Friday, July 5, 2013

Recovery Continues, & Some Cool News

I hope your July 4th was as awesome as mine. Don & continued our annual tradition of burgers & shakes with friends, then headed down to the waterfront to watch fireworks in what has to be the best Independence Day weather San Francisco has had in decades.

In a city where July is typically cold, windy, & foggy, we were so excited to be able to sit down by the water in T-shirts, perfectly comfortable, & see actual fireworks instead of faintly glowing fog. Also, thanks to our spiffy mini camp chairs, we got a prime spot that no one else wanted because it was on concrete. Absolutely the best SF fireworks I've ever seen.

Last week I was back in to see both my sport med doctor & my PT. The last time I saw my doctor, he was evaluating the possibility that my injury was potentially a femoral neck stress fracture instead of just a really terrible strain. The PT had requested he do some imaging to rule this out, but after having me do a few physical tests, he said that he didn't see any evidence for it at all & didn't think the imaging was necessary, but that he'd re-evaluate in three weeks.

So last Tuesday was three weeks. Although the progress day-to-day has been too little to notice most of the time, the difference between this visit & the one three weeks prior was HUGE. I was going up stairs fine (and even down some small ones), I could take a small bit of eccentric loading, & I wasn't having horrifically painful muscle spasms anymore. I could even hop on the leg some & had legitimately run half a mile the day before with almost no pain. All of this made him really happy & pretty much confirmed that the damage, severe as it had been, had been limited to muscle tissue. He said I could continue experimenting with running small amounts at a time as long as there's no pain & gradually increase the distance as my leg becomes stronger & more stable, & that I should be fully back to normal & ready to jump back into real training in about a month.

My PT was also encouraged by my improvement. In talking about what hurt & where & what I was now able to do vs what I could not quite do yet, he suggested that the actual grade 2 strain had probably not been in my TFL & adductors as we originally thought but instead in my sartorius muscle, the giveaway being the way the pain wrapped around from my right hip to the inside of my right thigh. His guess was that once that muscle was trashed, my TFL (& probably also psoas) had started trying to compensate & ended up with its own, less severe strain as collateral damage. (In PT speak this is called "over-recruitment.")

You can get a feel for what the sartorius muscle does if you think about sitting cross-legged with your ankle propped up on you opposite knee, or picking up your foot to check to see if there's something on the bottom of your shoe. (My PT called it "the hacky sack muscle.") Along with the IT band, the sartorius muscle also plays an important role in stabilizing the knee during eccentric loading (for example, single-leg squats, which is basically the same motion your leg goes through when you're running) & keeping it from collapsing inward.

LEFT: Knees not properly stabilized & collapsing inward (valgus fault -- super common, especially in female runners); RIGHT: Knees properly stabilized & staying vertically aligned with hips & toes. These pictures show how stabilization plays out in a double-leg squat, but you can envision how the valgus fault shows up in a single-leg squat or while running by just covering up one of the legs. Valgus faults lead to all kinds of hip & knee pain.

The upshot of my PT visit was that the strain is healing & he's optimistic, which means it's time to get back to the work we were doing before the strain & solve the issue that led to it in the first place. Which, for me, apparently means a lot of ART, ultrasound, & rolling around on Lacrosse balls.

So. That's the less-fun-but-necessary work coming up.

In other, more exciting (& surprising) news, the Berkeley Half Marathon sent me an email last week about sub-seeded status. A few email exchanges later...

Obviously, that's cool news just for its own sake, but it has some extra meaning for me. There have been a lot of sucky parts to this injury, but the most crushing was missing out on my sub-seeded spot at SF Marathon a few weeks back. Getting offered a sub-seeded spot at the Berkeley race was completely unexpected & has given me a big morale boost & something awesome to look forward to as I recover & get strong again over the next few months.

Don't get me wrong--just the idea of being able to run again at all is certainly enough to motivate me to work hard & do my best to balance ramping up training with letting my body finish healing. There is a bit of an extra push, though, that comes from having something external like this with a date attached. It makes the stakes feel just a little higher, just enough to make part of my brain go, "Hey, take this seriously. Don't screw it up." I feel like I've been offered a second chance that I certainly was not entitled to, which in turn makes me feel as if I have something--just a little something--to prove.


  1. So, 'splain this sub-seeded thing? Is it something I've been missing? Like, you're fast enough to avoid the walkers, but not quite Olympic qualifying yet?
    Glad you're improving so much. Hey, sometimes your body just needs a break! And it's good to have a race to look forward to.

    1. Some races have it & some don't, but usually I think it's an attempt to make sure they get a balanced field speed-wise. (SFM has a sub-seeded field for the 2nd half, which is the less popular half, & Bay to Breakers also does, probably because so many people just jog / walk it.) There are qualifying times for different age groups, distances, & male / female, usually a cap on the number of spots they'll give out, & in my (limited) experience usually a ~50% discount & a spot at the front of the first wave / corral. You should see if there are races by you that offer it!

  2. You have made some great progress over the last couple of weeks. I am glad that the stress fracture was ruled out. It sounds like you have a great PT! It is nice that he put you through some simple tests instead of making you shell out unnecessary money for imaging. Very smart guy!

    Exciting news about the Berkeley 1/2 marathon!!!!! I am assuming it is the "big race" you have circled on every single calendar?

  3. The firework shots are amazing, it was SUCH a warm night!!! Last year was so cold, even here!!

    Really excited about Berkeley, I think it's going to be great!! Congrats on the sub-seeded offer.

    1. Thanks! :)

      Yep. It's been cold & foggy every other time I've gone to watch fireworks. This was so nice!

  4. Good that your recovery seems to be coming along fine! Sounds like you'll be back at it shortly. And thanks for all the exercise suggestions, those are all good ones. Especially the standing thing, I doubt that I can get a standing desk at my desk now, but I might get a balance ball chair, which would at least get me out of a regular office chair.

  5. Those are like PRO fireworks photos. AWESOME!!!!