Friday, October 17, 2014

Ups and Downs

I've been running for a little over 2 months now since my PT gave me the green light to resume back to normal in August.  On the whole, I'm pretty happy with how it's been going.

I started with 3 mile runs every other day.  Pretty early in the process, maybe late August, my hip got inflamed/irritated and I felt that old familiar groin pain.  It started at the end of a run, but even lingered into the next day while walking, so I went the overly cautious route and took an entire week off running.  When I resumed, everything felt good.  That's been probably my biggest set back so far, which is really just a small blip; definitely nothing to complain about.  I stuck to 3-4 mile runs for the first month.  I've connected with a lot of other runners who had this surgery around the same time as me through Facebook and various running forums.  Some of them were doing a lot more running and a lot earlier, but I've been fine with my conservative timeline. 

As part of physical therapy, I was scheduled to have a video running evaluation done, which my insurance would pay for.  Score!  So we decided to do that at my next appointment.  After checking my range of motion and doing some drills to warm up, I walked on the treadmill for a few minutes. Then she had me run at a 10:30 minute mile pace to warm up. After a few minutes of that, she bumped it up to a 10mm and started videotaping. I probably ran for about 10 minutes or so while she switched the angles of the video camera. Then we played the video back both in real time and in slow motion/frame by frame.

As it turns out,  I have almost perfect running mechanics. My pelvis was straight, my feet landed at the right angle, my take off was exactly off my 4th metatarsal, my trunk vertical (or something like that) was perfect. She was so pleased with the video of my feet landing/taking off that she asked if she could use it in an upcoming presentation. Sure! So maybe that's why I've never been injured before this hip stuff happened -- I have good mechanics!  The only thing I could work on was cadence. Apparently my knees could be a little more bent when landing and the way to improve that is to up your cadence. She suggested running with a metronome set at 174bmp (a 5% increase from my current 168.) But she also said if that doesn't feel natural, that I should just roll with what feels the best.  I got as far as downloading a metronome app on my phone, but in all honesty I haven't gotten around to using it yet.  

I was still being pretty conservative about my running, with most of my road runs being 4-5 miles in length and trail runs slightly longer.  (My hip feels better on the soft surface of the trail.)  That is until I was convinced to register for a 6 hour race (Goosebumps 6 hour race in La Crosse, WI.)   I was initially going to just volunteer, but friends convinced me that I should run a little.  So what the heck, okay.  The good thing about timed races is that you can run as little or as much as you want to.  It was a 2 mile loop, so my plan was to run a loop, then walk a loop and repeat that sequence until I had done 6 loops.  That would give me 6 miles of running and 6 miles of walking, which I figured was acceptable on a still recovering bum hip. 

Of course you can figure out that I did more than 12 miles.  After the initial plan, we decided to a walk a little more.  Walking turned into a run/walk.  I wound up completing about 18.5 miles total in 4.5 hours.  My hip was starting to get cranky toward the end (just achiness on the outside, but no groin pain), so I called it quits, but I'm pretty amazed by how well it held up at just 6 months post-op.  General leg fatigue also set in after a few hours, as my body just wasn't used to moving for that long anymore.  I was happy to stop and drink beer until the race ended.  I was a little sore for two days afterward, but nothing lingered and I resumed my normal every other day running routine without any problems from my possible stupidity.

Me and my friend D before the race.

I'm not surprised at the 12 month recovery period for this surgery.  I still feel like I am making small gains even now.  I keep hitting new levels of normal.  My running has been moving more and more toward being 100% pain free.  I still get twinges or aches every now and again, but they never last and they are coming less and less frequently as time progresses.  My brain still hasn't caught up with my body.  Before surgery, when I would stop during the middle of a run and then resume running, I would get more intense pain.  Or going for a run somewhere and then getting in a car to drive home, I would get pain getting out of the car when I got home.  Now when I do those things it doesn't hurt anymore, but my brain expects it to.  I'll randomly start smiling in the middle of a run because I still can't believe that it doesn't hurt.

So far my longest run has been a 9 mile trail run.  My tentative plan is to keep my long runs to about 10 miles this winter and just base build.  I need to get more cumulative miles under my belt before I start upping my long run.  I've continued to stick to running every other day, but my PT told me to try running two days in a row soon.  I think my body feels ready for it, but I'll keep the consecutive runs short for a while.  Speaking of PT, they finally kicked me out after almost 8 months!  It was almost a little sad, because I liked my therapist and we had spent so much time together, but I'm so happy not to have any appointments scheduled in the near future.  I hope I never have to go to that building again!

Weekly mileage over the last 12 months from my running log.  Slow and steady build up.

Trail running through the autumn leaves.

Tuesday, August 12, 2014

5+ Months Post-Op

I have not had a normal, pain free, continuous run since spring of 2012.  I am optimistic that this is about to change.  I have completed the return to running schedule outlined in my last post, aside from the last week.  I even did a run on Saturday that was 5 minutes running / 1 minute walking x 6 intervals.  Which is almost a "real" run.  Yesterday my physical therapist gave me the green light to run for 30 minutes straight.  I feel good; I feel ready.  We also did a lot of work regarding my range of motion.  It's definitely not perfect.  She was super pleased with my strength, but I am definitely still having tightness in my joint when I move my leg is certain positions.  It doesn't hinder me from any activities, but it's still something I need to work through. 

On the whole, I feel pretty normal.  Normal enough to pound down a hill trail running.  I can't state that I am 100% though.  Occasionally I still get some minor aching in my groin after running, but it is short lived and disappears after a night's rest.  Since full recovery for this surgery is supposed to be 6-12 months, I have hope that the aching is still just part of healing and my body getting used to the rigors of running again. 

I have decided that this is the beginning of my second running life.  I'm going to pretend that the previous 6,000+ miles just never happened.  PRs are null and void.  I have never ran any ultras before.  New distances, new times, new paces are to be celebrated.  I'll be a noob all over again.  I hope this helps me have patience, since I can pretend there is not a "normal" I am trying to get back to.  Screw 70 mile weeks and long runs longer than marathons.  I never ran 29 miles on my 29th birthday, or spent 17 continuous hours in the woods, or watched the sun rise, then set, then rise again.  I've never ran in the dark, ran on snowshoes, ran through ten kinds of mud, ran in various states across the country, or gone through dozens upon dozens pairs of shoes.  I'm just your average new, fresh faced, excited C25Ker.  Kind of. 

I haven't needed to buy road shoes in years, thanks to stock piling my Asics a while back.  Sadly, that era has come to an end.  Asics discontinued my trusty shoes (grumble, grumble) and I'm back on the market.  My feet are picky, with flat arches and wide tootsies and it's difficult for me to find shoes that work, but I picked up some Pearl Izumi EM H3s and so far so good. 

So, I'm running!  I'm an official n00b!  Here's to 10 mile weeks and distance PRs. 

Thursday, July 10, 2014

Running - Sort of?

I am officially over 4 months post-op.  I am gradually inching back toward normalcy, but some days the process feels so incredibly slow.  Sometimes I feel very patient and then there are days where I just want to go for a run, dammit.  I can bike for hours and it just doesn't leave me with the same feeling than a simple 6 mile run does.  But I am running.  Kind of.  Not really.  I am running, but it doesn't feel like running.  I find no joy in what I am doing at the moment.  It's almost a chore to do.  But let's back up for a minute.

At 16 weeks post-op, I had an appointment with one of my PTs and he told me that I could start a sort of prequel to a return to running program.  It involved running for 30 seconds, followed by 4:30 of walking.  Rinse and repeat.  Have you ever set a watch for 30 seconds and ran purposefully for 30 seconds and only 30 seconds?  It's about the equivalent of jogging across an intersection.  Absolutely maddening.  I would rather just walk than mess with the mind game that is 30 seconds of running, but I was a good patient and did as I was told.  After a week of that, I bumped it up to 45-60 seconds.  And after a week of that, I had another PT appointment. 

At this week's PT session (18 weeks post-op), she gave me a real return to running plan.  It looks like this.  My "runs" are supposed to be every other day. 

Week 1: 90 sec run / 3:30 min walk x 6 cycles
Week 2: 2 min run / 3 min walk x 6 cycles
Week 3: 3 min run / 2 min walk x 6 cycles
Week 4: 4 min run / 1 min walk x 6 cycles
Week 5: 25 min continuous run or take 2 walk breaks

She asked me what pace I typically ran at during a normal run.  I told her anywhere between 10-11 minutes per mile depending on the length of the run, terrain, etc.   She then said that she wanted me to run faster than a 10 minute mile for my running segments to promote better mechanics.  I was fine with that.  However, then she started spouting off about how my body used to be trained to run for long distances and now that we're starting over she thinks I can be running 3-5 miles at a 9mm pace soon.  I just laughed at her.  I once ran a 5K in 28 minutes and wanted to die at the end.  That was in 2010.  Now I'm recovering from surgery and my cardio and what little speed I had are both essentially gone.  At least she gave me a good laugh.

So I did my first 90 seconds x 6 last night.  I estimate I covered approximately a mile during the total of those intervals.  I did not have any pain while running, but walking home I did have some aching in my groin that has lingered into today.  It is hard to tell whether it is coming from the joint or just high in the adductor.  I did ice as soon as I was finished with my "run" and I'll ice a little later and perhaps take two days in between runs just as a precaution.  Like I have said repeatedly, I am in no rush.  I just want to be running pain free again.

Hiking and biking have continued to go well and are pain free.  I put in 403 biking miles in the month of June without any issues.  I have not hiked anything longer than about 7 miles, but I also don't really have the motivation to do so. Recently the blackberries have appeared and are ripe and ready to pick.  I fought the bugs and the bugs won, but I did manage to come away with a few good handfuls.

Friday, June 13, 2014

3+ Months Post-Op

I am almost 15 weeks post-op now and I have passed the elusive 3 month barrier (June 3rd!)  According to my PT and surgeon, that means that my labrum should be pretty well healed up in there.  Now comes the battle of getting my muscles strong enough to support running.  When I walked into PT on Monday, the first thing she asked me was, "So have you run yet?"  I gave her a look and said, "No!  I've been following directions and no one told me I could!"  She laughed at me; perhaps runners are stereotypically a little impatient.  Since we're taking the conservative route with my return, she wants me to get more impact and agility drills under my belt before I start to run.  I'm doing side shuffling, forward/backward skipping, karaoke, the ladder, and a strength exercise where I am stepping down from an elevated step and trying to mimic part of a running stride. I can definitely tell I am getting stronger.  My PT sessions aren't leaving me quite as sore anymore. 

I feel pretty darn good these days.  It is rare that I have a flash of pain anymore from a certain movement or twist.  My hip flexor is finally cooperating with getting in/out of the car as well.  No more hanging onto the car to get in.  Sleeping is completely normal; I find I don't need the pillow between my legs anymore either.   I have still been hiking and have gone as far as 7 miles.  Walking feels fine with no difficulty.  Honestly, I have nothing to complain about at this point post-op.  I continue to move forward without any set backs and that makes me very happy.  I hope others who are earlier in the post-op game can find solace in that.  Now if I am well enough to enjoy fall trail running this year, I will consider everything a complete success. 

It's finally green here again; one of my favorite trails.

My big news lately is that I've started bike commuting to work again.  It is a 33 mile round trip, so it's a bit of a beast of a commute, but I love doing it.  I'm aiming for two days a week until my hip is a little stronger.  Last summer I tried to ride 3-4 days a week and would love to be doing that again in a month or two. Biking in general has been great and I think it's a great tool to build muscle without the pounding your body takes from running.  My legs and cardio are slowly coming back to me. 

Speaking of bikes, I bought my post-surgery present to myself!  I had to take a 4.5 hour road trip up to Minneapolis to make her mine, but here she is.  My new 2013 Salsa Colossal 2. I've been dreaming about this bike since I first saw it last year, and I promised myself that if I made it through surgery and I could still find it in my size, I would buy it.  It's a steel frame with a carbon fork, which makes the ride incredibly smooth.  I absolutely love it. 

Thursday, May 15, 2014

2.5 Months Post-Op

This morning everything hurts from my waist down...except my hip joint!  However, it's all a good muscular hurt.  I had a very productive PT appointment yesterday.  My PT decided that I'm ready to drop all double leg exercises and move onto only single leg exercises.  My program now includes lunges (ouch), a split squat with my operated leg doing all the work and my right leg rest on a chair, a squat and touch back from an elevated step, and drills with an agility ladder.  The agility ladder reminded me of playing high school soccer.  However, it was good to start to progress to some "light impact" activities.  She seemed pleased with my progression.  I asked her how long PT typically continued after this surgery and she said that we would probably be working together until September or so, but that my visits would eventually drop down to once a month.  In her words, "We don't just get you running a 5K again and then abandon you."  That was good to hear.  We talked briefly about my return to running and she dismissed my idea of not running until August.  She said that since I was doing so well, I would probably get to start a run/walk program in about 4 weeks.  I still plan on being very conservative with running in the beginning.  I am in no rush.  Like I told her, after you've been injured for 2 years, another month or two just doesn't matter.  But...RUNNING!

Last weekend I spent all day Saturday at my favorite race, the Ice Age Trail 50 mile/50K.  Being there felt a bit like having to spend the day with an ex who you still have feelings for, but it was a beautiful and sunny day; perfect for spectating and spending time with friends.  My hip held up well.  I walked around a bunch, stood, sat comfortably in camp chairs, and didn't have any issues aside from sitting on the grass for a little too long.  Last year I volunteered, but I didn't sign up this year because I was worried about being post-op.  My worries were unnecessary; it definitely wouldn't have been a problem.  I'll be back next year, of course, but hopefully with a number pinned on my shirt. 

Max King winning the Ice Age Trail 50 Mile with a new course record

Me and George at the race.  Sunburn in full affect.

So far I am incredibly happy that I had this surgery.  I won't hesitate to do it again if my right hip decides to fail.  I think it's so important to put information about this out there on the web, since you tend to find a lot of negative experiences from The Almighty Google.  Recovery has been so much easier than I anticipated.  The reason I am keeping this blog is to hopefully give others a different perspective of this surgery.  I think it is important to note that I am young(ish), an athlete, and my body has proven to be fairly resilient over the course of my life, so I can't deny that does give me a leg up in terms of recovery. 

I am not sure if it would benefit anyone for me to keep posting my weekly walking/biking miles.  I have been walking about 20-25 miles a week at this point.  I feel like I am getting close to approaching unlimited walking.  I have started hiking again as well.  The first hike was a little shaky with some weird muscular twinges, but that soon disappeared after a few more times out.  So far the furthest I've gone has been almost 5 miles carrying an 18 pound pack.  However, if I can hike 5 miles, why not 6?  If I can do 6 miles, why not 7?  (And so on.)  So I feel like from here, it's just a game of getting my muscles up to speed and used to pushing the distances again.  It struck me as I was walking the other day that I don't have groin pain anymore.  I can vividly recall visiting a friend in Chicago over the winter and feeling that steady ache as we walked to dinner.  It's almost strange to not feel the pain anymore.  Amazing, but strange.

Hiking on a grassy open field

Hiking amongst the new wildflowers on my Ice Age Trail

Wednesday, May 7, 2014

Week Nine Post-Op

I can't believe it's already been two months. Time has gone by so much faster after surgery, rather than waiting anxiously for surgery to arrive.  That said, I was in a bit of a funk this week.  Every day was cloudy, rainy, and cold; it's May.  Where did you go, Spring?  I also think that I've become used to my normal routine again.  Everything is normal, yet it's not.  I still can't run and am limited in my walking/biking.  I am just trying my best to keep up with my dog's never ending energy.  I am amazed at how well my hip is holding up with the increased walking.  I've also walked a few times on some gentle trails without problems.  (Aside from taking a small digger after getting my ankle caught in a hole.  Yeah, I went totally down.)  I am not sure what my limits are with walking yet.  I am trying my best to increase slowly and not hit a point where I've gone too far.  So far so good, although toward the end of the week I was quite tired and had a few minor twinges in my hip flexor on the operated side.  It has since settled down without issue.

Monday: 2 mile walk
Tuesday: 3.4 mile walk
Wednesday: 1.8 mile walk (Dog park)
Thursday: 3.2 mile walk
Friday: 1.8 mile walk (Dog park)
Saturday: 2.5 miles a.m. + 3 miles p.m.
Sunday: 2.5 miles a.m. + 11 mile bike ride + 1.2 miles p.m.

At PT this week I was bumped from once a week down to once every other week.  I was surprised that happened so fast, but I suppose it makes sense given that I do most of the work at home.  My PT said that soon I'll be able to start light impact and agility stuff like jumping, skipping, ladders, etc.  That sounds scary to me at this point, even though I tentatively tried jumping the other day and I felt no pain.  I'm still doing a lot of squatting exercises at PT.  He seemed very pleased with my progress this week -- we did a lot of me balancing on my operated leg in a squat position while I played catch with the PT from different directions.  Right now I feel like I am just biding my time until June or so.  I am anxiously looking forward to longer bike rides and some real hikes.  Next time I see Dr. Keene is later this month at almost 12 weeks!

Walking with the crazy girl.

Sunday, April 27, 2014

Week Eight Post-Op

PT was pretty uneventful this week.  I told them I wasn't able to complete all my exercises last week since my hamstrings were so sore, thus they didn't advance anything too much.  I am now doing skater squats with a band around my knees and walk-out bridges.  Those were familiar from my first round of PT before surgery, so no worries there.  Since my Monday appointment at PT, my hamstrings have been feeling much better.  My muscles are starting to wake up and get accustomed to being used again.  I can't wait to get rid of the mush that my legs have become over the past two months.

I think I am almost back to my normal walking pace.  Walking feels great.  In fact, I am starting to think that my operated hip feels even better than my non-op hip when walking.  It's smoother, not as tight.  That's a pretty scary thought.  While I am not having any significant pain in my "good" hip yet, there's a very real possibility that it will eventually fail on me.  During my first appointment with Dr. Keene he looked at my X-Rays and said that my right (good) hip looked worse than my left (going to be operated on) in terms of abnormal bone structure.  At least if I have to go through this again, I won't spend years trying to figure out what's wrong with me.  But I really, really don't want to have to go through this again.  Dr. Keene will probably be retired by the time (if) my right hip goes bad and I won't want to trust a new doctor with it.  I know I shouldn't think about the "what ifs", but it's always going to be in the back of my mind. 

Monday: 2.4 mile walk
Tuesday: 10.9 mile bike ride
Wednesday: 12.4 mile bike ride
Thursday: 2 mile walk
Friday:  10 mile bike ride
Saturday: 13 mile bike ride + 2 mile dog walk
Sunday: 1.2 mile dog park walk + 1.8 mile dog walk

The big news this week was that my dog came home on Saturday!  She stayed with me at my parent's house while I was there, but then got transferred to my best friend's house for most of the month of April.  I needed to make sure that I would be able to handle all of the walking that came along with taking care of her, as she's fairly high energy even at the age of 9.  So next week will be a test on my hip to see how it does with increased walking. 

Yesterday I absentmindedly jogged down a flight of stairs.  I didn't even realize I was doing it.  It didn't hurt, so I'll take that as a good sign. The timeline to return to running seems to vary wildly between people and surgeons after this surgery.  I've read about people starting to run as early as 8 weeks, which is where I am right now, and as late as 6 months.  I am absolutely not ready to run yet, both mentally and physically.  My PT told me that the most optimistic result would be 12-14 weeks post-op.  I am not in any rush to start running again.  I would prefer to error on the conservative side and I can be happy enough this summer with just biking and hiking.  My tentative plan is to wait until July/August to start running, which would put me at 4-5 months post-op.  Of course, that's subject to change.  I seem to be healing well without compilations, so maybe I will feel differently in a month.

I am happy with my decision to have surgery in late winter/early spring.  The better I start to feel, the nicer the weather becomes.  It's been encouraging to correlate my healing with the coming of summer.

Content to finally be home again.