Abnormal is the new normal: April 2020 recap

April 2020 in review!

Total running mileage for the month:  0.35, haha!  I did 0.1 on my last day of PT as a trial, and 0.25 before I got my cortisone shot to ensure I was doing the right thing.

Total biking mileage for the month:  1,036.6 - pretty pumped to be over 1,000 here!

• March 30-April 5: 225.8
• April 6-12:  246.7
• April 13-19:  174 (my PT had me take a few days off biking this week)
• April 20-26:  314.6
• April 27-May 3:  258 (with 48 hours off activity post-cortisone injection)

Total podcast interviews for the month: 1

Races:  I had 3 races planned in April, although I wouldn't have been able to run them had they occurred.  Two were rescheduled and one went virtual.  I had only registered for one of them, via an elite comp entry, so haven't lost anything on race fees with this injury.

Albani on Facetime with her cousins, "And there's
Mama laying on the floor after biking."

Workouts:

Biking: 

• I did several Peloton spin classes (most of my indoor rides), but I don't think anyone is interested in the specifics.  I enjoy the workouts for biking though!  
• I did a 20 minute time trial on the bike on a weekend that other athletes my coach works with were doing 5K time trials, and it was SO HARD...it was like 5K suffering but worse, probably because I'm relatively new to biking.  My heart rate was in the 160s the whole time and maxed at 171 (generally biking HR is about 10 bpm slower than running HR, so this would be like me running a 5K with my HR in the 170s and maxing at 181), which showed me I put forth a good effort.  I nearly died but I was really stubborn about averaging 30 mph+ for the 20 minutes, and I made it, barely.  
• I also did several bike doubles, which may not even be a thing for real cyclists, but I pretty much just approached cycling like it was marathon training.  Biking 40-50 miles in a double became easy for me.

Strength Training/PT exercises:  weekly totals of 1:20, 2:12, 2:50, 2:30

Yoga:  weekly totals of 1:45, 1:00, 1:50, 1:00

10.03 miles in 20:00

Long Runs:  0, but I did several 40-50 mile rides, which were long rides for me!

Pretending to by a cyclist!

Running Highlights:

• I was interviewed on the Rambling Runner podcast last month, and the episode was released April 7 - listen here.  I think Matt Chittim has the best podcast voice ever!
• I saw huge improvement in my hip inflammation after only one PT session with manual displacements and nerve glides - I could immediately walk without pain or a limp for the first time since February 12!  I still have a tiny bit of pain and a slight limp when trying to run, and although it feels like something I could push through if I "needed" to, I don't need to and will run when it feels 100% normal.  I had a cortisone injection on April 29 that I hope will be the final bit needed.  You can read more details about my hip issue and progress this month: MRI results, follow up answers, PT effectiveness, PT progress, and an update with a summary of it all.
• This quote, from a Time article by Allison Felix:  "Sometimes, you believe so strongly in that dream that you begin to think that you have already earned it, that it is already yours. Until it is taken away from you. This has been a sobering reminder that we are not owed our dreams, those dreams do not come free and you do not accomplish them alone."

Fun sock Friday lives on!

Life Highlights:

• Another low key month with COVID-19 stay at home orders in place.  I don't at all mind staying at home, and treasured the new experiences it brought me.
• We made a little trip for gardening supplies, to an Amish community.
• I will still be working mostly from home in May.  I am afraid I'm going to forget how to wear real pants and shoes!

Bandit joins me at work in the office/guest room often,
& can even open the door to come in on his own

PPE

Seen on my ride (I used to group run from here!)

The COVID-19 Easter bunny brought one egg
with a $5 bill in it

Albani bought a little succulent at the Amish
discount store

She loved on this same dog last year when
we made this little trek

Books:
I ran out of "real" library books on April 3.  Desperate times call for desperate measures, so I began reading ebooks and also pilfered some youth reads from my daughter's book stash.

• Nothing to See Here by Kevin Wilson
• A Nearly Normal Family by M.T. Edvardsson
• Wonder by R. J. Palacio
• The Alice Network by Kate Quinn
• Wait Till Helen Comes: A Ghost Story by Mary Downing Hahn
• A Spark of Light by Jodi Picoult
• Funny, You Don't Look Autistic: A Comedian's Guide to Life on the Spectrum by Michael McCreary
• 90 Minutes in Heaven: A True Story of Death and Life by Don Piper and Cecil Murphey
• The Dead Girls Club by Damien Angelica Walters
• A Stranger in the House by Shari Lapena
• Have a Little Faith: A True Story by Mitch Albom
• All We Knew But Couldn't Say by Joanne Vannicola
• Ungifted by Gordon Korman
• A Grown-Up Kind of Pretty by Joshilyn Jackson
• Girl, Wash Your Face by Rachel Hollis
• The 7 1/2 Deaths of Evelyn Hardcastle by Stuart Turton
• The Daughter in Law by Nina Manning
• Backseat Saints by Joshilyn Jackson
• Why Not Me? by Mindy Kaling
• Before You by Amber Hart
• Crazy Rich Asians by Kevin Kwan
• I Let You Go by Clare Mackintosh
• Three Wishes by Liane Moriarty

Biking & an ebook - what is happening to me?!

Theme for the month:
The New Normal - working from home and cycling became normal and routine for me.  I'm starting to forget that I used to work from other locations and run, hah!

Things I wouldn't have done if it weren't for COVID-19

I have been counting my blessings during this odd, unprecedented time, and I realized that there are several things I have done that I wouldn't have had this not happened.

1. Slowed down.  I'd already started down this road before the pandemic, when I used crutches for a couple of weeks for my mystery hip injury.  I experienced a great deal of frustration when I first started crutching around - I am used to going nonstop and suddenly everything took much longer and I needed help doing things that I usually take for granted.  I figured that God was trying to teach me patience, and that has carried over into the stay at home order and other changes.  The pace of my daily life has slowed down.  I'm still busy at work, but I'm not busy with much of anything else!  Everything is more intentional, deliberate, and in-the-moment vs. rushed.
2. Taken a crash course in and worked via Telehealth.  I did not have any experience as a Telehealth provider before COVID-19, and now I feel like a pro!  Some days I've had 8 hours straight of teleconference appointments.  Initially this change was stressful, particularly because there was no preparation time, but I have learned a lot and adapted.  I attended several webinars, listened to podcasts, and read a lot on the topic.
3. Explored bike routes galore.  I love the area we live in and am thankful for it for many reasons, but I have never been so thankful for the endless farm road cycling options just outside my front door until this time period!  Two bad things happened and coincided for this to work (pandemic plus my hip issue), but I wouldn't be able to lunch break ride if I wasn't working from home, so I'm super thankful this all aligned and for the biking options I have.
4. Used the Peloton app.  The app offered a 90-day free trial, which I jumped on since I was spending a lot of time on the bike.  I didn't realize all of the other activity options the app would have, but in addition to the spin classes (which I love!), I am also doing yoga classes, core workouts, and strength workouts.  If at any point I think my running career is over, I will for sure buy a Peloton bike.  I have been thankful to have a spin bike at home through this (I got one for Christmas 2015 and it's come in handy anytime I've been unable to run).
5. Read ebooks.  I read all of the library books I had checked out and had already read nearly all of the books I had at home, so I began checking out ebooks through my public library's system.  Initially I didn't like it - and I think I will always prefer actual books - but it grew on me and I love the selections right at my fingertips.  I also discovered I could easily read them (on my touch screen computer that has a keyboard that rotates around to tablet mode) while riding my spin bike, which was a great discovery.  I always read a lot, but the volume of books I read has also increased.
6. Finished all of my CEUs for my November 2021 recertification.  I just renewed by BCBA certification in November 2019, I so had plenty of time left to accumulate CEUs in my 2-year cycle, but several online CEU providers offered some or all of their CEU libraries for free, so I knocked them all out - for free!
7. Lived in sweats and no shoes.  A huge perk of Telehealth:  only your head and shoulders are visible!  I pretty much only wore shoes when exercising.  I haven't worn makeup, but on a regular basis my maximum makeup consists of tinted moisturizer and mascara, so that's not a huge change.

Most of my favorite cycling routes are versions of this loop,
which can be varied in about a thousand ways!

I also think the world has grown closer.  It's ironic because everyone is apart due to social distancing, but I think these shared global experiences have really brought people together.  People bond over shared obstacles, and people rally together to support one another more in times of trial.

I don't mean to minimize the seriousness of this pandemic, or those who have been heavily affected.  I know I am fortunate to be pretty unaffected, with job security, living in a rural area, and being an introvert (I have loved staying home!).  We lost a family friend to the virus, an elderly former neighbor who was living in Arizona, so we were touched by this, yet not nearly as much as many.  I pray that our world will come out of this a better place.

I've become a cyclist temporarily + hip update

In my last update, I mentioned how incredibly helpful just a couple of sessions of PT were for my mystery hip issue.  I am happy to report I have continued to walk without pain and without a limp.  I feel almost ready to run again, but not quite.  I've of course done the "run through the house" test several times, and my hip is just almost-but-not-quite there.  I have never had an injury recur after I returned to running, which I think means I'm really good at not pushing it when I'm almost-but-not-quite there.  I've been off running so long at this point what difference is another week or two going to make, right?  The difference between 1 week and 2 weeks off us huge; the difference between 10 and 11 weeks off is minuscule.

Since I had such immediate dramatic improvement, I thought for sure I'd be able to run by now, but improvement has been muuuuucccchhh slower since.  I am thankful I can walk without pain, and that I've been able to reintroduce strength work.  My PT recommended staying off the bike for a bit, which I have now done for one day (elliptical instead), but since I don't think the bike is bugging my hip I will probably get back on soon.  The PT thought the hip angle might be keeping my hip inflamed even though biking has never bothered it.

I am also considering getting the cortisone shot...

I've continued my cycling journey and have been really enjoying it!  I only started officially tracking my cycling mileage when I got my road bike tuned up and began going outside often, but since then I've had weeks of biking mileage of 164, 225, and 246.  I do a few Peloton workouts on my spin bike each week, several easy rides outside, and a long ride outside.  This week I'm taking a cut-back week instead of building again since I essentially went from 0 to nearly 250 miles in 6 weeks of biking (also since my PT recommended trying some time off the bike), but before quarantine is over I'm hoping to hit a 300 mile week.  Funny, when I initially got this injury I said I wasn't going to cross-train that much, but somehow we return to our "normal" level of activity, huh?

Banded clamshells with cat participation

2:45:01 and Beyond: Molly Nuun

Molly and I met when she messaged me on Instagram to say we have the exact same marathon PR!  As I started talking with her, I knew that her story of pursuing an OTQ would be an amazing one to share.  Her quest for the 2012 OTQ started with a question and comment from a coach, and she ran her 2:46:08 when the qualifying standard was 2:46:00, so was only 8 seconds away despite tripping and major wind gusts!  She ran 3 amazing marathons in 2011, but the wisdom she has from the experiences 9 years later is far more valuable.

2015 Wineglass Marathon win

Name: Molly Nunn

Age: 36
City/State: Winston-Salem, NC
Occupation: Sr. FP&A Manager 

Hobbies/interests outside of running:

Run-exploring new cities, golfing, writing my blog (although I do not update as often as I’d like), going to the car wash, sing-dancing loudly in the car, and eating great food and drink with friends. 

When did you start chasing the OTQ and what inspired you to try?

After college, a former Wake Forest coach noticed I was always out on the track doing workouts and asked what I was training for…I didn’t know! I did not accomplish much in college running other than walking onto the team (which was a huge feat for me since I went to a 1-A high school and had 23 people in my class) and I just knew inside that I needed something more from the sport. He said, “have you thought about trying to qualify for the Olympic Marathon Trials?” From there, I locked onto the goal. 

Tell us about the races you attempted to OTQ at and the outcomes.

2011 January Houston – Lesson: you need a LOT of GOOD calories before the race, I had McDonalds and could barely stomach the food. Dropped out at Mile 15.5. Lesson II: It takes a LONG time to get back to the start/finish or wait for a medical van.

2011 February Myrtle Beach – 2:46:59 – Almost made it!

2011 March Virginia Beach – “THE ONE” – 2:46:08. The day included 30mph wind gusts, but it was THE DAY. Got tripped at mile 16, lost my shoe, bruised my left rib, and bloodied up my left arm, but it was THE DAY. Got to the home stretch and saw the 2:45 ticking up, and up, crossed the finish line, and puked (it was the ONLY race I’ve ever puked in). Missed by 8 seconds, but it is THE DAY that stays with me.

2011 Wineglass Marathon – First Marathon Victory – 2:48:21. This is a day that should’ve stayed with me, but I was done trying to qualify for the Trials and unhappy. In 2015, I was able to win this race again after discovering “happy running;” I ran almost 7 minutes slower, but it was magical to live through that moment of winning the marathon.

What did you gain from this journey?

Now that it has been almost 10 years, the biggest lesson I learned is that you cannot constantly keep one foot in the past, and one foot in the future, you’ve got to, also, embrace that exact day, all that it gives you, and open your eyes to the magic you create; you also never know just how people you inspire to also pick up their dream and run with it. (ha pun intended!)

What are you most proud of about your OTQ pursuit?

I am proud to have discovered just how much strength we have been given, physically, emotionally, mentally, and spiritually… we have so much power but it’s our decision how we harness it or set it free to do great and wonderful things.

Do you have any regrets or things you wish you’d done differently in your OTQ pursuit?

Yes, two things: I tried to do too much at once; I was working full-time and paying the bills, going to MBA school, running 80-mile weeks, and not fueling or resting like I needed to. It was the burn out train, and I burned out which resulted in several years of injuries afterwards.

Second, is a hard one; sometimes, we get so focused on our goal and kind of dark and stormy about it, we push away people that want to support us in our relentless pursuit, the people that will still be there on the other side. We have to find the balance in the pursuit of the ‘dream’ and in meaningful relationships. Attempting to or qualifying for the Olympic Trials is a moment we can cherish, but dear family and friends is the part of life that’s priceless. I would’ve spent more time balancing and nourishing both.

What message would you like to send to those following your running pursuits?

My mantra has become “Happy Running” – life is very short and so it is important to work towards those meaningful things that help us become deeply and utterly joyful and happy.

Tell us something unique about yourself.

When I was 25 and a school teacher/coach, I had to get my CDL license and drove a school bus. I looked like a high school student DRIVING 60 high school students to cross-country and track and field meets.  It was terrifying.

What’s next for you?

… a 90 minute date with my elliptical machine! … and hopefully, a fast, fall Marathon!!!

Anything else you’d like to share?
Thank you Sara; you are an inspiration!

2011 Wineglass Marathon win

PT or voodoo?

My first PT appointment for my mystery hip issue was on April 1.  Along with an intake and assessment, the PT did manual movements for my hip called manual distractions, and gave me three nerve glide exercises to do twice daily on my own.  On April 2, I had Jon do the manual distractions at home, and after just two sessions of them I was walking without a limp for the first time since February 11!  My no-more-limp situation has continued through today, April 6.

It simply blows my mind that 2 days of simple movements that take about 5-10 minutes a pop helped me more than 8 weeks off running did.  Clearly the answer to this issue was not time off running, it was this.  Although I sure wish someone had showed me this 2 months ago, I'm sure thankful to figure it out now!

The manual distractions basically push synovial fluid out of the joint and allow it to be replaced with "fresh" fluid.  They are really simple.

I feel like I could try running any time now, but my PT advised "not quite yet."  I'm going to try to get her to peg down a recommended start date at my appointment tomorrow (April 7).

In meantime I've been doing a lot of cycling.  Running is always going to be my first and strongest love, so it almost feels like cheating to say this, but I have fallen in love with cycling throughout this time.  I have become a much stronger cyclist (the bar was set pretty low to begin with) and now crave going out for rides on my road bike.  I plan to reintroduce running slowly to be smart about it, so when I resume running I expect to be doing a combination of running and cycling for awhile.  Until then, I am chasing cycling PRs!

Follow-up answers

As I mentioned here, I several follow-up questions following my hip diagnosis/non-diagnosis.  I spoke with my doctor who was helpful in answering them all (I warned him I will probably have more).  I'm publishing my notes so I'll have something to look back on, but also to possibly help anyone else who goes through a similar issue.

Can you provide more information about the hip impingement I have?  It is cam impingement or pincer impingement? 

Cam vs. pincher impingement is mostly an x-ray finding.  My x-rays do not show definitive findings, but it would most likely be a cam impingement or a combination.  Both are treated the same way.  My x-ray doesn't show anything for sure.

What exactly causes the pain?

Pain is caused by movement and inflammation.  My anatomy has always been this way but something irritated it.

Could muscles in the area also be painful from compensating?

Muscles in the area will compensate for it so could be contributing to pain, and could perhaps be why it's so running-specific.

 

Is it a definitive diagnosis from my MRI, or the most likely issue? 

It is not definitive.  MRIs are the best tool to diagnosis this type of issue but can also miss subtle findings.

What is the prognosis for this issue?  Will this heal with rest and PT?  Will this always be an issue?  Will I be able to return to running high mileage when I'm pain-free?

This will get better with rest and PT.  The pain will go away.  It will not always be limiting/painful,.  We need to calm down the inflammatory process.  My anatomy will always be the same (and has always been this way).  I can definitely return to high mileage running when pain free; I have been running all of this time with this anatomy.

Would Aleve or a similar medication help?

Aleve may be helpful (or Ibuprofen, Motrin, Advil, etc.), taken with food twice daily.  I am going to try this before trying a steroid injection.

I had the MRI...

Getting the MRI was a saga in itself, but I had it on March 26 and received my results on March 31.

The good news!
No stress fracture or stress reaction.
No labral tear.
No bone death (avascular necrosis).
No torn muscles.
Nothing looks alarming.

The bad news!
No definitive diagnosis to explain why I still have pain even when I walk, and any activity with impact is definitely out the question.

The only abnormality was possible signs of hip impingement, which is generally something you're born with and doesn't come from over-use or running (although physical activity that extends the hip beyond it's normal range, like drills, could aggravate the situation).

None of the professionals I've seen have really been able to pinpoint anything, and I don't meet the diagnostic tests for anything, so it's frustrating.  I'm very thankful I don't have any of the "bad things" they were looking for, but none of possibilities thrown out there make sense.  It's also odd that a hip impingement issue would not bother me biking.

I started physical therapy on April 1 (not April Fools!).  The doctor said another option is to have a steroid injection to reduce inflammation in the area.  After how much pain I've had following the contrast injection I had prior to the MRI, I am certainly in no hurry to inject anything else in there, plus I'd always rather try more conservative treatments first.

This diagnosis doesn't seem very definitive and there is no clear timeline for when I'll be able to return to running (just when I'm pain-free).  I have a lot of follow up questions for the doctor now that I've processed and researched the issue (update:  follow up answers are here).