Monday, February 27, 2012

Triple Threat

I received my MRI results last week and apparently I have a trio of issues.  (Irony again, since I love to do TRIathlons!)  I only had a chance to speak to the doc over the phone, but I am scheduling a time to go into his office and have him walk me through the MRI.  I may also have an Orthopedic take a look and get a 2nd opition (the doc actually recommended this).  So, here's the down low:

Issue #1
I have a stress reaction on my right proximal femur.

In plain English – A stress reaction is often the precursor to a stress fracture. I am thankful that I did not stupidly attempt to tough it out at the Houston Marathon and run 26.2 miles!  The femur is the bone in the upper part of your leg.  Proximal means the part of a structure that is closest to the trunk of the body.

Keep in mind, I am not a Dr...nor do I play one on TV.  However, based on my discussion with the doc, my stress reaction is somewhere in the green circle at the top of the femur near where it connects to the pelvis.

Issue #2
I have a low-grade strain/tear on my iliopsoas tendon at its trochanteric insertion.

In plain English - Apparently, this is something found in long distance runners (hello, marathon?). I found this study to be pretty interesting. It talks about how this type of tear and stress reactions often occur together. It also mentions that there is reduced shielding of the bone due to muscle fatigue, which leads to more load transmission to the bone, exposing the femoral neck to injury during running. I also read an article mentioning that working on the core can cause the psoas to shorten, which can lead to injury.  Darn that Ab Ripper X! Moral of the story here – if you’re working on your six-pack, you’ve gotta stretch that psoas, too!

This lovely group of muscles is the iliopsoas.  It is formed by a combination of 3 muscles - the psoas major, psoas minor and the iliacus.  Again, the green circle shows where I have issues.
Issue #3
I have a partial articular surface tear on my anterior labrum (i.e. a labral tear).

In plain English - First of all, the labrum is a type of cartilage that surrounds the socket of the hip (and it’s in your shoulder, too). The labrum forms a ring about the edge of the bony socket of the joint and helps provide stability to the joint and holds the femur (leg bone) in place. Overuse and structural issues often lead to a labral tear.

Meet the Labrum...I never knew I had this, much less that it could tear!

What does this mean for training?
Fortunately, none of these issues are serious enough to require surgery.  But, these areas need rest.  The doc recommends absolutely no running, aqua jogging, elliptical, swimming, biking, spinning, etc. for 6 - 8 weeks. He said that he realizes that I will probably want to do something during this time (duh!), so I can work on upper body and core. However, I have to be careful not to do anything that causes me to flex the hip. So yes, this means that all those strengthening exercises and stretches that were originally prescribed (that I did for 6 weeks!) were probably not helping (and may have been hindering the healing process or hurting the area more).  Thank God Dr. Chiro (#2) told me to stop them!

As soon as I can begin working out the lower half of my body, I will need to work on strengthening my glutes…apparently, this helps support the hip area and my glutes aren’t nearly as strong as they need to be. And, I need to have a gait analysis to be sure that I am not running in a way that puts more pressure on my hips than it should. I may be able to attempt some aqua walking in 2-3 weeks. At 6 weeks, I may be able to aqua jog. The doc said that when I do begin running again, that I should take it very slowly when building up the mileage and that I might be able to also add in some biking.

So that’s it folks – I am soooo happy that I didn’t sign-up for this weekend’s ½ marathon. I signed up for the 5k a few weeks ago thinking that I’d be well enough to at least do that. But, even walking it would probably not be wise. I may volunteer at the race instead, as long as I can see the Hubs finish his ½!

On one hand, I am so happy to finally know WHY my hip was still hurting. After nine weeks, a missed marathon (and upcoming 1/2 marathon and 70.3), 3 guessing doctors, several painful massages, a x-ray and an MRI...and a partridge in a pear tree...I was extremely frustrated.  But, I am thrilled to know that I do not need surgery.  I am also happy that I can now stop trying to squeeze in doctors appointments during my busy work week.  Not to mention that it was getting expensive - I was quickly depleting my HSA (thank God my company gives us money for it, plus what I've added), the gas driving to work (instead of taking the bus), paying for tolls and paying for parking ($7 when I leave for the appt and another $11 when I leave work at the end of the day)!  Not to mention lost time, since I was leaving work for an extra long lunch break, then staying later/coming in earlier to keep everything caught up!

On the other hand, after already not being able to run for the past 9 weeks (unless prescribed by the doc), I am sad to learn that I will need even MORE time off.  At the earliest, I can begin running again in late April/early May.  It's odd to think that before Christmas, I ran 18 miles...less than a month ago, I rode a spin bike for almost 2 1/2 hours (which now I know I should NOT have done)....just a little over a week ago, I swam 3,000 yds (without kicking)!  And, in a couple of months I will be starting over with no endurance in any of these.


But hopefully, after 6-8 weeks, this will be the end of these hip issues.  I will be a good girl and do what the doctor says - rest, rest and more rest.  I will be very careful when I can finally run again.  I will work on those glutes.  I will work on my gait.  I will do whatever it takes to get back to where I was!

Oh, and just in case you have future injuries...if you suspect that you have more than just a muscle strain or tendinitis, ASK FOR A MRI!!!  I kept reading stories about how people wasted 2+ months stretching or going to PT, only to finally get a MRI and find out they had a stress fracture or a tear.  I SWORE in December that I would NOT be one of those people, but yet here I am.  I suspected it was more, but I guess I refused to believe it.  My condition had improved so much since December, I guess I was hoping the Dr was right.  I might have been halfway healed by now if I had demanded a MRI in January.  It's your body and you have the right to ask for tests that may give more definitive answers.  I've certainly learned my lesson! 


denee is gluten free said...

yuck-o. i am very glad you found out what is going on, though! 6-8 weeks is not that long of a time in the grand scheme of things.

Lisa said...

So glad you found out the REAL story with the injury.

{lifeasa}RunningMom said...

Yes, unfortunately we do have to demand treatment since we know our bodies best.

Ironically, I am going through a positive life changing moment and wish I would have more actively demanded my issues years ago with doctors. It would have made a huge difference in my life earlier but I am happy I am now back on course. I may need to blog about it one day when I am ready to share more. But right now, demand proper treatment and different treatment if your heart and soul tells you to.

K said...

Hi Christy,
I had a hip stress fracture caused by a tight psoas a few years ago. It was very painful and I ended up having to take off 4 months of training.
Things I changed since then...
1. Yoga. 1X/week. NOT P90X Yoga
2. Run/walk method of running
3. No track speed work.
I hope that you get some relief soon. I do believe that stretching and rest are the best course at this point. As soon as things heal, you will be stronger than ever.

Robin said...

Do what the doctors order and you'll be back to running before you know. Your health is way more important.

Stephanie said...

Oh bummer!

I'm glad that now you know what's going on with your body. I find the worst is not knowing.

Chin-up - you'll be back out there in no time - just in time for the Texas summer. :)

Swim Bike Mom said...

Guess you and I are on the DL for a bit! I have a labral tear too in addition to the broken foot. Ugh! Rest up!!

Laura said...

I'm glad you finally have some clear answers!! Too bad it's not exactly the treatment plan you would have chosen, but a little rest is very doable. I've never heard the ab-hip connection before, makes me nervous. How does one stretch the psoas? Might have to look that up! :)

Teamarcia said...

Wow. Wow. Wow. Finally the answers. I'm sorry to read this but I so admire your attitude toward it all. I know people who've had all the same afflictions. And they came back stronger than before. You will too. It seems like a ton of downtime but you know how time flies.
Theres a silver lining in everything. I know you'll make the best of this.
The MRI is great advice. Live and learn.
Hugs girl!

Tara said...

OMG, this sounds like an absolute nightmare, thank goodness you discovered the issues before they got any worse. I have hip/glute issues too, so I can definitely sympathize. Sigh, I hate doing strength work and stretching, but I have made it a point to incorporate it into my workouts. Hang in there and keep us posted.

Donna said...

Oh man... glad you got some answers! You'll be back in your running shoes in no time. Keep your chin up!