. He’s basically twisted the muscles of every podium runner in the city at this point and whether he was going to be able to alleviate the debilitating pain in my leg or not, I knew he was at least going to rely on a physical manipulation to aid my situation instead of just hoping for some “energies” to align themselves or something. Ok…I’m being overly bitter. Anyways, he did his twisting and digging, as if trying to bring me to tears (not THIS time, Terry!), helped loosen up some tightened muscles in my leg, but ultimately the deep-seated (nerve?) pain kept itself wholly intact. That’s ok, I wasn’t expecting massage to FIX me, just help with the overall pain and tightness that probably wasn’t helping anything.

After meeting with Terry, I called in my personal Obi Wan Kenobe, Darrell Barnes of St. Vincent’s Sports Performance center. Darrell was Bob Kennedy’s, American 5000 meter record holder for 13 years, personal physical therapist while he was embarrassing Kenyans the world over. He now works on athletes at the collegiate and professional level here in Indy, while also giving his time to any ol schmo (like me) who needs his extensive knowledge of the athletic body and its subsequent flaws. The first time I had an injury I couldn’t cure through rest and massage, Darrell stepped in and turned everything around in 2 weeks. So it follows that I couldn’t wait to meet with him again and get assessed.

First, here’s the crazy thing. Here in Indy lies the St. Vincent’s Sports Performance center, where the first time I was there I was sitting in the lobby with the most talked about college basketball player of the time. The next time I was there the best players in the NCAA were being prepped for the frickin’ draft. Professional athletes have their signed photos on the wall because they come there frequently for all the services offered. And again, I’m just some nobody local runner who gets to throw down $99 and get the expertise usually reserved for the elite of the elites, people who are PAID HANDSOMELY to play games. And guess what, Darrell recognized me in the lobby, greeted me, and when working on me was able to ask me about various happenings in my life that I didn’t even think he would know. Barnes is one of the most genuinely knowledgable, nice and engaged professionals I’ve ever had the privilege to work with…or be worked on by. Ok…on to the assessment.

I gave him a quick summary of my situation, where the pain resided and what I was doing leading up to that. He pretty much already had the answer in his head before I had finished giving him the rundown, but to be sure he had to do some range of movement tests before proceeding. He had me lay on the table to do some basic strength tests with my legs, had me turn over on my back and felt either side of my pubic bone, stood at the end of the table and checked my leg length, then had me sit up to tell me what was going on. I apparently have a misaligned pelvis where my left side is “jammed up” and my right side has taken all the brunt of the imbalance, therefore locking up in the hamstring, hip adductors and ultimately compressing a nerve around my buttock, lower back and upper hamstring. He could tell this, in part, because my left leg was noticeably shorter than my right. With a little manipulation and a couple abrupt jerks he brought my legs back to the same length. It sounds a little absurd, but sometimes, he explained, you just have to yank on the body to get it back to where it should be.

For the next 45 minutes he then began to work on loosening up the area around my hip which was completely locked in place in contrast to the movement I had in my left hip area. He displayed this by pushing my left hip adductor around freely and then pushing on my right, which caused the rest of my body to move at the same time. Jammed and locked indeed. With an extensive routine of stretching and “over-aligning” he continued to manipulate my right leg into submission, though I honestly had no idea if this was actually doing anything for the pain that rested deep in my body and would radiate all over. Then came the moment of truth. He asked me to stand up and walk around the area to see where the pain was resting and where else we needed to attack. I got up and took a few tentative steps and then a few more confident steps and then held back the urge to sprint across the room. Nothing. Absolutely NOTHING. Not a bit of tightness, pain or discomfort…at all. I couldn’t believe it.

I held back my excitement and simply stated, “It’s gone. I seriously can’t feel a thing.”

Beyond that, I now realized just how “locked up” my hip was leading up to that point. My gait was solid and free, where before I had favored it so much that I was leaning to one side and walking awkwardly. Now I remembered what it felt like to move normally. There wasn’t much more to do at that point. Of course, one session of manipulation isn’t the end of it…as much as I wished it would be.

He assured me the pain would return later in the day, but that the routines he was going to give me would help readjust my pelvic imbalances in order to take the pressure off the nerve and muscles that were causing me so many problems. That was all great, but honestly, I had a pressing question in the back of my head.

“When do you think I’ll be ok to run again?”

When I asked, I was afraid to hear him signal the end of my Fall marathon hopes with a casual, “Oh in about 2 or 3 weeks you should be good to go.” Instead, he told me I should be good to go for a short, light run, “THIS WEEKEND.” I couldn’t believe it…and maybe I shouldn’t have. We then went through a number of adjustment techniques I was going to need to do once or twice a day in order to get everything back in alignment for pain-free running. Even while running I was instructed I would only have to do them for a week or two and then never have to do them again as long as the pain dissipated. I was dumbfounded at the immediacy of the relief and short healing period and walked out of the office with an incredibly large sense of relief and excitement. All of a sudden I was a running bomb with a week long fuse that was going to explode when it reached the end of its trail. I. Couldn’t. Wait.

As advised, the leg/nerve pain did return that evening as I started the alignment routines Darrell gave me. No worries. I diligently stuck to the plan as advised and did notice that the pain in my leg no longer shot up to my lower back, causing me to bend over to one side throughout the day. This was progress. Each day I continued on with the routine, but in the back of my head a concern continued to grow that the healing was moving along as I hoped. 3 days until the weekend. Then 2. Then 1.

Finally, Friday evening I couldn’t take it and decided to go for that short run after work to see if everything had worked out and the death grip had let loose of my leg. I put on my shorts and shoes, which felt like pulling my skin back on alone and started to take a slow and deliberate stride up the sidewalk, feeling a tightness in my hamstring that I hoped would back off. I made it two blocks, turned the corner and headed back the other way growing increasingly concerned as the pain wasn’t just NOT gone, but not getting any better during the run. I completed the loop back to my house, kicked my shoes off and put my normal close on as I hadn’t even broken a sweat. By this time the pain had spread throughout my leg, into my hip and up into my lower back. Failure. The Fall marathon is off.

I’ll tell you though, just 2 blocks into the run and a feeling came into me that I didn’t expect…that deep and genuine emotion that THIS IS ME. Running just makes me who I am and I feel simple and honest when I’m in the act. I don’t know, it’s hard to explain, but for that short while it felt so great. Of course, now I’m left wanting as I struggle to figure out what is going wrong and why the assessment and plan of action didn’t work as had hoped.

There is, of course, so much more to talk about in relation to my mental state, but the gist of the update is that my “last resort” didn’t work out how I had hoped and now i’m figuring out where to go from here. Right now I’m continuing on with the alignment techniques, the strengthening my coach gave me and waiting one more week before taking another plan of action and going back to Darrell Barnes for another follow up assessment with this new information, or lack thereof.

I’ll spare anymore details of my current emotional state in relation to this as you might have already fallen asleep just reading this self-absorbed rambling, but next time I hope to offer something more applicable to the process of physical obstacles, obsession and the overcoming of both. Till then, enjoy your ability to get out there and run…just maybe spare me some of the details. 🙂

Where The Pain Lies

Sometimes the pain isn’t where the injury is physically located. Often it lies deeper in the confusion, the waiting, the not-knowing, the trying everything and nothing working. Sometimes the pain is in everything else that surrounds the healing, leaving you grasping for anything to simply get you running again. That is where I am right now.

For some reason, being “injured” always happens when I feel at the top of my game and this time it is no different. I could emotionally handle this better if I wasn’t in the middle of training, if I wasn’t on an upwards trajectory towards a specific goal and, most painfully, wasn’t feeling as powerful as I am (was) at this point. During my training I’ve only hit this point a few times and the encouragement is indescribable. It’s like I’m on the edge of a serious breakthrough. It’s that point every runner imagines, hopes for and works toward. All the miles, all the strain, all the struggle, is to push us past a certain plateau of performance, to bust through that glass ceiling. I’ve only been at that point a few times, so I know when I’m there. My runs feel smoother, more effortless, stronger. I start hitting sub-5 minute miles in the middle of a strong workout and have more in me to push on. I feel, in a word, powerful. I know I’m about to start running workouts that will put me in a place i’ve never been before and the excitement I hold within me can barely be contained.

There’s just one problem.

I get injured. Now, I know the pattern seems obvious and it’s like I’ve hit a ceiling that is more concrete than glass, but I don’t believe that is the case. I’ve broken through before and the way these injuries come on leads me to believe it’s just crappy luck and I can break through again. This time it was just..well….lame.

I went south to do some back to back trail runs in our State Park, my second home. Those trails are as much a part of me as the muscles in my legs, so I had no concerns going into the weekend. Saturday was my long run, so I gauged a solid 2 hours and 30 minutes of running to get in the prescribed 20 miles, however, I started around 1:00 in the afternoon and in the 90 degree heat. I ended up wobbling off the trail and taking the road back to camp, severely dehydrated and fighting that unmistakeable feeling of nausea. No big deal though. Nothing a whole bunch of liquids and food couldn’t take care of.

That night I went to bed…in the car. We had only packed one tent (on accident) and I let Michelle and Noah take it, unwilling to add to the psuedo-sauna a tent can become in that sort of humidity. Plus, I do ok sleeping in a car. For some reason, though, this time I didn’t. I couldn’t stretch out my legs and get comfortable. I couldn’t roll over. I couldn’t find that sweet spot. I would have slept in the back of our cavernous compact, but it was filled with camping equipment containers, so I relegated myself to the front seat, straddling my legs around the steering wheel, compressing my toes against the windshield, fighting off mosquitos creeping in through the cracked windows and generally sleeping and waking and falling back asleep all night. I woke the next morning to my alarm siren calling me awake, alerting me to the hour and a half run I scheduled for myself. Besides feeling groggy and not all that rested, I didn’t feel that bad. I was sore, but I also beat the crap out of myself the day prior to the point of dehydration. I expected to be tight and sore. In hindsight, however, I had forgotten about something that happened the night before. I was awoken by a pointed and distinct sensation somewhere near my right buttock, sharp enough to wake me from my weak slumber. I assumed I was just angled in the seat wrong, rolled back to the other side and went back to sleep. I remember wincing from the pain though, which probably isn’t a good sign.

Still, I got up, went through my normal warmup routines and hit the trails, completing a more reserved and solid hour and a half run. No big deal…until I stopped. Suddenly, I felt a sensation in my hip, hamstring and back I hadn’t felt before. It was pointed, but I was still able to do a number of activities with Noah, like skateboarding around the parking lot, albeit with a bit of pain and restriction in my leg. Then we drove home and when I got out of the car I was suddenly having to hold my upper glute and press into my leg in order to alleviate the pain and carry our stuff into the house. This probably wasn’t good.

The next morning I woke at 5am, stood up to get ready to run, took one turn and laid back down to get some sleep. My hip had a SHARP pain shoot through it when I put weight on that foot. Obviously, I needed some rest from the weekend and that’s all I expected it would take to get me going again. Silly me. I took the day off, headed to practice Tuesday evening, ran about 100 yards in the parking lot and called Michelle to come pick me up. It still wasn’t happening. This wasn’t good. I called off work the next day, then called coach, and went into the Athletic Annex to get a better assessment of how to deal with this, hoping Matt would give me a basic “do this strength exercise and stretch like this” routine, but after explaining what went down I could tell this might be something different. Straight to the point, he suggested going to an acupuncturist, which I gathered wasn’t a definitive solution he was offering me, but more a hopeful shot in the dark. He followed up with a “some people get miracles from it, others don’t”. I, being the adamant skeptical I am, cringed on the inside.

“Seriously?,” I thought. “An acupuncturist? That’s quackery.”

I believe he sensed my skepticism and followed up, “Hey, if anything it’s a nice nap.”

I wasn’t convinced. I waited a day, and another, and another, hoping I would start to see development with rest and stretching. I didn’t. 4 days went by. Then 5. Then a week. The depression and grave concern that often accompanies injury started to set in and desperation took over. I could see my efforts slipping away. I could almost HEAR the fitness leaving my body. My goal race loomed over me like a mocking, laughing monster. “You will never be strong enough to defeat me!”

I made an appointment with an acupuncturist.

Granted, I found a community acupuncturist that works on a sliding scale, so whatever benefit, or lack thereof, wouldn’t be a huge financial risk for me. Now, I just hope my HSA will cover it. I emailed my coach and let him know my plans, admitting that “my adamant skepticism will always take a backseat to my running obsession.” Right now, I’d probably let snake handlers pray over my leg if it got me running again. Ahhh…the roots of religion. I digress.

Of course, after making the appointment, I started thinking more deeply about acupunture, alternative medicines, my skepticism, why these practices “work” despite evidence to the contrary and how I can help make this happen for my own benefit. I put up a post about my appointment and corresponding skepticism on facebook, only to get a flood of expected responses that shifted from the “miracle!” to “bullshit!”. Some were curious about my coming experience with getting needle stuck in my body….and this is what I hope to address from this point.

I woke up the morning of my appointment hopeful about my leg. I had performed a lot of extensive stretching the night prior and it was feeling surprisingly better. Maybe the placebo effect was already working! Just BELIEVE you are better, or are on the path to healing, and your body responds. This was just the morning though and things always worsened through the day as I used my leg more. Makes sense. I hopped on my bike (not a good idea?) and rode the 5 miles to my appointment, in a mist that nearly soaked me clean through. I had on my running shorts beneath my regular shorts, envisioning this appointment being a one-on-one scenario, having to lay face down on a massage table as needles were placed into my affected leg at various points. I quickly learned this was not THAT experience.

I walked into the small, brightly lit waiting room to be greeted by the receptionist who was speaking so softly that I had to guess what she was requesting from me. Being the more energetic person I am, I responded with enthusiasm, but as she continued near whispering I realized I was totally breaking the “atmosphere” of the place and needed to tone it down. Oh, this is one of THOSE places, where the EXPERIENCE is as important as the treatment. I got it and instantly “turned it down”. When it was my turn to get worked on I was pointed towards a door. I walked through, again expecting a one-on-one appointment, so was a little taken back when I entered a room with six huge lazy boy chairs covered in soft blankets and a few other patients relaxing or asleep in them, needles sticking out of various points of their bodies. My skepticism rose exponentially, but hoped another part of the whole “experience” might do me some good.

I sat in one of the big chairs, raised the foot rest and settled in for an hour’s long “good nap” as coach said. The acupuncturist slid over to me and began explaining the process, at a volume that had me lip-reading more than listening. Honestly, I didn’t care too much what she was explaining. I just wanted her to put the needles in me and get things going, to figure out if this was going to have any effect or not. Mind you, I’m not trying to be calloused here, just practical. Among the things I did hear her say, she correctly ascertained I am dealing with Sciatica/Piriformus Syndrome. She also stated I’ll need to come in 2 to 3 times a week for a couple weeks in order to get back to a good place. This, confirmed my skepticism about this procedure. Let me explain.

I walked into this knowing that the stresses of running, coupled MAYBE with a night of terrible sleep after dehydration, might have triggered this injury. Every other doctor, sports scientist or physical therapist would probably look at me with a “Duh” expression on their face and tell me the same thing, “Running got you into this, so NOT running will get you out.” And probably they would be right. Runners, however, have an absurd ability to tune that sort of advice out. We only hear things about strengthening, stretching, and miracle cures to allow us to continue running through injury. This is why we are runners and not doctors. So yes, when the acupuncturist told me that it might take TWO TO THREE weeks for acupuncture to resolve this issue, I thought, “Right, I SHOULD start experiencing relief in two to three weeks”, but I SERIOUSLY doubt it would be from acupuncture. There is no verifiable evidence to prove this. If I ate vegan oatmeal cookies every day for 2 to 3 weeks and the symptoms of this piriformus syndrome started to dissipate, could I concretely say that eating vegan oatmeal cookies cures piriformus syndrome? (Eating oatmeal cookies, by the way, IS what I have been been doing and I’m going to continue relying on this cure until I’m fixed!). If I’m not running for 2 to 3 weeks, whatever I’m doing in the interim may have some positive effect (though unverifiable), but the greatest healing results would be from NOT RUNNING FOR 2 TO 3 WEEKS. That, seems obvious. I, however, was still sitting in the lazy boy about to get some needles stuck in my body and was willing to engage in anything at that point to get the most of the experience (and my money). So I laid back and let her do her thing.

She put some needles in my right foot. She put some in my left ankle. She put the rest in my left hand and wrist, of which a couple of them hurt! Then she walked away. I had the next 40 minutes to an hour to sit there and let acupuncture do whatever acupuncture does. I wasn’t contented to just do THAT though. I still believe there is the potential for both a placebo effect and mind-body connection healing process that I was willing to play with and with an hour to kill, I wanted to try it. First off, I wanted to let the experience of laying in a very squishy lazy boy chair, in a room with lights dimmed and calming music playing lull me into complete muscular relaxation. I wanted to believe that my Sciatica was being pinched by over-tightened muscles and if I could just let things relax, maybe they would let go of their death-grip. There was just one problem, I had drank about 3 cups of coffee before hopping on my bike and riding downtown. This doesn’t lend for a relaxing experience. My mind was going and I really wanted to have an excitable conversation more than just chill out with the sound of a heartbeat moving throughout the room. So instead I resorted to tactic number 2, “envisioning” or “imaging” or whatever it’s called. Basically, this is getting a made up picture in your head of the pain or ailment physically leaving your body. Some people swear this is how they cured their breast cancer, but I wouldn’t rely on it if I were you. Still, I was a captive audience and thought I’d give it a go, so for a little bit I sat there imagining the pain and tension leaving through the needles poking out of my legs and hands. I did that for a bit, but became distracted when I was finally able to succomb to the forced relaxation in the room, noticing a general heaviness in my body and letting the lazy boy take me to another place.

I entered that spot where you are partly asleep and partly not asleep, wavering in a dangerous dream place where the visuals in your head can be played out in reality if you’re not careful. I humorously wondered how many people were jolted out of a psuedo-dream state only to jab all the needles deep into their bodies, causing great pain and TRUE injury. Fortunately, I remained conscious enough not to let this happen, but instead hoped that state of relaxation was doing something for my leg. I also wondered how this played into people’s perceptions of acupuncture healing their ailments. For those in a situation like myself, healing doesn’t happen in just an hour. I don’t have a sore back. I don’t have tired muscles. I have a deep strain, a pinching, an inflammation. Healing something like this will take a period of fluxuation between stretching, strengthening and rest, not just a short period of relaxation. For others though, I suspect a solid period of forced relaxation, where their ONLY job is to just sit there, can have an immediate effect that lends to the idea that acupuncture instantly heals. I know I’m CONSTANTLY on the go. If I’m not cleaning, fixing, sitting uncomfortably while designing, riding, running, etc., I’m working on healing my leg through stretching, strengthening, etc., and so I was hoping that a complete forced rest where I couldn’t move AT ALL might do me some good. I wonder how many other people, when forced to just sit there, finally allow their bodies to fix themselves, possibly attributing that to acupuncture. I don’t know…this is just what I was thinking about.

At some point, I figured my time was up and was curious to see if SOMETHING, ANYTHING had made a dent in my issue, even if just temporarily. I would have been excited with temporarily. The acupuncturist came over, removed the needles from my body and, unexpectedly, started dabbing at blood that was dripping from one of the insertion points. I didn’t expect bleeding, even though it didn’t hurt, but that seems pretty obvious. She then offered the option of purchasing an herbal remedy that would “help get the blood flowing” and reiterated that I should keep coming back 2 to 3 times a week for the next couple of weeks. Now, I should mention that I don’t think she was saying this in a manner of upselling or being financially predatory. I truly believe she was offering me a normal timeframe of healing, which I addressed above, and something to facilitate the process. My problem, however, is not restricted blood flow. And how could we even guess the blood flow would somehow reach my affected area. And what made her think my blood wasn’t flowing properly anyways…wasn’t it just dripping out of my leg? I kid…mostly.

I quietly grabbed my belongings, slowly stood up from the chair and walked into the waiting room where I wrote a check (Come on HSA, help a brotha out!), rejected the herbal tincture, and said I would make another appointment online. At this point I had not walked far enough to tell if there was a difference, even temporarily, in how my leg felt. But when I walked out the door, across the street and to where my bike was parked, I felt… difference. I felt the same pointed, almost grinding pain in my hip abductor, the same sharp sensation in my lower glute and the same dull ache in my lower back. Admittedly, despite my skepticism, I was bummed. I really thought even an hour of NO moving would give me a temporary relief, at least a quick emotional boost if nothing else. This was unfortunately not the case.

Now, acupuncture supporters can quickly retort, “But you must give it time to work. You must let the process work by going back again and again.” Yes, that’s convenient, and I get where it comes from, but I have no doubt in my mind that any benefit I get from waiting comes not from having needles stuck in my body, but from simply waiting, from NOT RUNNING. Ugh, just saying it hurts my soul. The last time I had an injury, it was fixed by a combination of muscle imbalance strengthening and NOT RUNNING. This time, I believe it will be no different. And believe me, I WISH the experience of acupuncture could have done something for me, whatever it was, whether that be a placebo effect, forced relaxation or something else entirely. I WANTED something to work, but I’m left with the same theories I had going in, that the unverifiable evidence of acupuncture-based healing is unverifiable for a reason…it’s not there. I’m not saying others can’t gain value from it. I urge anyone that feels a sense of healing, whether physical or emotional, to keep going. Do what you have to do to feel better, if it means the converse is emotional or physical pain, then yeah, do that.

Personally, I need to move on now. I don’t believe my coach felt this was a sure thing by any means, but he also knows what happens to the mental and emotional state when we can’t run, and part of his job is to keep us hopeful, so administering the placebo effect needs to be part of his coaching tactics. I need to now focus on something more concrete, something verifiable to bring me back to a state of strength. I’m not entirely sure what that is at this point, but I’m going back to relying on the rest/strength routine that dug me out of my hole the first time. I don’t want to admit it, but this might also involve “rolling yoga” (getting on the bike trainer in my basement) to maintain some sense of fitness while this injury heals itself. I know without a doubt that I can measure the effects of spinning my legs over and over, just as I can measure the effects and benefits of hard, strenuous running workouts. This is verifiable and this is what I need to rely on now.

Admittedly, I hate that my perception was confirmed through this first experience. I hate it because I’m hungry  and I can’t satiate that hunger through waiting. I’m hungry because just 1 week ago I was at the top of my game, ready to crash through that glass ceiling and for the first time in my running career feel what it was like to run that strong and fast. I’m hungry for that and now I’m not sure when I’ll be back to going at it again. For now I’m left rambling on about my “first world woes” at the counter of a local coffee shop, (probably getting the same rest experience here that I was in the acupuncture clinic…for only 3 bucks instead of 50). I still have hope though. I bounced back from 7 months off from running surprisingly quick, so I’m confident the forced rest I’m having to take right now won’t set me back too much once I get going again. All I can hope is that my healing process gets me back out there in time to run the race I want in November. If I’m going to believe in anything unverifiable, I guess I’ll believe in that.