As I’ve posted before, in April of last year I developed a stress fracture in my right sacral ala. While I returned from that injury and ran a successful fall racing season, I had some residual discomfort in my right hip. During the fall, this discomfort would arise whenever I would complete a long run, but would otherwise dissipate with rest and recovery. Both my doctor and physical therapist suspected it was muscle tightness due to my time on crutches, and neither expressed much concern or thought I should not run. They suggested foam-rolling and stretching, which I did after most of my runs and on recovery days.
However, the discomfort amplified when I returned to training this past December. Whenever I would run for more than an hour or an hour and a half, my right leg would begin to feel as if it had run for over two hours, while my left leg felt as if I had not run at all. I reduced my weekly mileage to no avail, but also felt that the imbalance in soreness between my right and left legs, while annoying, did not rise to the level of an impending injury. So, I kept running. I upped my mileage to 50 miles per week, and then 60. I ran a number of NP_NYC PR days faster than ever. My aerobic fitness improved, and my aerobic pace decreased accordingly. All in all, a lot of good things!
But, the imbalance continued, and the discomfort, although low-grade, nagged me a bit more even when not running. I stretched more thoroughly and more often. I foam-rolled like a pro. I worked on this breathing technique that allegedly lessens the impact on each leg while running. Through hill work and leg speed drills, I increased my running cadence from around 175-180 steps per minute to 192 steps per minute, theoretically creating less pounding impact on the body. I rethought how I was tying my laces, which temporarily alleviated some, but not all, discomfort. I dutifully performed my squats and core-strengthening exercises (not just for abs, but for the hip flexors and IT band as well) in an effort to strengthen the muscles and decrease the likelihood of injury.
In other words, I felt as if I had done everything within my power to address this issue, short of hanging up my sneakers or seeing the doctor. Unfortunately (or, rather, fortunately), my body just kept telling me that I could not figure this issue out on my own, and after being sidelined for almost three months last year, I figured that I’d listen this time. So, I went to the doctor this morning.
The verdict? My right hip flexor, piriformis, and the top of my right IT band are tight and inflamed. This tightness and inflammation is causing the discomfort I’m experiencing both during and after running.
Why has this been happening? Not entirely sure, but it’s likely residual from the rehab I did after my stress fracture. For whatever reason, despite stretching and working to prevent injury, these muscles and fascia just don’t want to loosen up. Thus, even when I decreased my mileage and increased my other injury-prevention work, that tightness and inflammation did not improve. If anything, working and stretching those muscles in an aggressive manner probably made them worse.
The treatment? Two weeks of no running, but swimming and cycling are OK. One week of anti-inflammatory medication, and 3-4 weeks of physical therapy with lots of point pressure to target the inflamed areas. As my doc said, this PT is going to be painful, but worth it. After that, I’ll return to running on the treadmill, and build up my weekly mileage from there. My doc does not believe that the treatment will take me out of my spring marathon, the Inaugural Queens Marathon, so that’s good.
My feelings on the matter? I’m not that upset, actually. It’s frustrating to have to change my Queens Marathon training plan, but that’s the thing: I have to change the plan, not nix it entirely. I can still train. That’s huge.
It’s hard to stop running when your injury doesn’t actually prevent you from running. When I developed my stress fracture, I could not walk without pain. This time around, however, I would rate the discomfort as, at its worst, a 3 out of 10. Because the discomfort is generally pretty low, I’ve been running hundreds of miles a month and recovering well enough to keep going. In fact, I ran about 8 miles this morning with NP_NYC before going to my appointment, and felt OK overall afterward. But I get it: Having a low-grade, nagging sensation after running means that something’s not right, and if you’ve tried to fix the problem on your own to no avail, get it checked out by a professional, no matter how minor the issue seems to be.
In a sense, though, I’m excited. My left leg seems to absorb running without getting beat up at all. If this inflammation and tightness in my right hip is really just a residual issue from my stress fracture, and this round of drugs and physical therapy irons it out, then I can hopefully return to running on two healthy, tough legs that are adept at absorbing the impact of running. Running pain-free is always a plus.
And that’s the real thing I’m excited about: not being preoccupied about how my body will feel during a run. I love running. I really do. I like the physical workout and the challenge of a goal race. I like the fact that the clock provides an objective measure for my training and performance. I like the meditative nature of the act of running, and how the noise in my head ceases for the time I’m in motion. What I don’t like, however, is worrying about whether I’m doing permanent damage to my body while engaging in an activity I love so much. So, if I have to take a couple weeks off to move past a physical issue, which will allow my mind and body to run freer, then I’m happy to oblige. Life is good and I have no reason not to maintain a positive attitude.
Also, a shout-out to my doc, Chris Allison, RPA-C (registered physician assistant – certified), of Orthology (formerly NYSportsMed). Chris is a great guy who really cares about his patients. He’s one of the only docs I’ve ever had who actually listens to my complaint, understands the human element of medicine, and answers my questions no matter how trivial. If you are in the NYC area and develop any sports-related injuries, I would highly recommend Chris and his colleagues.
Happy running, everyone!