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…..no 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.

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8 responses to “Where The Pain Lies

  1. I once did acupuncture, more to experience it once than due to an issue or injury. My experience mirrors your expectations prior to your own 😉

    My acupuncturist actually showed me how the muscles will “grab” the needle. He slightly twisted it while it was inserted, and it was in fact hooked in. He simply twisted it back and pulled it right out. Also, very interestingly, he showed me a few of the needled that had actually been bent by my muscles!

    • Wow, that sounds gnarly. I remember the NB video with Anton Krupicka freaking in pain as his muscle grabbed the needle. I was kinda afraid I might have to go through that…but mine was much gentler. Maybe it shouldn’t have been!!

  2. I *really* enjoy your writing; you should write a book!

    I don’t think your perception was confirmed through your first experience. Just because acupuncture might take more than one treatment to work doesn’t mean it doesn’t work. Rest takes more than one day to work and you acknowledge that it works, so acupuncture may be no different.

    I’ve never had acupuncture, so I’m not an advocate for or against it, but I don’t think you gave it a fair chance.

    In any event, hope you recover soon!

    • Thanks Monica! I always have the idea to write a book someday, but right now I first need to find the time! And yeah, thanks for your thoughts. I’ve got one more avenue of healing to try before I go into total freakout, depression mode. I’ll probably post about that too…the healing, not the freakout. 🙂 – Scott

  3. I fought with sciatica/piriformis syndrome for several years. I never had accupuncture, but I went through PT for about a year and a half with minimal results. At wits end, I did something I said I would never do…I went to a chiropractor. I had heard horror stories about people coming out of the chiropractor in a wheelchair. I also knew that Dr. Sheila Wilson (Georgetown Chiropractic) regularly works on athletes/runners including members of the Invaders. I figure if she hasn’t broken any of them yet, I could give it a try. After just a few sessions with her where she realigned my SI joint, I was experiencing relief that I hadn’t felt in several years. I would highly recommend giving her a try. My experience is that you want to get this thing taken care of as quickly as possible because the longer it takes, the more muscles will tighten up around it trying to protect the area.

    Good luck!

    • Thanks for this info Todd. I have actually been to Sheila Wilson before. Right now I am setting up an appointment with Darrell Barnes from St. Vincent’s Sports Medicine to actually determine what’s going on before I do anything else. When I had a debilitating leg problem 2 years ago I went through a number of people before he set me straight. I’m going to see what he discovers and then proceed from there…maybe chiropractic work will be part of the plan. Thanks again for the recommendation. I appreciate it!

  4. As I was running my marathon last weekend, it was hard not to feel simply grateful. You’re obviously a talented runner, but your writing on running, and on being a runner, is almost always insightful and inspirational. Hopefully you get your legs back under you, and hammer the marathon you deserve this fall.

    • Hey, I really enjoyed your last race report…sounded like an awesome performance and experience. And yeah, I hope I get my leg back too…I don’t know where that will put me for my next race, but I just REALLY need running right now, on a cathartic level if nothing else. But yeah, thanks for the good words. P.S. – I had my first cup of Siphoned coffee today…it was damn good, but probably my last at that price. 🙂

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