What is a Physiatrist???

Today I completed only my 3rd run of the month. I wasn't too happy with a doctor today, so I went for a run. The past two weekends, I dusted off my running shoes and went for one 8 mile run to just see if things are improving in my left hip. I haven't run much since the beginning of September (and have gained about 10 pounds-yikes!) and was hoping for a sign that things were getting better. Both runs started off great. My legs and hip felt fine, without the stiffness that I had in the left hip all summer. I was thinking I might be healed.

But about 1/2 mile into each run, the muscle or bone right on the inside crease of where my leg meets my pelvis would start hurting. The inner thigh muscle then would start tightening up. As I ran, the tightness would spread around the inside and then at about 4 miles my glutes would start tightening up like they did all summer. As I ran things would get tighter and tighter all around my hip. Saturday, I had no choice but to stop just 1/4 mile from my house, not because I was tired, but because it started shutting down on me. The next day, after both runs, I would have to fight all sorts of sore and stiff muscles (not running sore-but out of place sore).

After failing to complete two MRIs, I was to see an orthopedist this morning. I was looking forward to see what the next step would be. So much of my malfunctioning hip sounds like a labral tear (what they wanted to check out on an MRI), but I wasn't ruling out a stress fracture, or some other problem. I was expecting to be sent to Boston for an MRI (where they can put you out!) or maybe get a cortisone shot to see if that would help things.

The new doctor did a few tests of moving my joint around, measured leg lengths and then said that she didn't think I have a labral tear at all. She said she looked at the x-ray (which the previous doctor said showed nothing) and said that I have a little bit of arthritis. I always assumed "arthritis" is the "name" given to something that you are not sure of and that you don't want to treat. I guess that was the easy answer. She said I was good enough to run again. "Hello", I have been trying that and something is still wrong. If I could run every day, I most certainly would.

This was a ridiculous appointment, coupled with the fact that I was her first appointment of the day and it still started over 1/2 hour late. She said she would like to refer me to a Physiatrist. She wrote down 4 local names (which I can't even read it is so poorly written). I asked her if they worked with athletes and she said she wasn't sure, but she said I could research it myself if I wanted to find someone different. I don't know anything about physiatrists. It seems that a physiatist is a medical doctor who focuses in on rehabilitation (rather than surgery). They are like a physical therapist but with more training. They treat the whole body and not the symptoms with a lot of different approaches. It sounds good to me, but where do you find one that specializes in sports injuries and if it worked so good, why do I never hear runners talk about them? I see that they also work with accident victims, amputees, the elderly (almost there), and people with other needs so I am not sure that every one has the training, knowlege, insight, or desire to work with a runner that refuses to stop running. I am sure great ones are out there, but is that person nearby and how do I find him or her? I will be working on it, however. Hopefully, I can find someone real good!

So even though it was a lousy appointment and I think I was just gracefully "shown the door" I can only hope that I find the right physiatrist and find a way to figure out what is wrong with my hip and how to fix it!

I could have bought a nice television or an iPad or something really cool, but I got these instead so I better show them off!

On another note, I picked up my permanent orthotics last night (three weeks after getting them molded for my feet). Not only are they expensive (I think that is the most I have spent on any one item in a long time) but they seem really fragile. That could be good or it could be bad. They are the lightest orthotics I have ever had. I had a pair in the 80s and another in the 90s and they were like boats. The base is reduced in size compared to what I have had in the past and they are incredibly light. They feel like they are made out of chalk and that they could break or dissolve in a few days of use. It has a seemingly flimsy covering with the cutouts for my 1st MPT joint (to treat Functional Hallux Limitis). They are extremely light in my shoes and have a different feel than the generic FHL insoles that I have been using since the summer. I think the cutout for my joint is deeper and my feet roll differently in them.

One thing that I hope is that they may help my hip. I have wondered is if the "off the shelf" insoles might be helping my FLM, but at the same time hurting my hip. An angle or balancing point may shift my foot, leg, and eventually hip into a position that stresses my hip. While many things got better for me in my foot through the use of the insoles all summer, my hip seemed to get worse and worse.

As I ran in them today, I liked the feel of them in my shoes and apppreciated the lightness of them. I noticed my foot working a bit differently and I noticed that as I ran the tightness went from the inside of my hip to the front outside of my hip joint and that was new, as if I was using the joint in a different way. I have decided that I will try to run more, but for smaller distances (I ran 4 miles today) to keep my glutes from acting up and tightening. Maybe things will improve.

I will be on the starting line of the Bay State Marthon on Sunday. I would like to see how far I can go before  the tightness sets in. Maybe I'll only get a few miles in. Maybe I will get a 1/2 marathon in. Who knows, maybe the orthotics will work and I can jog the whole 26.2 mile thing. I don't give it much of a chance, but if the hip doesn't hurt, it would be interesting to do a marathon after barely running the past month and a half! At least, I can cheer on my teammates out on the course once I do stop.

On a final note, I have used many different types of foam rollers, but I think I have found that best foam roller ever made. I have been using this for two weeks and it is quite a monster and can hit muscles in ways that a traditional foam roller cannot and it feels better than it looks as it can really isolate tight spots and trigger points.

I also got this book today. I am going to need something for my abs after all the weight I have gained after shifting from my favorite pastime (running) to my second favorite (eating ice cream). Actually, I have an opportunity to talk with the author, Jonathan Ross, on the phone next week and I want to be ready. He is one of the countries top trainers and I look forward to asking him about the use of the TRX as well as what insights he might have to fix my imbalances. Here is his website for his book "Abs Revealed".