Monday, March 31, 2014

My First PT Appointment and Dry Needling

Alternatively titled: The Time I Jumped Head First into a Controversial Medical Treatment on Blind Faith

This past Saturday I had my first physical therapy appointment for the pain I have been having in my hip. My physical therapist, Mike, was all business and I liked that. I am completely serious about getting this issue kicked as soon as I can so I can get back to running.

After a good while manipulating my legs and hips he narrowed my problems down to the piriformis and my SI joint. Apparently they are all out of whack (yes, this is the actual scientific medical terminology) because my pelvis is pretty unbalanced. I favor my right side, which makes the left side weaker and less flexible.

Immediately he made a plan: 1) deal with the pain, 2) get my pelvis properly aligned and 3) strengthen the left side. I was pretty encouraged by his enthusiasm and confidence that he could fix me.  Furthermore, I was pretty psyched that we could start dealing with the pain right away with some Dry Needling. 

I'm sorry, needle? What?

In Dry Needling, small acupuncture needles are inserted into the trigger points, or knots, in your muscle. The needle is inserted directly into the the knot and than moved slightly around the area. This causes a local trigger response, which feels like a muscle spasm. This makes the muscle fibers release allowing the muscle to relax. 

Mike warned me extensively that this was not a comfortable procedure. He offered me the chance to go home and research it and come back. Or I could do it right now.  I surprised myself in agreeing so quickly, since I am a huge baby when it comes to needles, but I love running more and I want to get better quick.

He had me lay on my stomach on the table while he located the knots in my piriformis. The muscle is so tight that it was quite uncomfortable just to have him palpate it. The needles themselves didn't hurt, just the tiniest pinch. I felt nothing until he hit the trigger point. When he did, it felt like a jolt of electricity which was quite uncomfortable.  He did this for 4 trigger points before we stopped for the day. 

When I got up off the table the results were immediate. My pain was gone. It was crazy and too good to be true. I was sore from the muscle spasms, but the actual pain I had been experiencing for the past three weeks was so much better.

I woke up on Sunday with quite a bit of soreness which, from what Mike told me and from I read after the fact, was to be expected. This morning I am feeling no pain in the piriformis area. My SI joint is still pretty achy, though.

I have to say that I am glad I didn't go home and read up on it first because a lot of what I have read would have deterred me from going through with the treatment. Most people say it is very painful. While there was some element of pain and discomfort, over all it wasn't too terrible. Also Dry Needling is a pretty controversial treatment in the PT world and not approved in every state.  I can only speak for my own personal experience. I went into that appoint hoping for a miracle to cure my pain and I got one.

This is only the first step to my road to recovery. I will most likely need more dry needling sessions in the coming weeks, but now that we've been able to significantly lessen the pain, I have to get to work on the underlying problems that caused my pain in the first place. We'll work on strengthening up my left side. hopefully a return to running might not be too far off.

Tuesday, March 25, 2014

Change of Plans

I've had pain all around my hip for two weeks with little to no improvement. I was nervous to go to another sports medicine doctor because my last experience was not awesome. But by last Friday afternoon I was nearly crying from the pain. I was able to get an appointment with a different doctor first thing Monday morning.

After some x-rays and being bent and twisted every which way, the doc said he didn't think I had a stress fracture. In terms of soft tissue injury I have "a little bit of everything" - tightness and strain in my IT band, my piriformis and SI joint.

"Great!" I said, "So can I run my marathon in 3 weeks?"

For a split second he just looked at me.

"Ummm, no"

I mean, I knew what he was going to say, I just needed him to say it out loud. And the knowledge that he was actually going to say no, didn't make hearing it any easier.

He did say that I could run it, but most likely I wouldn't finish and turn a manageable injury into something much worse. I tried to hold myself together while we discussed our plan: 6 weeks of PT with a focus on core strength and hip flexibility. (I also have to say that I am glad I didn't let my previous experience with a sports med dr keep me from going to a different one. I loved this doctor. He had such a great attitude and seemed to genuinely care about getting me back in my Brooks.)

When the appointment was over I allowed myself a couple of minutes to cry it out and wallow in my self pity. I mean, months of running in the freezing cold just down the drain. Eventually I gained some perspective. This is not a real problem. A set-back for sure, but there will be other start lines. Right now I am choosing to look at this as a lesson that in the back of my head I knew had to be learned: that I can not train for these long distances by running alone.

This winter I half-assed my core work and barely lifted anything heavy. I knew better but I just didn't follow through. So I am picking myself up and pulling up my big girl pants and getting to work.

Step 1: Get Better

My first PT appointment isn't until Saturday. Until then I will be rolling and stretching like a boss. I was using just a regular foam roller but have since upgraded to the Trigger Point roller after many recommendations. I bought a lacrosse ball to get the oh-so-hard to reach piriformis. (I had to look up YouTube videos on exactly how to do this. I don't recommend that. It was kind of creepy.) The stick comes with me to work, much to the chagrin of my office-mate who asked why running is my hobby when I need to use torture devices to do it. Some people just don't understand.

Step 2: Cross train

Running alone just isn't going to cut it anymore, especially if I want to run longer distances or improve my speed. Definitely going to put more emphasis on core work and strength training.

Did you know that "Go For It" by the Hot Sundaes is
not available on iTunes? WTH?

Step 3: Nutrition

While I am working on the bigger picture I can not ignore the vital role of nutrition. If I can focus this rebuilding period on cleaner eating and perhaps even some weight loss, all the better.

Overall, I am surprised at how quickly I have come to accept my current situation. I mean, crying and self pity is not going to change anything. It turns out I already had a back-up plan. Last week I found out I was accepted into the Marine Corps Marathon. I couldn't be more excited. It will be my biggest race by far. I'm ready to do the work because in 7 months I am more determined than ever to make it to this start line!

Thursday, March 20, 2014

Everything hurts

Well, I am three weeks out from my marathon and everything hurts.

And not in a good way. My training came to a screeching halt about 2 weeks ago after my first 20 miler.

The run itself was good. I consisted of 2 5-mile out and backs on my favorite running trail. There are a couple of people in my running group also training for the Rock n Roll Raleigh full and I have loved running with them. I had pleasant company and mentally breaking up the run into 4x5-mile segments was a great way to get the run done.

When my Garmin did hit 20 miles I stopped and walked and stretched a bit, but my legs just completely locked up. It was quite painful, but I just attributed it to having run my longest distance ever. I continued stretching and rested the next day.

In the week that followed I developed a pain in my left hip that radiated down my leg. I tend to suffer through some minor hip pain at least once per training cycle. I decided to rest for a couple of days and concentrate on yoga. This combo has always worked immediately in the past.

This time it isn't working as quickly, or at all for that matter. Right now I am existing on ice packs and Advil. My tiger tail massager is my constant travel companion. I am contemplating calling a sports medicine office. I am getting really nervous about not being able to run this race that I have been working so hard for.

Until I know any better, I keep stretching and icing and try to remain calm.