Friday, June 2, 2017

Morphing.

Much of my inspiration to write comes when I'm out on a long run. Somewhere along the banks of the Charles River or amid the hills of Somerville, my body finds a rhythm and my brain slows down enough for thoughts to flow with far less judgment and self consciousness.

Which, perhaps, is part of the reason why nearly three months have passed since I've written a blog post. That little injury I picked up on an ill planned long run in January? It snowballed into a four months, and counting, string of rehabilitation exercises, MRIs, injections, adjustments, massages, scraping, dry needling, cupping, and wallowing. A nasty IT band injury reared its head along with the lumbar herniation and sciatica screaming down my leg. There have been ups and downs in the process of healing, but not a whole lot of running.

Instead of racing through the winter and spring as I planned, I gave up my race bibs and cheered from the sideline. The transition from participant to spectator proved to be both challenging and rewarding.

(That's Meb running the Boston Marathon)

BP crushing Boston Marathon


Steph finishing strong at Newburyport River Half Marathon
Three half marathoners
I've balked at doctors who recommended drugs to ease my pain. When a spine specialist confirmed via MRI that a herniated disc in my low back was responsible for the radiating throb, stabbing sensations, stinging, burning, and cramping down my left leg, I reluctantly agreed to an epidural steroid injection because I hoped it might allow me to sleep more than two hours per night. It did not work. It did confirm my opinion that a traditional medical approach of a belly full of pain pills and a body full of steroids is not for me. Instead, I've become rather adventurous when it comes to experimenting on my body with alternative treatment approaches.

Here's a sampling of the methods of rehabilitative torture I've dabbled in:

I've seen three physical therapists. The first was not a good personality match for me. He admitted to being an anti-runner. The second was a better fit, but our hours didn't line up and he prescribed the same clamshells and hip lifts I've been doing routinely for years. Then, my mother-in-law urged me to make a trip out to Hopkinton to see the physical therapist who'd helped treat her injuries. It was a long hike down the Mass Pike to get to her, but Kim gave me the Ah ha! I needed. "You're plenty strong," she explained, "but your hips, glutes and IT band are seriously tight." Strengthening to correct imbalance would be important, but she wanted me to first focus on targeted, sustained stretching after exercise to help things loosen up. So I stretched and stretched. Every day. Within a week, my poor, lopsided pelvis felt decidedly less crooked and the constant sensation of tightness was slowly easing.

Duncan supervises stretching time
A chiropractor has been scraping my low back, butt, and leg with a variety of metal spatulas using the Graston Technique, a self described "form of instrument-assisted soft tissue mobilization that enable clinicians to detect and effectively break down scar tissue and fascial restrictions". It's felt modestly effective and mildly medieval.

Image result for graston technique


Every three weeks or so, Liv, the amazing yoga teacher and orthopedic massage therapist has been using her magical hands to work out the tight junk and helping my body get more relaxed and evened out. In our most recent appointment, we gave cupping a try on my IT band. This therapy/experiment involved placing glass jars on the skin of my left upper leg. Using a handheld pump, Liv suctioned the air out of the jars to create a vacuum, drawing underlying tissue partway into the cup. The idea is that this works like the inverse of massage. Rather than putting pressure on the muscles to urge release, the suction pressure lifts the tissue upward, theoretically allowing for enhanced circulation in areas that are gummed up. It looked gnarly (warning, gross picture below) and left me with some epic leg hickeys. But it felt pretty good.



A physician specializing in Physical Medicine & Rehabilitation (PM&R) has been using trigger point dry needling on my wickedly tight glutes, outer hip, quad, and calf. Dry needling is a treatment for myofascial trigger points where fine needles are used to mechanically stimulate the trigger point, creating a local twitch response (LTR) within the muscle fiber. The idea is that the LTR sends a message to the spinal cord to let go of gripping and tightness in a muscle. Although evidence of efficacy in research is modest, this is the intervention to which my perception of relief and responsiveness has been the strongest. It is painful and intimidating at first, but when I feel the muscles twitch and fire there is a strong and real sensation of release. Dr. Bailey has been the most amazingly patient, thoughtful, and holistic physician I've ever worked with. If you're in the Cambridge area and are struggling with myofascial pain or a sports injury, Dr. Bailey may be able to help you too. I wish I had a picture, but I was distracted by my quivering calves and forgot.

Amid my parade in and out of the treatment rooms and medical offices, I've reluctantly decided to acknowledge that my body is asking (yelling) for some change in my approach to endurance training. So I signed up for swimming lessons.


And bought a new grown up bike. It feels fast!


I've had a lot more time to experiment with strength and endurance training mashups. In the early injury stage, I felt so lost without my runner's high that I sought out the highest intensity forms of cardio strength training I could find. This pseudo CrossFit approach to training certainly got my blood pumping and my muscles tired. Lifting heavy stuff while breathless is exhilarating, but I quickly learned that this approach should probably be delivered in modest doses if I want to prevent myself from even further injury and recover between workouts. So I'm balancing out with more traditional resistance training and lots of stabilizing exercises.


video


These days, I'm spending more time on prehab and rehab exercises than I am on any sort of competition specific training. It's hours of foam rolling and stretching and stabilization and strengthening and balance and postural alignment and ice and sometimes just plain resting. That's the hardest part. I'm learning to be patient.

I am striving to make peace with my body, not to try to force it or control it or cajole it. I recently listened to Tina Muir's podcast interview with Amelia Boone. Amelia is an obstacle racing phenom, but she also happens to be right around my age and lives a human woman's life with a full time job. She spoke about her experiences facing serious injury.

"It's not about getting back to yourself," she said...
"To try and return to a previous version of yourself is ludicrous, so I tell myself to give myself permission to morph into a new kind of athlete."

The inspiration to write this post came to me on my first 10 mile run since January. It was slow and it wasn't easy. I'm not the same runner I was before, and I give myself permission to morph into a new kind of athlete.

Stay Tuned.

Saturday, March 11, 2017

Injury, Identity, Perspective


Forgive me. It's been a while. While winter in Boston has marched on, I've been busy wallowing in self-pity.

42 days with no running.

A lumbar herniation aggravated by a series of foolish decisions left me with agonizing sciatic pain in my left leg. I've grown pretty accustomed to my body doing what I tell it to do. Suddenly, it simply could not. I clung to the railing and winced my way up the stairs at work. I couldn't walk to the grocery store. I couldn't sit or sleep. I realized how completely I take good health for granted and began to imagine that constant pain was simply my new normal.

And the 42 days of no running.

Hyperbole and a Half

Running is my release. Running is a routine that grounds me. Running is a habit that gives me a sense of control when life feels turbulent. Apparently, Running is also a part of my identity to which my self-esteem is deeply tied.


In the first weeks after injury, I thought I was coping pretty well. In spite of feeling like a caged animal, I was trying hard to maintain a positive attitude. After all, this injury was not life-threatening and unlikely permanent. Just a small blip in the history of my active life.

I pedaled home from the grocery store on my bicycle one Wednesday evening in February with pain radiating up and down my spine and my left leg throbbing. My sister, husband, and friends were out together at a group run. I walked in my door, dropped my backpack and crumpled to the floor to find a position that provided some relief from pain. Before I knew what was happening, tears streamed down my cheeks. I gasped for air and wiped snot from my nose, feeling completely foolish and very much alone.

I found myself wishing for bad weather. If I couldn't run, I wanted everyone who could to feel miserable doing it. I sneered in contempt at carefree runners.


I felt guilty and embarrassed to admit that I was struggling. When I held up running next to the legitimate challenges so many people experience every day -- loss of a loved one, financial hardship, serious injury, homelessness, lack of access to healthcare or education, the list goes on -- my situation seemed trivial. But, trivial or not, I experienced this blow to my identity in a very real way.

On a Saturday morning when I typically would have gone for a cathartic long run outside, I instead hauled a water cooler, Gatorade, and snacks into the back of my sister's car on our way to set up a makeshift aid station along the Boston Marathon course. Carly works for Best Buddies, a nonprofit organization creating opportunities for one-to-one friendships, integrated employment and leadership development for people with intellectual and developmental disabilities. On this morning, it was Best Buddies' turn to host aid stations for Boston Marathon charity runners on their long training run. Carly recruited me to join her in volunteering. I poorly masked my jealousy as we set our table up at the run turnaround point on Beacon Street.



Runners began to approach our station, stopping to chat as they snacked on pretzels and refilled their water bottles. Many expressed relief when I announced that this was the point where they could turn around and run home. All all expressed gratitude for our support. The perspective from this side of the water table was surprisingly satisfying, and it filled me with appreciation. I thought of the many folks who've given up their weekend mornings to hand me a cup of water, point me around a turn on a race course, or yell for me from the sidelines. It was the least I could do to return the favor this one time.

I went for my first post-injury run one week ago. I'm cautiously optimistic, but it's going to be a slow return. It will probably have setbacks. I am grateful for my body, for my good health, and for my ability to take care of myself. I am going to be fine.

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