Friday, June 12, 2020

Inflammation Issue Update/Summary

I've stopped calling this an injury, because if the diagnosis is accurate, it really isn't one; the process isn't about healing but about getting inflammation down, and the bone formations in my hip has always been this way.

I wanted to write a more organized summary that linked all of my other posts in case it can help someone else with the same issue. Will my blog come up when people search "mystery hip injuries in runners"?  Hah!  I have been updating this post over time, and now that I've been really running for 3 weeks I'm going to re-post this as the final version.

The summary of the issue is:
  • Feb. 11 - I did new knee drive drills after a light progression run, in what was scheduled to be my first week of fairly normal training after the Houston Marathon on Jan. 19.  I took more time off and easy after Houston that I ever had after a marathon, which makes this ironic.  My body was still weak from having bronchitis though.  Basically it was the perfect storm (illness inflammation + weakness + coming back from a break + knee drive drills).
  • Feb. 12 - I ran 8 miles easy, with a slight tightness in my hip flexor area at the beginning and end of the run in 35 degree rain.  An hour later I could barely walk and by the end of the work day I couldn't walk without holding onto something.
  • Feb. 13 - I could walk enough to go to work, but I was limping badly.  I saw my chiropractor and had ART; he thought my TFL muscle was irritated.  I again had ART on Feb. 17 and 20.
  • Feb. 20 - I saw a sports medicine physician, who ordered crutches and an MRI.  I used the crutches for about 3 weeks (update after this appointment is here).
  • March 3 - I started biking more.  For the first few weeks of this injury I did very little for me, about 30 minutes of cardio some days (bike or pool) and focused on strengthening my glutes and core (mainly with floor work), hoping that would alleviate my issue. I did some yoga throughout this whole time - how much depended more on the time I had available and what else I was doing versus any recovery factors.  I love how yoga makes my body feel overall, but it didn't do anything positive or negative for this issue specifically.
  • Throughout March - my biking increased, not because I wanted to keep running fitness or I was obsessively cross-training, but because I started to love cycling!  It was fun to have cycling mileage goals to chase, and I love being outside. 
  • March 26 - I had the MRI, which was a long story in itself.
  • March 31 - I got the MRI results, which ruled out all of the "bad stuff" and pointed to a possible hip impingement (not a definitive diagnosis).  The physician prescribed PT and gave me the option of having a cortisone injection in my hip; I chose to do PT first.
  • April 1 - I started PT.  After my very first session of manual manipulations and nerve glides, I could walk without a limp for the first time since Feb. 12!  No pain and no limp with walking have continued through present (PT update here).
  • Mid-April - When I started PT she had me take a couple weeks off all strength work, then I started reintroducing that mid-April.  By the end of April I was back to doing standing work (weighted squats, weighted deadlifts, walking lunges, jump squats, band walks, etc.) with no problems.  Of course all of the gyms were closed so I was lifting at home with my 20 lb dumbbells.
  • April 23 - I finished PT.  I also ran 0.1 mile to test out my hip, and I still had slight pain and a small limp when running (85%), so I scheduled the cortisone shot.  The PT said it would likely be more successful since I did PT first.
  • April 29 - I got a cortisone shot.  That morning I ran 0.25 to make sure I was doing the right thing. My hip felt better than on April 23, but just.not.quite.there. (90%), so I felt I was doing the right thing.
  • May 7 - I ran a mile pain-free!  I ran 0.5 on May 2 but was about 95%, so decided to take a few more days since the cortisone shot could take up to 2 weeks to take full effect.
  • May 8 - I ran 2.23 miles (#irunwithmaud) pain-free, although something felt a little "off".  My whole body felt pretty odd running though, which I expected after not running for nearly 3 months, so I thought I was still on the right track.
  • May 9 - I started to run another 2 miles but stopped about 100 m because my hip was back to 85%. 
  • May 12 - I spoke with my sports doctor again, recapping my progression and regression following the cortisone shot.  He said that the shot having a positive effect showed that the problem is in the area we have been targeting, although he'd hoped the effect would be much longer lived.  He advised to give it some more time and to continue cross-training (anything that doesn't cause pain is fine).  He said future options include another steroid shot in 3-4 months or a PRP injection.  He also had a hip specialist in his office look at my MRI, and he agreed with the course of treatment my sports doctor was doing. 
  • Week of May 10-16 - I walked 2-3 miles most day, to see if that would help me ease back into running.
  • Week of May 17-23 - I discovered run/walking allowed me to cover 3-4 miles with no issues.  As much as I disliked stopping to walk, I dislike not running at all even more.  I started with 1:00 run/1:00 walk, then upped to 1:00 run/0:45 walk, 1:30 run/0:45 walk, 3:00 run/1:00 walk. Another perk of doing this was that I didn't get discouraged with my pace being slower, because of course it's slow; there is walking involved!
  • Week of May 24-31 - I continued run/walking and continued increasing my run time, for runs up to 5 miles.  I also ran 5 miles straight on Saturday, and tested the waters with a tiny bit of faster running (4 x hill strides).
  • Week of June 1-7 - I started running for real!
  • I'm going to stop this "come back" log here, but I'll continue to write monthly recaps about whatever God has in store for my running!  I am pretty sure that He knew I wouldn't handle the uncertainty of 2020 races and them getting cancelled one by one well at all, and also that I wouldn't take down time if I could avoid it, so this was the best path for me through this time.  The hip thing clearing up as it did didn't make a whole lot of sense, but I know that God healed it in His time.
  • June recap
  • July recap 
  • August recap
  • September recap
I was partially through this core workout when I noticed
Bandit laying on his back next to me & had Jon snap a pic

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