Rabbit's epic healing thread ;-) (feel free to ignore)

[alpinerabbit]

You asked for it - ok, where do I start.

Edit: P.S. - Wahine/Yoda had to listen to much of this via pm. I just wanted to give her the credit she deserves.

2004 when I started running? 15-20 minutes - I was depressed. Doc said it would do me good and I was proud of myself :)
2005 when I started cycling? EO 2006 I managed running 10K.
2007 - the spring I ran 15, 18 km a couple times? when that spot on my iliac crest started aching? It got better but never went away again.
The fall, when I took up the actual 10K training plan from my new tri club? - what with speed work on the track and such, suddenly my anterior shin muscle was hot and hurt a little. I iced, I laid off running. I had it massaged a couple times by a PT. Since then I know I have trigger points.
Shin muscle keeps "pinpricking". But lucky it's not shin splints per se. I went to an orthopedist to get an analysis. Of course I overpronate and have dropped arches, so got custom orthotics.

Early 08 - Started back on running, baby steps, shin muscle keeps acting up.
Spring 08 - at a running clinic, I discover a midfoot technique that helps with the shin. It also took 20 sec of my kilometer time.
I had a "second opinion" video gait analysis, tweaked something on the orthotics. But the technique change helped more.

2008 I ran a 5K, two sprint tris, and an oly on minimal training (2 times/week on average). I also cycled around 5000K.
After the late August Oly, total layoff from running until EO October. I thought that would really let me recover.

In the meantime I did Yoga twice/week where I discovered a massage ball technique to treat my trigger points on my own as best I could.
Since then, I ran maybe 6 times, 5-7km. The shin is now quiet, but attachment points at the front and back of knee, at the hip - that old spot at the iliac crest - keep aching.

So finally off to the sports doc who examined me, finding a load of stiff, tightened muscles - in spite of yoga - quads, psoas, butt, shins - mediocre flexibility and a weak core.
And i had been working on the core the past 3 months in Yoga :D

She sent me off to physical therapy which I will start next week, twice a week. Manual therapy and introducing me to more core work.
The good news is that she said it's no true inflammation, so my worries about tendons degrading or weakening are calmed now, and I won't need oral or injected anti-inflammatories.
She also said this can turn into some sort of "personal training" where they even go practice on a track with me. This is a specialized sports clinic where some "real" athletes from my tri club go.

Oh and everything was always on the right leg. Which is the one where my hip is much more open&flexible (the doc said actually the other one is not open enough). She even found weaker perfomance in the right thigh (psoas I think).


Ok now for a question - what are severely hardened muscles?Like when the doc pushes around on your butt muscle and says "release your butt" - "oh, you have released?"

[Zen]

You and I have similar maladies except my weakness is on the left side.
I just wound up PT (I did improve a little) but decided I need yoga and regular massage.

Do you have any back issues that would affect your hip or gait/muscle imbalance?

[alpinerabbit]

Not that I know of, doc found nothing. She pushed around on my back and nothing hurt. She didn't say anything was asymmetrical.

I have less tightness in the back these days than I ever had, since I did yoga in my late 20s - never had lower back pain in 10+ years, sometimes the iliosacral joint locks but unlocks again.

I believe I have rather strong back muscles (love those backbends). There's a very likely imbalance.

[Jolt]

If you get any good tips for keeping trigger points from coming BACK once released, let me know. I have one (right peroneus brevis) that I thought I had gotten rid of that decided to come back a couple of days ago so now I get to work on it again...not sure if I stopped working on it too soon or what but it's annoying. The weird thing is that before the past couple of months I had NEVER had issues with trigger points (of course, I hadn't had any injuries either and then had a couple at the end of the summer). I don't have them as bad as you do, but have had a few lately.

[yellow]

Do you have any back issues that would affect your hip or gait/muscle imbalance?

Bin-go.

As I learned, just because the doc doesn't find anything wrong with your back doesn't mean it might not be contributing to the problems. If you have insurance that will cover it, consider an MRI. In my case, what I thought was a hip problem turned out to be a back problem. We wouldn't have known if it wasn't for the MRI.

Don't be shy to go back if it doesn't get better with PT (says the woman who avoids going to the doctor and generally tries to just work through stuff)!

[alpinerabbit]

I don't think I'll be willing to pay for an MRI. It would be out of pocket.

[yellow]

I don't blame you; I wouldn't pay for one either. I suspect your PT core work will hit your back, too.

I think your theory about imbalance is probably spot on. One can be very, very strong but if you have a hypermobile joint on one side (or a sticky joint, like your SI), or something tweaky with your back, or whatever, it's easy to get off kilter over time. Hang in there...I know it's frustrating!!!

[alpinerabbit]

I got a photo from the Oly in August this weekend. It shows that I still heel strike. Maybe it would look better if I wasn't tired, but I was beat on that run.

I looked at mommelisa's blog - in her IMAZ race report you can see that she has a nice "footfall" even midway through an IM marathon.

Anways. Paranoia begone - I'll jot down tomorrow what the PT said at our first "date".

[alpinerabbit]

So she's been "attacking" my major triggerpoint in my thigh for now. Hurts, but in a good way. It already seems less.
I think the asymmetrical hip thingie is mostly muscular. I can lay the "tight" leg all the way down, been playing around with that.

Unfortunately, I've been having such a tense back for a week now, like I haven't had in a few years. I'll have to ask her to do something about that first.
I hope I didn't hurt myself overdoing swimming/yoga while not able to do anything else :(, the muscles on top of my shoulderblades ache. I couldn't find a restful posture to go back to sleep at 2 a.m. in the past two nights, in desperation I dug up the leftovers of some strong painkillers I had in my medicine chest.

[eclectic]

Alpine - glad to hear things are moving along and you are doing what needs to be done.

re the painkillers in the middle of the night - just wait until you are in your 50's that is a nightly occurance :p well I guess I shouldn't speak for all mid 50 YO's but I know it is for me :(

[alpinerabbit]

Golly, Eclectic, thanks for *that* piece of info.

sooo... tuesday, PT lady suggested "why don't you go for a run and see how it goes" - nudge, nudge ;)!!

Give me credit, this was after last night's company Xmas party. I had loads of fun dancing, a few drinks and got in past midnight. I rehydrated well in the morning and hit the park for lunch - it was snowy, slushy, puddle-y, so it was slow going and a type of dexterity exercise. 35mins.

Tonight PT lady poked around some more and found that indeed, my tensor fasciae latae is affected too. I was *this* close to ITB syndrome (didn't I know that). Her elbow action left me *speechless* (youch, but good).

Back's ok again but I got frustrated in forward bends at tonight's yoga. With all the props I need I look like a car that's getting a wheel change. And it hurt right where it was so tense last week so I bailed out and just laid there and stretched the back a bit. and to be honest, cried. Must be period time.

[alpinerabbit]

Welcome to the Christmas edition: http://www.mywlm.com/downloads/displaypictures/christmas/christmas-ball-smiley.gif

So Monday I went to another therapist at the clinic who is also an osteopath, and he popped something in my right ankle, then my back and now I'm a bit scared of him.

Went for a x-mas run and am a bit sore, worked with massage balls on the TFL, butt muscles, back.
I was very good and "earned it" with core work (plank, side planks, one minute each) and the piriformis stretch they tell me to do.
I probably won't get another PT appt. before January 10th or so, so until then it is experimenting time :D! (i.e. how much can I take)
Tomorrow the pool is open again. Maybe I'll even do a double tomorrow.

[alpinerabbit]

So since Dec. 24th, I did 5 runs, between 30 and 50+ minutes (that one was interspersed with walking over a total of 1-2 hours).

I massaged and stretched a lot and I stuck with my new year's resolution of earning every single run with a session of core work and stretching - either immediately or separately.
So far I've run "pain free".

Today in the PT session she advised to keep to the ~30-40 mins until the next appt. in 2 weeks. Ok, I'll be good. My body has been teaching me lessons:
As mentioned elsewhere I made up training time with too much swimming (was bored!!) - and ended up hurting my shoulders. So this means a week off, reduced yardage, no more paddles or attempts at fly, and more stretching.

Don't know yet what to do about the back which is still very tight. I'm a glutton for massages by DBF but it's only temporary relief.

[Jolt]

For the back, maybe try sticking a tennis ball between it and a wall and rolling it around?

[alpinerabbit]

Oh, I have these special rubber massage balls to roll around on. I just discovered the sticky yoga mat can double as a roller too. I worked thighs, butt and back and it felt real good (in a painful way).

Now for the rest of my yoga session and then the core work for yesterday's run (still my new year's resolution to do core to"earn" each run)

[alpinerabbit]

Hmmm.

things have been going so-so, running steadily anything between 30-60 minutes (PT said keep at it but only mentioned 45. the 60 was once).
Still the occasional "itch" around the old spots and massaging, I get the feeling of "hot spots" in the quads.
I've been good with core work - and stretching: some poses I have really made progress from being very tight&short.

Also I hurt my shoulder swimming (i think; ah what am I saying, of course I overdid that as well.) and I am inching my way back into using it.
Back's much better.

It suddenly occurred to me that I might not be eating enough protein. So the repair functions might just be slower than they could be.
:eek: some days are almost entirely protein free. I don't want to eat the low-quality cafeteria meat and I don't want to buy lots of meat. I do buy a nice (preferably organic) steak maybe once a week.
I also want to eat as little fish as I can for ecological reasons.
But otherwise its's a bit of milk or yoghurt with cereal, a bit more milk in my coffee and maybe a joghurt for a snack.
and I should be getting 1.5 grams/kg/day... right?

So Saturday's shopping list included whey powder, and omega 3 capsules (some ladies suggested it may help against inflammation?). Still need to find a branched chain amino acid supplement.
What shocked me is that the supermarket sells 2 kinds of whey: one actually contains 85% protein, that's ok (but it contains artificial sweetener) - the other contains only 15% protein and a whopping 90% carbs!

What a ripoff!!! Good thing I read the label!

[Jolt]

Glad to hear you're improving, even if it's more slowly than you'd like. As for the protein, that makes a lot of sense as a factor that might be affecting things (and it's something I need to be better about too, probably hasn't helped my situation either). I was at Trader Joe's the other day and thought about getting some whey protein powder but I just am not sure how good it is to use something so processed, even if it's not loaded with artificial ingredients, so I think I will just try to pay more attention to eating enough high-protein whole foods. 30-60 minutes of running is pretty good; I'm not up to that yet. Partly because I haven't been running as consistently lately; I have been taking advantage of the snowfall here (we're getting more as we speak) and going snowshoeing whenever I can and I think that may end up helping because it seems to work the hip muscles that need work in my case. Skating seems to be good too and I may try to add some of that to my routine as well. If you have areas that need strengthening, is there any cross-training you can do that will help?

[michelem]

Good for you for keeping at the PT and adhering to the recommendations (I don't think that one 60 min. run qualifies as disobeying!).

There's a thread going on right now in the nutrition forum about getting more protein without meat. You might want to check it out for some more ideas.

[alpinerabbit]

I don't know. Yet.
The PT said she'd do manual work one more session, then look with me at things I can do for strengthening.

I do swim... but I haven't seen the inside of a gym for years. I'm not very keen on it, I find it boring. maybe some theraband stuff she can show me.

[alpinerabbit]

So today was my first "training" PT session.

She made me do lunges while concentrating on my core. Tricky business for someone who's not very coordinated - she also made me warm up on a trampoline.

NEways, I had to do 5x10 on each side and on the last ten my right thigh was on fire. So it's a load weaker than the left.

fun.

[tulip]

Interesting thread, Alpine. There are lots of ways of getting more protein even if you don't eat meat. Personally, I do eat meat (all kinds except pork, I don't like pork), but I buy from local farms.

Beans (all sorts) and rice (or other grains), eggs, yogurt, etc. are all good. I prefer to eat whole foods rather than processed (like protein powders) if I can, but it all depends on what is available to you.

Does Swiss chocolate count??

[alpinerabbit]

Hi Tulip ! I do eat meat, just not all the time. Tonight's indian lentils, rice, veggies.


It's been an interesting trip so far.

I'm wondering to what extent pain is just a part of an aspiring distance runner's life. I don't mean searing, limping, screaming pain and I don't mind a hard workout. I mean the little twinges, tweaks and itches - with me, they come and go, never for long but always at one or a couple out of a choice of known spots.

is this just the way it is and I need to learn how far I can go (and do that slowly) and how to manage them? Have I been too much of a scaredycat? (rabbit, I mean.)

[alpinerabbit]

Soooo...

after that first time of doing lunges, I had the most horrid DOMS (oh how sophisticated sounding!! sore muscles anyway) in my right rectus femoris (read outside quad) and both sides of my butt (gluteus medius).
So quite obviously, the rectus is the weak spot, overloading the other leg muscles. Looks like I had a reason for having all the trouble on the same leg. At least we're getting some results here.

I went running one time since, and had a twinge around the outside of the knee and nearly freaked about getting ITBS.
I also had sore, hot lumps in my right quad.

Another PT session, she finished off with stroking out the thigh after the exercise; the day after it really hurt down there and it was swollen - SHOCK! And cycling season approaching? If this kills my season I will be so pissed off at myself, so I'd rather give up the whole idea of triathlon, period, and stick to cycling. After all I also screwed up the shoulder so maybe this just isn't my sport? and so on and so forth ad nauseam...

By yesterday I was bored, way too cold for any biking, so I did my lunges and stretching and rolling in the morning. By lunch, bored out of my freaking mind, I did go for another run, I thought heck, even if this will be the last time I ever run.

8.5 K, took me over a freaking hour, but I was just peachy. Another bit of stretching afterwards.

This morning, nothing. No pain.

So I'm not giving up, but maybe reducing to 2 times a week but longer. Jeez, this is really getting epic.

[Jolt]

Yikes, sorry to hear things are rough! I wouldn't worry too much about the DOMS when you've just started something new. That is a normal thing that happens (I've been having it lately myself, having recently started doing some strength training and experimenting with running barefoot) and should decrease after a few times of doing the new workout. Definitely keep working on those knots; that twinge around the outside of the knee could well have been from one in the vastus lateralis rather than an ITB problem and if your quads have been having issues it's pretty likely. Keep an eye on that though (and make sure you don't have a trigger point in the TFL on that side--that can make it tight which of course makes the ITB tight)--IT band syndrome is a bummer. Good luck and keep us posted.

[alpinerabbit]

Yes thanks - as I was writing humorously, it might not have gotten across that I'm pretty sure it's not ITBS, but at the moment I felt it I freaked.

I'm keeping the TFL in mind when stretching and massaging*, and I actually appreciated the sore muscles I get from that exercise. It means something's happening and it pointed to the muscle that is weak, so that's a good thing in my view.

Today I'm really, really good and the mood is far away from the "panic" range of the color scale.


*it's hard to get at but the massage ball is doing the trick

[Jolt]

Yes thanks - as I was writing humorously, it might not have gotten across that I'm pretty sure it's not ITBS, but at the moment I felt it I freaked.

I'm keeping the TFL in mind when stretching and massaging*, and I actually appreciated the sore muscles I get from that exercise. It means something's happening and it pointed to the muscle that is weak, so that's a good thing in my view.

Today I'm really, really good and the mood is far away from the "panic" range of the color scale.


*it's hard to get at but the massage ball is doing the trick

Glad to hear today is better. I know what you mean about appreciating the sore muscles--it means the exercise is working! And I agree about the TFL being an awkward spot to massage; I use a firm rubber ball (smaller than a tennis ball) on the floor and that works pretty well.

[eclectic]

Wow alpine! I haven't been on for awhile - you certainly are having a time of it. Glad to see you are making some progress. Don't give up on tris yet. Heal, strengthen and condition slowly w/ sense and you will be back at it.

Sorry to hear about your shoulder :(
When you swim do you x-train strokes or just do freestyle?
The majority of what we do is freestyle but it is mixed up w/ full IM strokes. I have found that has helped me keep all my joints and muscles in balance also I can do backstroke and butterfly a lot better than when I first started :D

- Have to share this story - one of my students came w/ a support on his foot (whatever they are called as they don't cast any more) He had cracked some bones in his foot. I asked him what he had done. It was a swimming injury. Like he said "I am doing the lowest impact and totally non-contact of all sports and I break my foot" Apparently he was coming into the wall fast, missed the turn and broke it on impact and push off. Go figure . . .

[alpinerabbit]

Wow. what crappy luck :-(

I do all strokes in guided practice, and mostly freestyle on my own with some breast. I think I simply overdid it, although I think attempts at fly might have contributed to the strain. I also think my backstroke is not up to par (catch and push phase).

[Dogmama]

Rabbits, for what it's worth - lunges will cause major DOMS at first. Everybody complains about it. With your history, I would suggest that you be very careful about lunging correcting - be sure your knee is tracking directly over your foot (not side to side) and try to keep your knee behind your toes at your lowest position.

[alpinerabbit]

@Dogmama, I'm aware of that, side-to-side is no problem; the knee over the foot thing I'm looking out for.

So I had another appt. with the doctor and she prescribed me another round of PT (9 sessions - I'm paying myself anyway), to get some more exercises but also to get more deep massage work.

I sat on the trainer for the first time this year tonight and I also noticed a difference in strength doing one-leg drills. Wonder if I should just do that more on the right side than the left.

I've run 3x last week and I feel pretty good. have to keep at the rolling&balling - think this will be my fate from now on?

[alpinerabbit]

So the bunny (http://www.albinoblacksheep.com/flash/bunny)has been healing for 3 more weeks now -

http://www.magiclanterngraphics.com/tiny-rabbit-ani.gif

been at it self-massaging - I'll soon order a pilates/foam roll to better roll out my muscles...

been at it with lunges (they don't affect my rectus femoris so much anymore, rather the glutes*)...

been at it a 1:20 long run sunday a week ago*, and another 1h Saturday without aftermath, (*that aftermath was in effect until Saturday...)

been working the core according to my new year's resolutions (the swimming part did not materialize due to an unhappy shoulder);

been to PT today - she showed me a nasty balance exercise (raise leg from plank while positioned on a football), and worked on releasing my hip (not convinced yet that I need that or that it works).

been doing stretching & yoga (same thing anyway): I now manage a decent downward dog (http://www.bbc.co.uk/northyorkshire/content/images/2006/04/05/downward_dog_400x300.jpg)and even a supta virasana (http://www.yogabuch.de/bigimg/supta_virasana.jpg) (haven't been able to do that safely in years).

3 more weeks until cycling hols/training camp...

http://www.magiclanterngraphics.com/rabbit_looking_out_hole_lg_clr.gif
*down the rabbit hole*

[Wahine]

Sounds to me like you're doing great!!:D:D

Good job on being diligent with the strengthening, core work and streching. That's so hard for many athletes.:cool:

[alpinerabbit]

As of last week I am "on my own", after 2 PT prescriptions (9 sessions)
I think I can manage my thigh muscle well with rolling, less so the tibialis anterior, and running 10-11K is still about as much as I can take, and about a total of 15-20K a week.

But listen to my newest theory: I think it gets more aggravated from cycling than from running!

No, really.
And I think my flat feet are half of the problem (I've put superfeet in my cycling shoes and I believe my legs are being worked in entirely new ways). I *think* I detected a visible muscular imbalance on the inside of my calves - and with superfeet they are being worked.

Here's the rest of the theory.

In Mallorca, the tibialis anterior and my hip flexor got aggravated again. I feel I can manage that if I take care to adjust my right leg as the guy told me last year during my fitting - my right knee was too far out, as was my heel.

But I still have the trouble that I believe my right shoe is somehow crooked, does not fit. Although during the fitting, the cleats were put in their optimal position, I point my foot down to slip further into the toebox often, because it just feels different than the left. And if I don't, the tibialis "aches".

I think I'll invest in another pair of shoes, to be tested and fitted at the shop that fit my bike.