April 14, 2017

One massive, complex & confusing jigsaw puzzle

Firstly, please ignore if you are looking for a post with scenic trail pics or race reports.  I appreciate the injury updates can be pretty boring stuff for most folks out there but it's a month since my last update so I figured it was time to update again on my progress ... or lack thereof ...

When I last updated I was in the middle of a series of prolotherapy injections to try stabilise my lax sacroiliac (SI joint).  This involved a weekly visit to the doctor for six consecutive weeks to have 60 injections at a time into my SI and lower back area.  Luckily I got local anaesthetic injections each time too so it felt like not much more than an intense session of IMS, and Dr. Gillies - an older British woman - regaled me with stories of cycling in Thailand to distract me.  Many folks react quite strongly to the injections and have limited mobility for a few days, but I found I didn't react too badly and was fairly mobile after each session - but that doesn't indicate that the injections (which are dextrose and tighten ligaments) aren't working and in fact they did.  After six weeks Dr. Gillies was very pleased that my SI was much more stable, though I will be going back for a booster session in a few weeks time to increase chances that it stays that way.

Throughout the course of prolotherapy I was not allowed to do anything that might make the SI shift so that basically meant to activity - no running, no gym work, no hiking, no biking, no swimming.  I knew I was getting desperate when I asked if I was allowed to do yoga or not - I'm not sure if I was relieved or not when I was told that that was not allowed either.  I was allowed to walk for 2 x 15 minutes day, oh well - at least I could go grocery shopping then!  After six weeks of zero activity and much over eating and youtube video watching (I don't have a TV) I was allowed to try a 30 min jog.  Man oh man, I can't tell you how terrible that felt.  I'm super out of shape right now (but that's the least of my concerns) but everything just hurt - I was tight, tense and my legs were sore to touch.  I knew that a lot of this was because I was simply deconditioned to running (or really any movement) and even after a few days of 30 minute shuffles I began to feel a little more human again - my shoulders and back had loosened up and with thanks to the foam roller my legs were beginning to feel a little less like concrete blocks.  I wouldn't exactly call it progress but I was getting back to not feeling much worse than before the prolotherapy so that was a positive.

My doctor has been checking my SI most weeks since the completion of the six weeks of prolotherapy and so far it is (almost) as good as it was right after prolotherapy, despite a slight increase in activity.  So far I have been allowed to try some easy hiking, easy cycling and easy runs, all wearing an SI belt as an insurance policy to hold the SI in place.  There's nothing better than wearing a tight band around your hips when you already feel pretty chunky ;)  But the basic problem remains that my left leg just doesn't work like my right leg does.  This is pretty darn frustrating as I was hoping either the prolo or the six weeks of total rest would really help (and I wasn't too fussy which would help, so long as one did).  Don't get me wrong, having a stable SI is pretty much essential for an ultra runner, but getting that tightened up has not really resolved the underlying issues of my original injury at all.  The original pain in my groin of a year ago is not there (for now) but my adductor is constantly overworked, my left glute refuses to do any work and since around Christmas time my hamstrings have been shouting and so far have not piped down much.  Of course with being injured for this long it becomes pretty obvious that it's unlikely fixing one thing will solve the puzzle or that the puzzle will be solved overnight - there are many components at play and it's trying to get them all lined up at the same time that is proving the tricky part.

For now I am running a small amount every other day.  I really have to emphasize that it is a little - so far 8km/ 5 miles is a long run for me and I don't plan going over that sort of distance any time soon.  It's not pain free but it's tolerable and it's keeping me sane - some folks might under estimate that but if a short jog is only slightly uncomfy but keeps my overall body feeling ok and gives me 30 minutes of enjoyment then I feel that is important.  For now, SI stability permitting, I'm easing in some other activities to try just maintain my minimal fitness and to get outside, these privileges will be revoked by my doctor at anytime she feels my SI is getting worse.  I've been a little scared off strength work for now (a gym incident in January truly showed that my body was fragile) but I'd like to get back at that when I can as I know I have lost pretty much any strength I had, but that's what six weeks of lying on the sofa on the back of 10 months of curtailed activity does to you.

I'll be seeing, yet another, physio next week to check out a new angle and I'm waiting to get an MRI (which could be a few months) just to double check the hip area again (I had one back in July but worth re-checking and this should be a contrast MRI which can show more detail).  I made two goals at the start of the year - 1, that by December I hope to have run a 10k race (I don't care how slow but at a proper race effort) and 2, that by December I would also run a local trail route that's about 15kms (Headwaters to Norvan Falls for any locals reading).  Now we're in mid-April  I'm not sure if these are realstic goals but there's still a few months to start making progress.

At this stage I am truly grateful for both my sponsors and the medical folks who have helped me along the way.  I am also super proud and grateful to my coaching clients - I currently have about 35 clients all over the world training for anything from a half marathon to a 200 mile race, I absolutely love my coaching work and it's always a pleasure to help guide folks to achieve their dreams and personal goals.  Whilst my own personal running goals might be on hold for now, I'll never tire of talking about running and helping others to weave their running ambitions around family commitments, busy jobs and sometimes far from ideal training grounds.

Special thanks go to:

Salomon Running
CLIF bar
Drymax Socks
Sundog Eyewear
Flora Health
Suunto

and

Dr. Jim Bovard (he says he's getting stubborn, I'm glad because I sometimes feel like giving up).
Dr. Jean Gillies (prolo treatment)
Bobby Crudo RMT (especially for saving me at 4pm on a Friday when my SI gave out in the gym that morning).
Chris Napier, Marylou Lamy, Carolyn Bliss (physios)
Joe Uhan (physio and gait analysis)

 Happy trails,
Ellie

I helped iRunFar with race coverage at Chuckanut 50k.  It was a fast and furious race to watch!

Hiking in the rain.

25% off sunnies til end of April!

It's not really been great cycling weather but hoping for more sun for more skinny tyre miles.

Fun times hanging out with CLIF bar in Whistler.

Trail conditions in North Van, April 10th.

102 comments:

  1. Hi Ellie. I know there is almost nothing worse than the "have you tried this..?" responses to injury posts but I am going to do it anywa in the spirit of hopefully helping you solve your jigsaw puzzle. You clearly have a great team of healthcare professionals but I figured another persective based on experience couldnt hurt. I have been in a similar position with the left glute not doing much and the adductor and hip flexor constantly being over-worked. I don't know if I have SI instability but once I went through 10 weeks of prolo therapy and rest for a high hamstring tear, I have found a mixture of motor control exercises and heavy weight exercises with particular attention to form have helped my L glute do more and actually get stronger. I've also found that my L core muscles were also not doing much and do some breathing and muscle activation exercises 2 times a day have helped. Every body is different and this may not apply to you at all, but my physio found my L hip flexor was always "on" because my core wasn't and this was pulling my hip forward, thus throwing off the whole alignment and making things not fire or fire too much. Wishing you good health and pain-free running!

    ReplyDelete
    Replies
    1. Thanks for the tips. I have always done heavy weights but that does not necessarily lead to recruitment of glutes when running. Good you are back running!

      Delete
  2. Hi Ellie. Just touching base to let you know that we are still big supporters of yours and hope that you are able to get back to pain free running. I am slowly getting my mo-jo back after a prolonged time away from running and have signed up for my come back ultra in September. Having a nearly 3 year old in toe deffintely fills in the time, but would not change it for the world. Tanya, Sylvie and I all cant wait to touch down on Canadian shores one day in the future and hope we can also welcome you downunder. Take care!

    ReplyDelete
    Replies
    1. hey Campbell! Super to hear from you and awesome you are doing an ultra this year! I'm sure you'll get back on track and do great - slow and steady in the build. Would be wonderful to see you three back in Canada one of these days :)

      Delete
  3. Hey Ellie,

    Anthony here from sunny South Africa! Im truly sorry to hear about your troubles (i can certainly relate), I hope you manage to get to the bottom of the issue real soon, we miss you at comrades!!

    I wanted to ask, have you been checked for possible FAI ? (femoral acetabular impingement) - google that. I had a long term injury with very similar symptoms to yours - ie: groin pain and SI joint pain, hamstring issues which are all symptoms of FAI.
    After alot of frustration and misdiagnosis and after having an xray and mri done i was diagnosed with FAI. Its basically bone spurs that develop on the hip joint which end up causing damage to the surrounding labrum/cartilage and prevent or limit normal hip range of motion.. the most common symptom is groin pain.. which you mentioned. In most cases the only real solution is surgery - because its a bone issue, and no amount of physio actually helps.
    Maybe worth checking out if you haven't already.

    Good luck, and hope to see you in our beautiful country soon!

    Anthony

    ReplyDelete
    Replies
    1. Thanks Anthony, I too hope to make it back to South Africa one of these years! I have already had MRI and awaiting another to be sure, but thanks for tips (although symptoms sound a little different from mine).

      Delete
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  6. Hi Ellie,
    A friend steered me to your blog as I'm embarking on my 4th month of no running post-injury. Being injured feels pretty lonely, and I really appreciate your transparency and perspective. I watched you crush Chuckanut in 2016 and admire your example during recovery as much as your strength and speed during that race. Best wishes in the healing process.

    ReplyDelete
  7. Just read your blog Ellie - this morning I did my third "recovery" run after a 5 week complete lay off with the "chest infection from h*ll". Dropped 3/4 stone in 3.5 weeks. 5.7 miles of grim hilly misery this morning and was feeling pretty dejected - Tor Des Geants in September seems another world away!
    But having read your latest (last month) blog in so glad I did. Sounds daft but just made me feel less "alone" in my gloom. I know things will get better with perseverance but it's just a real toughie when I knew I was rocking and setting training run PBs before getting ill...cest la vie ��
    I should be used to setbacks by now (long story involving a REALLY bad off road motorbike accident 6 years ago), but "bouncing back" doesn't seem to get any easier, even with lots of practice. I can really empathise with your SI and joint problems - I was a mess after the crash ��

    But keep your chin up, be patient (as patient as a determined ultra nut can) and above all else, smile, laugh and persevere!

    Thanks for the blog

    Brandon ��

    ReplyDelete
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