I hit 12,000 total miles on my ElliptiGO during yesterday's ride. I have owned it 1 1/2 months shy of two years. Bridge is in Pepperell, MA
On Wednesday, I had the second round of Prolotherapy injections in my si joint and lower back from Dr. Borg-Stein at the Newton-Wellesley Hospital. I had my first injections six weeks ago and I have been thrilled with the results. My doctor was just as happy as I have been on hearing the results so far. I am one of the few people who seem to get pretty quick reactions from the injections (which means I probably won't need as many rounds of them)! My lower back and si joint feel better than they have in just over 30 years. I have a new found stability and am no longer feeling my back or si joint "go out" or give me muscular problems in my daily life. Honestly, since around 1984, each day has been a struggle to not let my back or si joint ruin each day. I would run to try to get normalness, but I very rarely had a good night's sleep without getting up multiple times to stretch or "crack' or "pop" something that felt out of place. I avoided doing a lot of things around the house or even going to events because I was always feeling uncomfortable. It is nice to be able to move around and do all sorts of activities now, without any repercussions.
For the past month, I am just rolling through life feeling feeling very stable. I have had a few days where things might get a little bent our of alignment and the next day, I would be fine again. I have been doing heavy training on my ElliptiGO during this time. So, two thumbs up to Prolotherapy.
Besides getting injections for my left si joint and one of the facet joints in the lower back, this time I also got an injection halfway between the si joint and the left hip. She said this is where the glute medius often gives people problems and that is true for me. Besides feeling a "fullness" when I got the injections, I didn't feel anything after them in terms of discomfort (even did a light 30 miles on my GO that afternoon). Last time, I could feel the ligaments tighten near the injection point, but I guess that has already started healing, so it wasn't obvious to me this time.
I am letting things heal and not rushing into running (if I can) and I am getting the real results I wanted and that is to go through life without so much daily discomfort. I did try a run two weeks after the first injections and it felt great. I did two laps around the neighborhood (one mile) and my whole left hip and pelvis area felt tremendous and stable. I had no problems. It was wonderful!
I am also really happy to finally get to ride my ElliptiGO outdoors
this week after riding 1300 miles on the indoor trainer since January 1.
Wednesday, I had my first prolotherapy injections for my si joint and lower back. What I expected was that I would be sore for a day or two and beyond that feel nothing new. I was told it may not be until the third set of monthly injections that I notice any difference and would be able to tell if it works for me or not. My doctor also said that for a very small percentage of people it works right away even after the first injection. Prolotherapy involves injecting a substance into ligaments that make them inflamed and starts them on a healing process to tighten them up. The osteopath I went to in order to put my si joint back in place before the injections says it is like fusing the joint back together.
Since I started having si joint problems when I started competing in triathlons back in 1983, I knew this was a chronic problem for me (and it led to a torn hip labrun that I had surgery for in 2011 to repair). The injections weren't as painful or plentiful as I imagined. When I got down to my car 20 minutes later to drive home, I thought my pelvis area was feeling better, but it could be due to the lidocaine or whatever medicine they put in the shots for pain-relief.
After an hour drive home, I felt pretty good, and the injection sites were not that sore at all. As I walked around, I felt as if the bones of my hips and low back had been tightened up, but the muscle around them had been loosened from their tightness. It was a good feeling. I was more steady and solid on my feet instead of feeling off and twisted like I usually do. Again, I think the medicine or just the positive feelings of taking care of business (finally) had my feeling good.
I didn't exercise that day (as suggested) and while I was a bit sore that night (nothing as bad as when my hips are tight and out of alignment), I woke up still feeling good. I noticed that my roll out of bed was easy. I usually can't stay in control of twisting out of bed or into or out of a car because there are certain parts in my lower back that feel dead. I walked around all day with what felt like a new left side, I was in control of my hip movements on that side. It felt like my left (bad) hip had been zipped into place and was now pulled back where it belonged. I assume this was because of the si joint and not the hip, but that is how it felt. As I walked, my hip worked normally, something I am not familiar with at all. It was really weird and the knee (popliteus) tightness and tightness on the bottom of my foot had disappeared. My left leg was moving and holding my weight normally right down to the bottom of my foot. Gone was the twisting and off balance feeling I am so accustomed to. I haven't felt this way in years- dare I say since 1983, I do not understand this and expect it to all fall apart soon, but I rode my ElliptiGO the next day for 15 miles and 24 miles today with no changes in how good I feel. I also felt more balanced on my ElliptiGO, although not perfect, something I have been struggling with since the summer. Everything is working better!
I did not expect this at all and don't expect it to continue, how can it? I keep thinking the ligaments will stretch out again or something else will start hurting or fall out of place, but for now I am enjoying what feels like the start of a new body. Basically, I always felt something messed up in my left hip (could it have been the laxity in the si joint that threw everything else off) and that there seemed to be a piece missing in my left lower back that made it always feel like it was collapsing just a little bit (no strength there). Could those little injections already have started to tighten things up. They aren't supposed to take full effect for 4-6 weeks. Was it more the relaxing of a big spasm when she put the needle into my lower back? That even surprised the doctor.
What I do know is that I can feel better, if only for a few days and I feel really good that I am on the right path. What I don't know is even if this eventually makes me as strong as an ox where the ligaments made me weak, if I will ever be able to run pain-free again or even run again. Who knows what will happen when I start to run. I definitely am not going to try doing that yet. I will let things heal and just be patient. If it all falls apart tomorrow and I lose all these good feelings and improved movement and balance, I will not be disappointed, because this just shows me that I can get back to a more balanced body that is strong and working on both sides. I am just really perplexed at how quickly things started to feel so good! I would be extremely happy to feel this good for the rest of my life as it feels like a breath of fresh air to this constantly twisted painful body. I don't go back for my second injection until the middle of May. It will be interesting to find out what happens to my body in the next few weeks. Let's just say that this little experiment is making me very happy, as I was extremely worried that I might just be wasting money I didn't have, to try out some new type of therapy!
Here are three new exercises to try that work on improving your alignment for better and more pain-free joints when running. I had my first prolotherapy injections today, so I am not ready to try these yet, but once the ligaments around my si joint and hips tighten up again. I hope to get my alignment under control. These come from MaryAnn Berry and feature ideas from Posture Align Therapy.
A common myth is that running is bad for your joints because it is high impact and leads to joint wear and tear. But if you are experiencing this pain or joint wear and tear, consider that running is not the culprit.
In truth, your body is simply out of alignment, kind of like a car that needs an alignment. Your car’s tires (or your knees) wear unevenly and eventually need to be replaced or repaired. While that might work for your car, it’s not a great plan for your joints.
These three simple alignment exercises are no quick fix, but they will help get your joints into a better position before you run.
I had my first Prolotherapy injections today to my left si joint and lower back. I only felt a few injections, but my doctor used guided flouroscopy (I think) to move the needle around to hit the ligament attachments on the bone. I had a big spasm from the injection in my lower back. The injections are supposed to make me sore today, but I feel pretty good. Actually the lidocane, or numbing agents, has my hip and pelvis feeling more stable and better aligned (it could be just my positive thoughts!) I will need to go in monthly for a few months before we know if it works for me. A small percentage of people feel better after just the first set of injections. It does not immediately heal things, it inflames the area around the joint so that it can jump-start healing. As my osteopath said, "It should make it like the si joint fuse together." My hope is that strengthening the joint helps with my instability and then I can better deal with my imbalances and misalignments. The doctor does say that after all is done, I may need PRP or stem cell treatment in my hip joint.
The doctor that will be doing prolotherapy on my si joint the first week of April (if I elect to do this) wanted me to get my joints realigned by an osteopath before I come in and just so happened to recommend one that has office hours three miles from my house. So I went today, did the quick history thing again, and she did the maneuvers that got some pops out of my joints so that I am hopefully realigned. However in checking me over she wasn't so sure my si joint is the cause of my problems since when she pushed on it I didn't feel pain. She said that because of my funky left leg mechanics, when I run it puts a lot of torque on my body and pelvis and when I was younger I could compensate more easily, but now that I am older my body can't handle it. In other words, I am an old man! I agree with that the torque causing problems, but I am still not sure the prolotherapy couldn't help. I asked her and she said it is like "fusing" the si joint together and it may improve things. Well, that is the point! I will see if the adjustment helps over the next two weeks before I go back again (unless I get a call to come in for the prolotherapy as I am on the wait list if someone cancels). Well, I guess I am officially an old man!
Is this what the doctor's see when I go in for appointments?
I went to see a doctor about my si joint and getting prolotherapy to see if it can help stabilize everything around my hips and low back. I went to a doctor who specializes in this at the same clinic where I had my hip arthroscopic surgery in 2011. She is a physicist who specializes in prolotherapy and other regenerative techniques. I was waiting for an appointment at the end of the month, but got a call to come in this week. The only problem was that it was an early morning appointment and I had to get up at 5:00 (on my vacation week) to make it through traffic and get their on time.
She went through my history and did an evaluation. What I liked is that she doesn't just focus on one body part. It all works together. On the other hand, that means she can't pinpoint the actual problem for me. She says the si joint and hip joint all work together. She said she would have like to have seen me 10 years ago and that she would have done injection in my hip back then.
She explained that using prolotherapy on my si joint would be a good idea, but with the bit of arthritis found in my hip, it may mean that later, she might need to suggest PRP therapy in my hip joint. I read enough and I am ready to give it a try. The part I don't like is that insurance does not cover prolotherapy and I will have to pay for each visit (around $350) and she suggests that patients commit to coming in once a month for five to six months. She said we would know by the third visit if it is working. I would also have to not ride my ElliptiGO (at least at the intensity that I do) after the injections for a few days or longer. Then after she has worked on my si joint, the hip issue comes into play. I am quite sure PRP therapy is a lot more expensive and I am not sure I could go there, unless I was 100% sure for a positive outcome.
Meanwhile, everything around my left lower back, si joint, and left hip are somewhat troubling every day. I feel OK, but can't do the things I would like to do on a daily basis as everything keeps going out of balance and pinching or pulling all over the place. I started using my Serola Sacroiliac Belt and that gives me more freedom and stability, but I sure would like my body to do the work without resorting to a belt.
Anyway this gives me a bit of hope, even if not for running, just to get rid of the constant imbalances origination in my hips and si joint. She also wants me to work with an osteopath to get myself realigned before the injections. She knew a ostepathic physiatrist up in New Hampshire and gave me her information. It turns out that she has some office hours at one office just 3 miles up the road so I have an appointment next week. This is good as I was searching for a local osteopath last month, but gave up after the first office I called wanted to make it very difficult to even set up an appointment. I decided to skip it at that point. With my current insurance, I am at the point where I don't have to pay for office visit or even copays anymore, so I should take advantage of seeing specialists that may help.
On a related note, I went to visit a podiatrist again at the office where I had my orthotics made back in 2011. The world renowned podiatrist that used to work there is now retired, I had to pay out of pocket to see him a few years ago, but now my new insurance pays for the visit. Let's just say this new guy does the minimal that I ask of him and shows no interest in me as a patient at all (something I notice a lot in the health care field). I visited him a month ago for the first time and he did what I asked: looked at my left foot and adjusted the cuboid bone and also the poplitius. That foot has felt fine since then, but the right foot felt out of whack. I asked him about that and he checked and adjusted something with the ankle, looked at my left foot and readjusted the cuboid and then he was basically done and out of the room before I could ask about anything I could do to help myself with stretches or something. I glad I didn't have to pay out of my own pocket for less than 5 minutes of his time. I mentioned that I was hoping to get some prolotherapy done and he said he had never heard of it. I find that interesting as a few people I know let me know that had it used on their ankle and feet with great results. I am often amazed at how little doctors know or are even curious about new or different therapies than what they were taught. I would think they would read up on everything they can about how to better service their patients (I read everything I can about teaching to improve how I teach). I guess I call that going through the motions and it is quite obvious that this is what this guy is doing.
This article is old, but this was interesting about PRP therapy (use you own blood plasma rather than a sugar solution) and labral tears: RH:
One condition you mention there was hip or labral issues. Do you find that is a condition that responds to regenerative injection therapy?
JBS: I don’t know yet. The hip girdle is complicated. Often times labral tears are incidental radiographic finding and not the proximate cause of pain. I think we need to be diligent and careful in our physical examination and assessment of the hip girdle: anteriorly, laterally and posteriorly. I don’t think there is any data yet, and certainly no radiographic data and pre- and post- studies, looking at what happens to the torn labrum if one gets regenerative injections.
Here is a Wall Street Journal acticle (again it is 5 years old): A Pinch of Sugar for Pain concerning prolotherapy. Here Dr Borg-Stein is again quoted on the effectiveness of prolotherapy (I believe I am one of those carefully selected patients as I don't think she would waste my time otherwise). I do have back pain, but that is related to the si joint and the second doctor talks about how this responds well to prolotherapy.
The strongest evidence in the scientific literature is for chronic tendon problems such as tennis elbow, says Joanne Borg-Stein, medical director of the Spaulding Wellesley Rehabilitation Center in Wellesley Mass. Some studies suggest it can work for thumb and finger arthritis, she adds. The evidence for back pain is conflicting, but Dr. Borg-Stein says she finds it effective in carefully selected patients.
One type of back pain, caused by looseness of the ligaments around the sacroiliac joint—near the hip—responds very well to prolotherapy, says Michael Osborne, assistant professor of physical medicine and rehabilitation at the Mayo Clinic in Jacksonville, Fla.
Here is a video of prolotherapy performed on the low back by Dr. Hauser. It is not for the squeamish or for those who dislike needles and but cracks:
I have given up on running. I have never been able to figure out what is going on with my hip post labral tear surgery. Last year I only ran a total of 88 miles (most of those during snowshoe races). I did not run an actual running race for the first time since I started running in 1973 and decided it was not worth it to do more snowshoe racing this year knowing that after each race, I would spend a few days with my hip area all beat up and uncomfortable. I have read everything, tried everything, and have found nothing really helps that hip area: strengthening, mobilizing, or rolling things out, PT, doctor, and injections have not been helpful either. I say my hip is sore, but it really is not the hip socket, but everything connected to the hips within and without.
I have even been feeling uncomfortable riding my ElliptiGO. I am getting my rides in indoors this winter, but my hips always feel rotated or off level. Before Thanksgiving I was really off and sore in the sacrum area. I again researched ways to fix a stuck si joint. I worked on some self mobilazations,I found that were way beyond my flexibility, but low and behold a heard a pop and then everything calmed down for me.
I started getting more discomfort in the si joint after a few weeks and kept trying to work through it. I decided to research more and it hit me quite clearly that what I have been fighting is an si joint problem. The more I read, the more it made sense and everything I read about the symptoms matched me totally. There are methods that can pop a stuck si joint back into positions,, but the problem that people have is that the ligaments connected to the si joint get stretched and don't stretch back, thus chiropractic adjustments can make things worse.
One method that claims to fix this is something called Prolotherapy. I certainly have read about this before and found comments I made (TDF) on running message boards about this from back before my hip surgery. I had ignored it, because it considered experimental and insurance does not cover it. Basically, they inject a sugar type solution into the ligaments and that is supposed to stimulate recovery. It seems to work well with the si joint and tightens up the ligaments and making the joint strong again.
I am in the process of trying to get an appointment with a doctor for this and then I will have to see if it is for me and if it is even something I can afford.
Update: I have an appointment at the end of March with a doctor that specializes in this at the same clinic that I had my hip arthroscopic surgery. Surprised that the doctors, physiatrists, and PT people that I saw there didn't mention this, but maybe they were just focusing in on the hip.
Here is how it makes sense to me. I always had an awkward running stride, but I made it through high school and college running with no problems except my knock knees and weird stride (due to femoral anteversion). Then two years post college, I got into triathlons. Six months and after only two races, I completed my first Ironman distance triathlon. There was no such thing as bike fit back then and I had problems with my left weird leg getting comfortable right from the start and jamming up my hip-lower back. That winter, my back was already sore, so someone recommended I see an osteopath. He did manipulations on my si joint and I would feel good for a day or two and then it would hurt, so I started lying down an pressing on that si joint myself until it clicked and I felt better. By the end of my my fifth season doing triathlons I could barely stand comfortably and was clicking my back 10-30 times per day. I had my first PT to try to figure it out in 1988 right before my wedding because I didn't think I could stand comfortably through the ceremony. I was told to never run again.
I now know that was the si joint and if the ligaments remained stretched, then I have been fighting that unstable joint for over 30 years (and yes, that is what it always feels like even if I am riding my ElliptiGO). I think once I run and put all the weight on that one joint, my body tries to compensate and that is why everything falls apart when I run. It literally feels like it needs to be stitched back together.
This video even shows how an si joint dysfunction is a cause of a hip labral tear (particularly someone with a long standing dysfunction). Well if I have run for over 30 years with this (I have never been comfortable since 1983- but have controlled it better at times) then that may be a real good reason why I developed a labral tear.
Another video explains the symptoms of si joint dysfunction. Instead of saying, "You can have pain.." she could have said, "Jim has pain..." as it describes my last 30+ years quite accurately.
I will be curious about the Prolotherapy or anything else I learn along the way. So far, the best appointment I can get is in July! If anyone reads this and has comments or has had good or bad results from prolotherapy, I would be interested in hearing them.
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and that gives me more freedom and stability, but I sure would like my body to do the work without resorting to a belt.