Sunday, January 8, 2012

Trigger Point Injection Therapy

This week I had the second round of my trigger point injections. Trigger Point injections are used for painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. A physiatrist is doing the injections. The first injections were two weeks ago in my glutes and I had noticed that my left leg and hip felt "lighter" and more relaxed as soon as I got in car to drive home. I wasn't sure if it was supposed to act that quickly, but I asked the doctor this week and she said that indeed it does work quick like that. This week we talked about my adductor tightness again and she said where it is tight and feels like it is pinching is more a ligament and this therapy won't work on that, but when she pressed on my left vastus medialis she said it was very tight. She also said that the vastus medialis rotates the knee inwards which is part of what my knee does (knock-kneed) so she gave me 3 trigger point shots to this muscle.

Then I four or five more injections to my glutes. She hit one point that I knew I had (can feel like a light electrical shock at times) that was a bit more painful  when the needle hit it. I hope this is my major trigger point. She said that was in my gulte maximus. Other shots went into my glute medius, glute minimus, and the edge of the piriformis. I didn't feel immediate loosening this time, but she tried a different type of needling than last time. These were quicker and she didn't move the needle around so much (really it doesn't hurt like you might think!). However 24 hours after the shot things loosened up nicely. I haven't read much information on trigger point injections and their effect on runners, but my glutes are relaxing more so I think it is good so far. She also does PRP (Platelet Rich Plasma therapy) which I think is more for tendons than muscle, but that isn't covered by insurance like the trigger point injections. She likes the trigger point injections over prolotherapy which she can also do. It is all very interesting and I am thankful that my insurance covers these shots. I am not sure the long-term benefits to them are, but they seem to be helping me with my recovery back into running. I go back in two weeks for another round and then possibly another visit after that too. The question I have about trigger points this week is that she is relying on me to tell her where I am tight and sometimes trigger points refer pain elsewhere. Why then would the doctor not actively search out more trigger points?

This week I had to take days off due to the shots so I only covered 16 miles this week, but I think my form is slowly improving as my strength improves. I still have weaknesses and tightness around parts of the hip after a run, but nothing this week like the really tight adductor pain or the glute tightness that I have had previously. This coming week I intend to run more mileage to see if I still do better on a longer runs.

This weeks mileage total = 16 miles
Monday- 5 miles treadmill good pace
Tuesday- 3 miles treadmill
Friday- 3 miles treadmill
Saturday- 2 miles treadmill
Sunday- 5k Freeze Your Buns race

I decided to do the Freeze Your Buns and not worry about racing, time, or embarrassment over either of these. I felt a lot better than I did running the Thanksgiving 5k race. My hips felt solid and my stride smoother than I am used to. I am just way out of shape and have to lose weight over the next few months. I ran about minute faster than on Turkey Day even though I ate a big dinner last night. My goal was to finish under 25 minutes. I did 23:39. My PR for the course is 18:02 set five years ago so the time was rather humbling. That time would have won this race, but instead I finished in 47th place. I was out of breath, but not pushing or trying to race and I did start picking off people after the first mile and only had two people pass me near the end. The good news is that there is lots of room for improvement and I felt pretty good, even when compared to the stumbling around I use to do 5 years ago when I was racing almost 6 minutes faster.

I did notice after the race today, that the major trigger point has a bit of a sharp needle-like feel to it at times, but the muscles are not tightening up like they used to, so maybe that is because I used and stressed the muscle a bit running today.

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