Sometimes, injuries are complicated.
I have been lucky in that, up until this year, I’ve only experienced moderately non-complicated injuries: primarily stress fractures, which tend to heal…and then you get back into running and everything is fine and wonderful, and you promise yourself to ALWAYS do the little things so you’ll never ever get injured again…until you’re 8 months into running again and become a little overzealous and start prioritizing miles over those little things, like rolling and lifting, that you vowed to ALWAYS do. Then, before you know it, that little niggle turns into something more, and then you’re out with a full blown injury…again.
It’s human nature to be inclined to do the things we love (running) over the things we don’t love (stretching).
So as I approach the 7 month mark on my hamstring tendinopathy turned sacral stress fracture turned SI joint dysfunction with a splash of facet joint irritation (yip…that’s the new dx)…I’m over here wishing I had just had another femoral stress reaction.
BUT. I think I’m starting to finally see the light at the end of the tunnel.
I really do.
I received a diagnostic injection on May 31st into my right SI joint to confirm or refute that pain was still emanating from that location. My doctor thought it seemed logical that things were still inflamed in the sacral region because of the January MRI reading of edema in my sacrum (a stress reaction/fracture–my doctor used both terms interchangeably). The SI injection contained lidocaine (a numbing agent), followed by a little bit of cortisone to help with swelling and inflammation.
I’d write in detail about the experience, but when they offered to knock me out with twilight sedatives for the procedure, I quickly accepted because I didn’t want to lie face-down on a table for 20 minutes feeling large needles going into my butt cheek.
So the actual procedure itself was quick and painless and I received some sweet drugs…as well as a backside that was 98% painfree after the procedure.
I was extremely discouraged to feel the lidocaine wear off after only an hour post-procedure. But I was reminded by a friend to stay positive, because the fact that the shot had provided so much relief meant that there was FINALLY some more answers as to why my back was still bothering me. That and the fact that I did receive a LITTLE cortisone, which has a delayed response, so hopefully I’d feel that provide relief soon.
The days immediately following the injection were amazing. My pain had mostly subsided…until the 3rd day:
After some tears, I realized I needed to manage my own expectations: I had expected for all pain to be COMPLETELY gone because of the injections…but it wasn’t, not completely. So I chilled out, gave it a few more days, and tried my best to stay calm (s/o to my friends who dealt with my incessant crazy…you deserve a tropical vacation). Wine helped my mental state a great deal. As did online shopping.
And then…things turned around. Exactly two weeks after the injection, I woke up and realized that the sciatic pain down the back of my leg was 98% gone and my pain was SIGNIFICANTLY better in my back (albeit not completely gone). Without much direction from my doctor (but after careful discussion with a friend who is v smart and also an MD) I decided to set out for a 2 mile run on Global Running Day.
The run was probably the best run I’ve had in almost a year. No sciatic jolts. No butt pain. No back pain. Nothing. I felt amazing.
…until after the run. When things locked up and my leg/back got tight, just like they would’ve before.
I completely lost my shit. I knew I was being irrational, but it felt like my world was shattering over and over again with this injury. Why was I still experiencing pain down the back of my leg and in my back after being away from running and training for almost 7 months??? Why am I not getting relief? Do I need surgery? What am I doing that’s delaying healing? Do I really need to think about never running again? I just want to run easy and be happy — is that too much to ask?
But life goes on, I guess. That weekend, I went to Bird Camp, even though every ounce of me wanted to stay home and sulk.
Being among powerful women and friends made me feel so supported in more ways than I ever thought imaginable. While at camp, I was able to manage my expectations while also convincing myself that perhaps I was just going to have a little twinge in my back forever…it wouldn’t be the end of the world, right? –at least I was able to run for 20 and 30 minutes at a clip. Chronic pain is TOTALLY normal.
Ok no. Chronic pain is not totally normal.
The glorious comeback 6.0 came to a crashing halt when I visited a new PT last week, a few days after Bird Camp, for a full evaluation. This PT is a guy who was referred to me by my awesome MD friend and he also specializes in runners. For the first time since this entire saga started, I left the evaluation feeling as though I had not only been given an assessment of my ENTIRE body…but that I also had a definitive plan for recovery.
There are levers and leverages in the body that can stress the SIJ including the lumbar spine, thoracic spine, hips etc. So we will treat you as an integrated kinetic chain to make sure that you are better across the board. –The Magical New PT
The Magical New PT carefully listened to my entire story and gave me a physical evaluation. Not only was the SI joint dysfunction discovered, but he also identified my generic “low back pain” as irritation in my facet joints (specifically L4 and a little bit of L3). He essentially told me that if I kept going with what I was doing, I would be on the path to developing spondylolisthesis.
I was also given a gait analysis so we could check out wtf my body was doing to my body while running. Two words: HIP DROP.
To my surprise, my form wasn’t horrendous, but I did show some weakness and a 9° hip drop on the bad side. Additionally: every time I toed off the right side, my lower spine SIGNIFICANTLY torqued–so much so that you can physically see a difference in the muscle tone of my lumbar.
My mind was blown. And the jig was up.
I was told it would be best to stop running BUT I would be allowed to start up again once I had passed a few clearance tests and the spine stuff felt better. The plan of action? Go back to basics. Core. Glutes. Pelvic floor. Posture. The little stuff.
A huge part of the issue is that my large muscle groups are too strong, therefore essentially deactivating stabilizers in my spine, butt, and hips. How strong? So strong that, during an exercise in today’s PT session, I had to hold a certain position for 10 fucking minutes because that’s how long it took for my nervous system to switch over from sympathetic to parasympathetic, and for certain stabilizers to activate. 10 minutes.
So it’s not that I’m not strong; it’s understood that I am strong AF. To be honest, I think my strength and movement efficiency is a reason why I’ve been quickly written off by previous doctors and PTs. I never received help with the little stuff I so desperately need. The inherent problem is that I lack motor control in several movement patterns, therefore putting too much reliance on muscle groups that are inadequate for the job.
And just like that: the reason behind my chronic pain was unveiled. It all makes much more sense.
There is so much relief in having more answers…and answers that are logical. I suspect that some of this damage is not just from running, but also a factor of rowing for 4 years in college; the body can only withstand so much wear and tear, and dysfunction can only be loaded for so long before shit starts to break down.
But one thing’s for sure: I do think I’ve (we’ve) just about figured this out, and I will be back. The Magical New PT seems confident that I will be able to make a triumphant comeback to running, so long as I fix my inherent deficiencies and become a more stabilized human. I have another cortisone injection on the calendar for August, but my goal is to not even need that.
And, along the way, I’ve learned to always ALWAYS trust your gut, and keep searching for answers, even if everyone around you is telling you you’re fine. In many cases, chronic pain is NOT normal. In my case, both my previous PT AND orthopedic doctor told me, “meh, you can probably start up running again.”
Um. Wait. What?
I truly do suspect that if I started running again, the same ole symptoms would quickly return, and I’d eventually have to stop once again. The fear of slipping into spondylolisthesis is absolutely terrifying to me. So sure…it might suck that I haven’t been able to train for 7 months, and I might miss running SO so terribly. But fixing the problems now are going to help me in the future. Long term success is something I can definitely get on board with…because fuck 2017; I’m already looking ahead to 2018, and thinking about being happy, healthy, painfree, and stronger than ever before.