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.

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!

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.

RNR Raleigh Training Weeks 7-11

I don't even know where to begin.

I tend to break my life up into three compartments: Family, Work, and Running. Right now all three are demanding my full attention and the unfortunate result is that I feel like I am falling short at all of them.

I'm happy that I am taking a relaxed approach to this marathon. I'd be lying if I said I didn't have a time goal. But it is a modest one, my main goal being to finish strong and happy. I want to know if my body and mind can handle the higher mileage. This approach is making it easier to handle the unexpected snags that life is throwing at my training plan.

Over the past few weeks we've had a couple of big snow and ice storms. Perhaps you've heard the South doesn't exactly handle snow and ice well?

(Source)

Luckily it wasn't all bad!

In more rural areas like mine the roads were covered in ice for days with each storm, which meant that everything was closed, including my gym.

Despite missing more mid-week runs than I would have liked, the positive is that I have been getting in my long runs. I'm getting into the thick of the training and starting to hit mileage that is new for me.

Two weeks ago, I had a fantastic solo 16 miler. I set out to take it nice and easy. The result was evenly paced miles (a huge deal for me) from miles 1-12 and progressively faster miles for 13-16. Overall average pace was only 15 seconds slower than my goal pace. It was an amazing run.

This past weekend was an 18 mile run which I had been nervous about. We were running the same route we ran a few weeks back. During that 14 mile run the last two miles were straight up hill. I struggled a lot and was a bit demoralized by the end. This run was amazing. We took the pace nice and easy. I killed the hills at the end and felt fantastic at the end.

See? I look totally happy.

All in all, I feel like I am doing the best I can in terms of training. I don't want to sound like I am making excuses, but my reality is that I have a husband who works 70-80 hours a week, my own full time job, and two kids who have school, karate, swimming. I've been as flexible as I can fitting in my training and I trying to be proud of what I am doing rather than be disappointed in what I should be doing.

Luckily the weather seems to be changing for the better and I am super motivated to do the very best I can in these next 6 weeks.

RNR Training Weeks 5 & 6

Considering that I am halfway through week 7, I'd say this recap is a little late. But honestly there isn't much to write. Both of these weeks were a wash for different reasons. Since I am training to finish and simply cover the distance I am not overly concerned, but I am glad it happened in the beginning of my training cycle.

Week 5: aka the week of the Polar Vortex.

I missed my mid-distance hill run because it was bitterly cold and the kids' school was delayed. Other wise it was an ok week. I got in 4 runs for a modest total of 19.25 miles. Had I gotten that 6 extra miles I would have been right where I wanted to be for the week, but it is what it is.

• Wednesday: 4 mile treadmill speedwork consisting of 1 mile warm up followed by 4 x 0.5 mi repeats at increasingly higher speeds, 0.1m rest between, 0.5 mi cool down. This certainly made the treadmill a little more tolerable
• Thursday: Holy cow my quads were sore from the workout the day before! An easy 3 mile treadmill run flushed them out.  Core work afterwards.
• Saturday: 10 mile long run with my running group. Would have liked to have tacked on a couple more miles afterwards but some really strong storms were rolling in complete with tornado warnings. I thought it best to pack it in and go home.
• Sunday: 2.25mi on the treadmill before my yoga class.

Total miles: 19.25

Week 6: aka the week I find out how effective my flu shot was.

I woke up on Tuesday morning feeling not well at all. I sat in bed for a good 45 minutes contemplating getting up and going to the gym to get my workout in but in the end decided against it. I was feeling a little feverish and overall not well.  By about 10 o'clock I was on my way home from work because I was feeling progressively worse throughout the morning. By noon I was on my couch unable to move. I stayed home from work the next two days battling a mild case of the flu/strep throat. Needless to say there was no running at all.

I was feeling well enough on Saturday to attempt my long run with my running group. Whether or not it was the smartest idea, I will not say. It was a cold cold 13 miles. The last mile and a half was all uphill and I was definitely feeling tired, but I got it done.

Total miles: 13
-------
Overall I am not beating myself up. I feel I am doing the best I can with the time I have and I still have a lot more time in my training plan. I am just praying that this brutal winter weather will let up so I can spend a little more time outside.

RNR Raleigh Training Week 4

Maybe you heard on Twitter that it is a little cold outside? Here is my personal favorite way to stay warm! He's going to be too old and too cool to cuddle with his mama soon. I am soaking up every possible moment.

I have a feeling that when I start getting into the thick of marathon training -  a time when the newness of training for a new distance wears off but the race is still many weeks away - that I will look back on this week for some motivation.

So much seemed to go right for me this week:

• Monday - Rest 
• Tuesday - 4.6 miles to get to 700 for the year (200 miles over my original goal!)
• Wednesday - 3.1 miles to start the year off right.
• Thursday - 6 miles on my hilly route
• Friday - Rest 
• Saturday - 14 mile freaking cold long run
• Sunday - 2.5 shakeout miles on treadmill to hit my first 30 mile week. 1hr yoga class.

Total miles: 30.2

I am not really following a set training plan for this marathon. I know I want to run 4-5 times per week. I have my running group's long run schedule which I will start following once the weekly group runs hit 12ish miles. Until then I want to keep my long runs between 10-12 miles. During the week I want to run one run where I push my speed, one mid-distance hilly run and one or two short easy runs. Somewhere in there I will try to be more diligent about core work and cross/weight training.

This week was one of my first weeks running 5 days and my very first week hitting the 30 mile mark. I didn't set out to run my highest mileage week ever but between not having work this week and feeling great while running it just happened that way.

I am trying to be relaxed about the whole thing. My race pace is not too challenging for me since my goal is to finish this race healthy and happy. My "speedy" runs are based more on effort than actual numbers. Mostly I am experimenting with adding more running days to my week and running higher weekly mileages.

This week, everything seemed to go well. I ran in my neighborhood for the first time in a really long time and was able to crush 3 different hills that I used to have to walk up. I love seeing progress like that. My 6 mile run on my hilly trail also went really well.  I am starting to feel really strong on a couple of the steeper hills that traditionally give me trouble. My splits for the 6 miles were pretty even. Slow for me for sure, but usually they all over the place because of a few steep hills.

My long run was supposed to be 12 miles - 8 with my running group than 4 more miles afterwards. A couple of other people from my group were heading out for 6 more and told me that the particular trail was not a great place for solo runners. I was (easily) convinced to tack on the extra miles and ended up having a fantastic negative split run, despite the freezing temps.

Bare, frozen wetlands on my long run. I miss the color
green and temps that don't start with the number 1.

Mostly likely I won't see another 30-something week for a couple more weeks, but I really had some fun this week. My confidence is definitely high right now!

RNR Raleigh Training: Weeks 2 & 3

These past two weeks have been a whirlwind of Christmas, road trips and running.

My devil elf.

Week 2: This was a crazy week between work and the kids' holiday events at school. The result in terms of running was nothing very impressive, just some more base building. A last minute trip to South Carolina cut out a 4th day of running for the week. But snuggles with my 7 week old nephew made up for it.

• Wednesday: 3.1 mile progression run with strides on the treadmill at the gym. Rush home so the hubs could get to work early
• Thursday: 5 miles on my go-to trail for hill training. Pretty chilly, but nice to be outside
• Sunday: 10 miles in South Carolina

Total miles: 18.1

We drove to South Carolina on a whim to visit my husband's sister and her 7 week old baby. I was able to find a rail trail in Greenville, which I was pretty excited about. I figured a rail trail would be a perfect place to run my long miles and not get lost. Famous last words. The first three miles wove through the downtown area with quite a few twists and turns. The trail was usually clearly marked, but there were times where I made a wrong turn, stopped and stared for a while before finding my way. When I was finally out of downtown the trail straightened out but I was almost immediately halted by a freight train stopped across the the trail. I waited for a while trying to figure out a way around and almost gave up and headed back when it finally started moving.  Just as I turned around at 5 miles the skies opened up and I spent the rest of the run in a torrential downpour with no rain gear. It was quite the experience, but I was grateful for the new scenery.

 

Week 3: Finally my schedule allowed me to add a 4th day of running to the mix, even with our second road trip within a week. 

• Tuesday: 3 treadmill miles
• Thursday: 6 miles on hills. This was a great run for me because it was the first time I made it all the way around a challenging 3 mile loop twice. It's been a goal of mine for a while now but I always manage to talk myself out of it.
• Saturday: 11 miles through Lancaster County, PA. This was definitely one of my favorite runs in recent memory. It was sunny, yet chilly and the scenery was just amazing.
• Sunday: 3 easy treadmill miles at the hotel

Total miles: 23