Tag Archives: Overuse Injury

Jinx!

I should’ve known posting an Instagram picture saying “I’m back!” and writing a post about how I was finally at a good place with running would come back to bite me. That’s just how my luck goes (and often why I try to keep quiet on things for fear of jinxing myself).

If you follow me on social media, then you already know that I’ve been out with a (likely) femoral shaft stress reaction for just under three weeks. It all started on March 10th. I ran 11 miles after work on the 9th and felt fine. Went for a run on the 10th and also felt fine during… but as soon as I stopped I felt a weird sensation on the side of my right thigh. I chalked it up to tightness, took Friday off, and ran 11 miles on Saturday without issue. I carried on the following week pretty normally with some unspecified discomfort in my leg; I was never really able to pinpoint it, and it didn’t hurt enough for me to alter my gait or have to stop. I felt discomfort up more towards my hip at the end of the week, so I foam rolled and massaged myself to the point that I was bruised. I ran a 5k that Saturday and was fine.  Again, there was something there, but I couldn’t quite put my finger on it.

I went for a run on Sunday and it was pretty uncomfortable, but I wasn’t sure if that was because I raced the day before. So I took Monday off, and did a speed workout on Tuesday. It still felt off, so I immediately started to panic. I decided to stop running (this was March 22nd), Googled non-stop for two days, tried poking and prodding to find the source of the discomfort, but I came up empty handed. Panicked, I called my doctor at the Women’s Sports Medicine Office at the Hospital for Special Surgery, and got an appointment to see her the following Monday (3/28). I had x-rays and talked to her… and nothing showed up on the x-ray (no surprise), so she ordered an MRI. She said it was possible it was a stress fracture, but it could also just be a deep muscle strain. The pain wasn’t in my hip (so we ruled out femoral neck or labrum issues), which actually put me at a slight advantage. I had my MRI that Wednesday, and then went back to the doctor to review my results on Friday.

We looked at the MRI together, as I pretended to have any clue as to what I was seeing on the screen as she scrolled to zoom in and zoom out. I’ve been through the “OMG I HAVE A STRESS FRACTURE” panic so may times before, and each time the results have been in my favor. This time, though, I wasn’t so lucky (but wasn’t completely unlucky, either). She said there was a little something that didn’t look quite right, but it wasn’t a fracture line, either. Both the MRI technician and my doctor had the same diagnosis — it was likely a stress reaction and even if it wasn’t, it should be treated as such. Whomp, whomp.

While I was disappointed to hear the diagnosis, I was also relieved. It meant that the discomfort I was feeling had an actual cause. More importantly, it meant I could put a plan in place to heal and get myself back to running again. Since I caught it early, my doctor ordered no running or high impact activity for three weeks. After that, she said I could try a run, doing a run-walk method to see if I had any discomfort during or after. At the time of my diagnosis, I had already been off my feet for a week and a half… in fact, I hadn’t done any physical activity since March 22nd (and was starting to go crazy). I was so thankful to have the green-light for other activities mostly for my sanity, but also so I could attempt to maintain some of the fitness I had finally started to gain back after my last running hiatus. Since my diagnosis on April 1st, I’ve taken three spin classes, swam once, did hot yoga once, and returned to Refine Method over the weekend. I also did a few at-home workouts focusing on my core and glutes, which always need work. And as of today, I only have two more weeks of no running before I can give it a try… which really isn’t that bad!

I’m really thankful that I was smart and stopped running as soon as things really started to feel off. I’m thankful that I have a lot of other workout options easily available to me. And I’m thankful this was only a stress reaction and not a stress fracture. While it’s troublesome that I wound up with this injury — I had blood work done this past weekend to see if there’s anything I can do with my nutrition to help, since the femur is such a big and strong bone — it isn’t a nail in the coffin for me. I am confident I’ll be able to run my fall marathons.

Onward an upward!

 

Tell me…
Have you ever had a stress fracture? Reaction?

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Running Update: Physical Therapy & Massage

Last time I mentioned running on the blog I wasn’t running, but rather cross-training a lot. I figured an update was due even though much hasn’t changed.

For those of you that don’t remember, I first noticed some weird IT band tightness and aching on the outside of my left knee in the middle of October. I thought I was being smart about it and skipped a few runs, foam rolled and tried to do as much at-home strength work as I could, and crossed my fingers and toes. Unfortunately that wasn’t enough and by the end of October I had full-blown ITBS. I had to drop out of the Philadelphia Marathon, but assumed I would be back to running by the end of November at the latest. Well, here it is the end of December and I’m still not really running.

The funny (and frustrating) thing about this injury is that it doesn’t hurt unless I’m running. I can walk miles and have no issues, go to Refine Method, take a spinning or yoga class, and feel fine. But previously, if I went for a run, I’d start to feel discomfort that turns into pain anywhere between miles 2 and 4 (when it starts to hurt is random – depends on the day!). So as you can imagine, I’ve been doing everything but running. It stinks that I haven’t been able to run, but I’m thankful that I have access to so many different kinds of cross-training to help keep me sane. And it doesn’t hurt that I’m already seeing results from my Refine Method classes!

My cross-training best friends

My cross-training best friends

When I realized a few weeks ago that the ITBS wasn’t going to go away on its own I decided to visit a Physical Therapist. The first visit was an assessment where she had me do lots of walking, random movements, and basic strength tests. It was determined that my IT band and hamstrings weren’t actually that tight, but that the general area was tight and weak…. including a weak butt and core. I was given instructions to continue my at-home strength work (clam shell variations, leg lifts, etc.) and to come back for some manual massaging, stretching, and Graston. I also made an appointment for (and had) my first ever massage.

Originally I had dismissed the idea of going to Physical Therapy. I assumed they would just tell me to keep doing the exercises I’ve been doing without much else. It hadn’t even crossed my mind that they would be able to do manual massage and some myofascial release, which could be a huge help considering the injury I have. So when I went for my second appointment and she took out what resembled Medieval torture devices, I knew things were about to get serious (and painful). I’ve heard horror stories about how painful Graston is during as well as after, and I’ve seen pictures of some gnarly bruising. I don’t know if I just have a high tolerance for pain or my PT was just being gentle, but it really wasn’t that bad.  Sure, it was uncomfortable, but it wasn’t painful at any point. What I found most interesting was when she’d be working on one area, and another would hurt… goes to show it really is all connected!

Graston - torture tools

Graston – torture tools

I’ve had two more Graston and massage sessions since then (the second included some serious knot removal from my glutes), and as I mentioned earlier, I got my first-ever deep tissue massage on Sunday. Now if we want to talk about something that was simultaneously relaxing and painful, that would be it. Since it was my first massage and I’ve been dealing with injury, I splurged and went with 80 minutes versus 50… and it was worth every penny. She spent plenty of time with my legs and glutes, and on top of feeling relaxed when I left, I felt as though my legs were ready to run. So, that’s exactly what I did. On Monday during lunch I decided to go for my first run since December 1st (with only 3 runs before that in November).

I ran two pain-free miles! It wasn’t fast, it felt kind of awkward, and I spent the whole time worrying and waiting for that twinge of pain to start outside my left knee, but it never did. I had a slight ache outside my right knee for a moment (before being stopped at a light), but I’m hopefully that was just getting the cobwebs out. I’m hoping this is finally the end of my ITBS drama (it’s been 2 whole months!). I’m going to start out slowly and work my way back to regular running at a much slower pace than I have before, and I’m going to keep up with my strength work and cross-training… something I always say I’m going to do, but never fully follow through with. I’ve decided that 2015 is the year I become the strongest I’ve ever been. I need to invest in myself and my fitness (both running and just overall). I’m excited to see where it takes me. #GetStrong2015

Tell me…
Have you ever had a sports massage? Love it? Hate it?

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Running Update: Setbacks & Moving Forward

Running was going really well for me during the late fall and early winter. I PR’d two races (5 miler and 5k) and was crushing workouts and loving the run. I was running 6 days in a row with a long run, a tempo/workout run, and 4 “easier” days of running all together. It was a big adjustment to the type of “training” I’ve done in the past, but it was already producing results, and I felt great. I was being diligent about my pre-run warm-ups, and was actually doing post-run prehab, albeit not as frequently as I should have. I let time get in the way of things, and found myself coming in from a run, hopping right in the shower or getting started on dinner, and then going about my business and forgetting to do the routine that was scheduled. Well, that naturally resulted in a little bit of an overuse injury – dreaded ITBS.

I noticed a twinge when I would go from sitting down to standing up after a 10 mile run on December 21st. I didn’t think much of it, and continued the next week as normally scheduled. Looking back, I should have spent some extra time foam rolling and doing some strength work, but I didn’t. By the time I got to Christmas Eve, as I finished up an epic tempo run, I felt that dreaded tightness on the outside of my right knee. It’s a feeling I know all too well, as I’ve experienced it during almost every marathon I’ve run around mile 21. It wasn’t painful, but I knew exactly what it was. Since it was slight, I was hopeful that it wasn’t much of anything, and Christmas morning’s 4 mile run would be fine. Unfortunately, I was wrong.

Yes this is what I wore when I ran Christmas morning.

Yes this is what I wore when I ran Christmas morning.

Christmas morning’s run was painful, and I knew the ITBS I thought I had was, in fact, ITBS… and that it wasn’t going to just go away. The run on 12/25 was the beginning of a month of on and off runs, most peppered with knee pain. The pain would start about a mile and a half in, and come and go depending on my stride. Sometimes it was brutally painful, and other times it was manageable. But I’m happy to report that after a month of rest and rehab, I’m back on the streets and running! I think it’s so important for runners to take the time to do a warm-up before they start a run, and to also do some type of post-run prehab routine. There are a few things in particular that I found to be extremely helpful as I battled ITBS, and I wanted to share them with you!

  •  Strength Running’s ITB Rehab Routine – If there’s one thing I’ve learned with the injuries I’ve sustained over my short running career so far, it’s that having strong hips, glutes, and core can be the difference between pain free and fast running, and sitting on the couch whining about how you can’t run. This routine focuses on strengthening the glutes and hips, which is where the ITB starts. All you need is a resistance band and about 5 minutes post-run. I did this daily during the month of January, and now do it 2-3 times a week.
  • Mrtyl Routine – This also focuses on the general glute and hip area, and doesn’t require any equipment. I also do this about 2 times a week.
  • Core work: Strength Running’s Standard Core Routine & Dr. Lesko’s Dozen Routine – Let me tell you, having a flat stomach does not mean you have a strong core (not that my stomach is flat). I always thought my core was decent, since I swam for so many years and a lot of power comes from your core, but I’m learning that is not true. Both of these routines are more than just crunches, and they work your entire core. The supine leg lifts in the Standard Core routine are killer, and I dread that part of the workout every single time… but I know they help, and I’m looking forward to the day where I can get through it without shaking uncontrollably and not counting down every second of the minute.
  • Foam Rolling – it’s awkward and it hurts, but it works. I don’t particularly enjoy it, and for awhile, I just didn’t do it. I bought a foam roller about 2 years ago when I had tight hips, but I just couldn’t get into a regular routine. I learned quickly, though, that the foam roller is really helpful – whether you have an injury or not. I try to spend about 5 minutes everyday foam rolling my hips, hamstrings, quads, and calves. If nothing else, it helps build my upper body strength as I’m trying to hold myself up while using the roller.

I’ve been running again consistently for two full weeks and am just starting my third. I have my fingers crossed that this little bout of ITBS is behind me, and I can carry on with training as scheduled for the month of February. How do I feel about finally being back in action? See below.

Hooray for pain free running!

Hooray for pain free running!

That being said, I don’t think the Shamrock Half Marathon in Virginia Beach on March 16th is going to be a PR attempt. Unless training over the next few weeks goes fantastically (and it warms up and stops snowing and being icy), I don’t think I’ll have my fitness back up to where it was in December. So, my plan is to run the Shamrock Half as a workout, and run a goal half in April instead. There are quite a few around me, so after weighing my options and chatting with my coach, I decided on the Asbury Park Half on 4/26! This is the day before the New Jersey Marathon, so I’ll be able to cheer for everyone running the half or full on Sunday! Since it’s down the shore it should be relatively flat – I just hope it isn’t a windy day. I’m also planning to work a few other short local races into my schedule, but I haven’t committed to anything yet (as you can see from my Races page).

Tell me…
Have you ever dealt with ITBS? 
What’s your favorite runner specific strength routine?

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