More miles and Physical Therapy

Before I had my arthroscopic hip surgery for a labral tear, I had read to expect to start running 2-3 months post surgery if all things went well. This Monday was the 8th week post surgery and today was exactly 2 months. I did not expect to start running until the end of October. This week I ran 21 miles. Things are going real well.

 Monday: 5 miles in Mine Falls
Tuesday: 4 miles (first run on roads post surgery)
Wednesday: recovery
Thursday: first physical therapy appointment
Friday: 8 miles on the road (felt good- about 2 minutes slower per mile than normal)
Saturday: 4 miles road
Sunday: 10 miles mountain bike
Total 21 miles
I was really tempted to run 4 more miles today to make it 25. I could have, but it wouldn't have been smart. My hip feels good, but I still get tight hip flexors and a day off from running sounds smarter than to just push things.

Thursday I went to physical therapy for the first time post surgery. I had to ask for it, just to make sure I am doing things correctly and to move things along without getting hurt. It was a smart decision. I went back to Leigh Boyle at Pinnacle Physical Therapy. Leigh also runs the excellent Athletes Treating Athletes website and blog. It is an hour drive to get there and I am sure there are thousands of physical therapists working closer, but I want to go where I can get the right treatment and advice. Leigh worked on my hip last winter, so it was interesting to see what she thought of my surgery. I think she was surprised that I was running already as she said most doctors don't give the OK to run until 3 months post surgery. I had been told to start light jogging just weeks after surgery and as long as I felt OK, I could run. This is partially why I wanted to see a physical therapist. Why ruin the surgery by running too soon.

 Leigh tested out my hips range of motion and she was impressed by what it can now do, that it couldn't do last winter. My internal and external rotation is greatly improved. I asked her about the "synovial impingement" that was debrided. She said that along with the labrum (which was torn) this tissue was supposed to hold my femur in place. It was not. When she would mobilize my hip last winter, it was just clunking around with no support. Now post surgery, it is good and secure. She said that I was really messed up last winter and that my leg could not extend back properly. I was given four stretches to work on. It is nice to do them as they take away the tension in the muscles around my hips after a workout. They are all stretches that I have tried in the past with my bad hip, and that I learned to avoid because they would pull my femur around in my hip and lead to problems more often then a solution. Now I feel that my hip joint is solid and it stretches the surrounding muscles rather than mess up the joint itself.

This has more meaning for me post surgery: it wasn't the win, it was how I did it.

Anyhow, the discovery of the tear, the surgery, and now the recovery makes me feel strangely proud of the many years I have been running with this bad hip. I recall many times trying to explain how that hip didn't seem to work right, how it had no stability and clunked around, and how I literally had to concentrate on every running step for years just trying to make it work. I am sure many people thought I was nuts and just liked complaining. Last summer, my goal was to beat that hip up and work it as hard as possible to try to fix it and I knew that if nothing worked, I had to consider a "tear" or possibly surgery of some other kind. In July I ran a week of 75 miles and another week of 85 miles (52 miles in 3 days). I raced a lot. In August I ran 12 races before finally giving up at the end of the month knowing that my hip really needed fixing. I think of one race in particular, the Moose on the Loose 10 miler. I wanted to win my age group because it was an RRCA state championship race. My hip felt horrible in this race. I felt like I was running on one leg and using the left leg for support and balance, but it just seemed to be "stuck" in positions that didn't make it easy to run. Every step was miserable. I had to work hard to pass a guy ahead of me win my age group, but no one will really know how hard it was to move during that race. Performances like that are something I hope I never have to replicate, but it makes me proud that I persevered.



I also showed Leigh the pictures from my surgery (as seen here). She said ideally they should look white. The labral tear (in red) shows how bad it was and the yellow in the bottom pictures show old debris. It is a good thing I got that surgery and it feels good to know I am on the path back to running pain free again.

Congratulation to Patrick Makau for setting an official world record in the marathon this morning in Berlin. I still think the two faster times run at Boston this year by Geoffrey Mutai and Moses Mosop should be recognized with Mutai being the world record holder.

Watch more video of 38th BMW Berlin Marathon 2011 on flotrack.org



Update:
This new book from the author of The Entrepreneurial Patient blog is a must read book for anyone with hip problems and is thinking about about arthroscopic hip surgery or has had arthroscopic hip surgery for a labral tear or FAI.

Beating Galen Rupp

Week 7 post hip surgery. After two weeks where my running mileage totaled 12 miles each week, I dipped back into single digits this week hitting just 8 miles of running. I am just being careful of my hip (actually the surrounding muscles and just giving them time to adjust). My hip flexors and left glute medias or piriformis gets tight after running some days. I did have a few post surgery landmarks, however. Anyhow this weeks totals: Monday: zippo Tuesday: 5K miles Mine Falls Wednesday: 5 miles recumbent cycle, 5 miles indoor cycle, 2 miles elliptical Thursday: 10 miles on the elliptical machine at the YMCA- former best was 7 miles Friday: 10 miles mountain bike in Mine Falls Saturday: 3 miles indoor cycle, 1 mile in 7:14, 3 miles recumbent cycle, 1 mile in 6:53 Sunday: 5k run in Mine Falls then 3 miles cool-down on the recumbent cycle at the YMCA Friday I did 10 miles on the elliptical before the program finished. It won't let you go beyond 2 hours. Saturday, I was inspired to try to break 7 minutes for a mile on the YMCA indoor track (previous best post surgery was 7:30. I was happy to do that the second time around, but was sucking wind big-time. The corners on this track (9 laps = 1 mile) are not as easy for my hip. Sunday I was inspired enough by Galen Rupp's recent 10,000 meter American record to beat his time for 1/2 the distance. Galen ran 26:48 in Brussels. I wondered if I could run that fast on the Mine Falls 5k course. My best time post surgery had been 27:29. I was happy to run the course in 25:33. By next spring, I hope to shave another 6 minutes off that time to be where I was last summer with a bad hip, and then if all keeps going well, to start getting faster after that!

Starting All Over Again

I had another successful week testing out my hip to see what I can do. For the second week in a row I did 12 miles of running, however last week I did no gym work. This week I also went back to the YMCA to work on the bikes, elliptical, and indoor track. I also went out mountain biking for the first time post surgery.
Monday: nothing
Tuesday: 5 miles run. I felt OK during the run, but my piriformis or glute medius got real tight after the run and into the next day. I decided to be careful of pushing too much.
Wednesday: 10 miles recumbent bike, 5 miles stationary bike, 2 miles elliptical
Thursday 5 miles stationary bike, 2 miles elliptical, 1 mile run
Friday: nothing
Saturday 10 miles mountain biking-felt great- only a bit of difficulty getting my leg over the crossbar, 1 mile run, 1 mile elliptical, 1 mile run, 1 mile elliptical, 1 mile run
Sunday: 5k run through Mine Falls Park

I am being careful to not hurt things, my hip feels fine, but the muscles around it can act up a bit. Last Monday, I called my doctor's' office to see if I really was OK to run. I was told it was find as long as it doesn't hurt. I called again today and asked for a referral for PT, just to make sure I know which exercises to do and which to avoid to speed things along.

I saw this video posted on two sites that I follow last week:  Better Movement and Conditioning Research. It shows one of the greatest explorers of all, a human baby, as she learns to move. Babies work hard to figure things out, we sometimes forget how to move and our bodies become rigid and locked. This leads to a lot of aches, pains, and improper movement patterns. The video reminded me to continue to practice Feldenkrais movements, particularly after surgery. I have written plenty on Feldenkrais before as it is a gentle and powerful way to get back in touch with how your body should move, just like the baby in this video. Despite having plenty of Feldenkrais audio lessons I decided to try out The Fundamentals of Better Movement as well as Becoming Bulletproof: An Uncommon Approach to Building a Resilient Body. I will review them later at another time as well as review Martha Peterson's The Essential Somatics Pain Relief Through Movement DVD. I found her website through this link on labral tears two days before heading to Kenya and learned a few of her Somatic exercises that literally kept me out of pain for the longest time in over 25 years (you have to explore more on her website- look for posts written in February on the hip). I was free from the pain that I normally get and can never fix the whole trip. Except for the day when we flew to Kenya, I was able to control all pain by doing less than 5 minutes of exercises that I found on her website. The whole flight to London, I was very uncomfortable because I did no exercises that day. When we stopped to change flights to Nairobi, I did the exercises and I was fine the rest of the way as well as the rest of the trip. Every time I felt like things were getting out of balance, I did the exercises and I was fine. Some of the exercises are similar, but presented in different way with the Feldenkrais movements on "The Fundamentals of Better Movement".

 

Exceeding Expectations: Back to Light Training

Tomorrow will mark six weeks since I had labral tear surgery on my left hip. My recovery continues to exceed my expectations. Am I actually starting to train again? This week I ran 4 times. Each run was on the 5k trail for the Mines Fall Trail series race. I ran Monday, Wednesday, Friday, and Sunday for a total of 12 miles! I feel fine, but slow as I run. Each run was at about a 28 minute 5k pace. My left hip feels stable, balanced, and strong (something that has been missing for 25+ years) and I can sense my muscles readjusting and reorganizing each day. I can definitely sense and see more symmetry between both sides of my body. My hip joint doesn't hurt at all. After each run, I can feel some of the stabilizers and rotators around the hip, but it is not a pain, more like they have been used and are strengthening. I take a day off between runs to let them adjust. My hopes keep getting higher and higher that this surgery is doing more for my body than I could have ever asked for or imagined.


It has been exactly one year from when I decided I needed to see a doctor, as I was pretty convinced at that point that my hip pain had to be caused by a labral tear. I made this post Hip Hobbling Around to announce my thinking.

It took a long time to decide go to a doctor about my hip, but I had some deep suspicions about what is wrong with it and after everything I have tried it has suddenly become worse. I got an x-ray of the hip last Friday. It turned up negative, but I saw an orthopedist this this week. After a short time, he said the words that I expected. He thinks it may be Labral Tear and he wants me to get an MRI to confirm it. I have read about labral tears for the past couple of years, and many things about it seem to fit my hip, however, I wasn't ready to look into seeing if I had that without trying all the available options, particularly when I could still run (even with my constant imbalances, stability issues, and loss of coordination in the hips).

It is also interesting to note that in that post I made one year ago, I mentioned what I though recovery would be like:

If I need surgery, it seems like it might take 6 months before you can return to running, and a year until you are back in form.

Well, this is what I mean by exceeding expectation. I returned to light running 4 weeks post surgery. I have a long way to go, but that prediction was way off! I did have one prediction that was spot on, however, as I wrote in the same post last year:

I haven't been able to run since the aborted run on Tuesday. I have been able to eat extra ice cream to compensate (this won't be good).

I was extremely accurate on that! I only was able to do a few exploratory runs here and there over the past year.What a miserable year for someone who likes to run and exercise. I compensated by eating I guess, or at least not reducing my eating as I was no longer burning calories. Yeah, I ate ice cream and it wasn't good for me. I now have 40+extra pounds from one year of inactivity and I predict it is going to take a year to take it all off, but at the current rate of progression, I predict it is going to be a very good year.