When an injured athlete is faced with a period of non-weight bearing activity and handed the crutches of doom, all sorts of questions and fears may arise. Will I lose all my pre-injury fitness? Will I gain weight? Will I have to start over from square one? Will I be forced to give up coffee since I can’t carry a cup?! (Because really, that’s all that honestly matters.) While each athlete will have unique circumstances, I’m 97% confident I can say the answer to each of these questions is NO. Including giving up coffee!

Steps to staying fit while crutch-bound

(1) First and foremost, get medical clearance from your physician. Check what is OK, what isn’t, and keep your medical team updated as you progress through recovery.

Assuming you’ve been given the green light…

(2) Don’t check yourself out mentally!! Even if you “love” to workout, it’s pretty dang easy to hang up your handicapped parking tag over the couch and stay there for good. And what goes better with a movie than a pint of Ben & Jerry’s…?!

Don’t get me wrong – take your well-deserved time to recover and mentally/physically recharge. But don’t get too comfortable on the couch, because you will eventually be able to get back at it again, and there is no need for you to start over from the very beginning! Instead of getting down because of what you can’t do, focus on what you can. Which means…

(3) Upper body strength: Your arms will get a head start simply from using crutches, but if you’re an athlete who is used to putting in a couple of hours a day, chances are that won’t quite cut it. Free weights can be difficult to maneuver as you need  both hands to crutch, and probably shouldn’t try and grab that 35 pound DB with your pinky. Machines, however, are for the most part very doable. Push ups, yes. Pull ups, yes. (Just remember not to jump down!!) Chest, shoulders, triceps, biceps, back… you can hit em’ all.

The biggest hang up for me is that I superset all my lifts. The patience is simply not there to sit on a machine and just wait between sets. It drives me nuts!! But for the time being… I will get over it. Logistically it makes life a lot easier to take one machine at a time. If possible, try to hit the gym at a less-busy time of day.

(4) Cardio: It is still possible! Two options (that I know of… if there’s something else out there, please let me know!!): Hand cycle ergometer, and pulling in the swimming pool. Unfortunately not all gyms will have a hand cycle… but if you have access to one, I definitely recommend taking advantage of it! Forewarning: the first few times (just like when pool running) it will feel like you’re not doing anything. And/or it will feel very difficult. Possibly both at the same time. Chances are that it’s mostly mental because it’s simply not an exercise you’re accustomed to. Keep at it, and you will likely notice it starts to feel [mentally] easier, and you will actually start working up a sweat!

In terms of swimming, please make sure that any open wounds/incisions have completely healed before you get in the water!! You may be dying to get back to exercise, but not at the cost of big nasty infection. If your doctor has cleared you to get in the pool (submerged – not the same as showering!!) then hop splash to it! Assuming most readers here are triathletes, this is your golden opportunity to work on that often-dreaded portion of multi-sport. How much you can use your legs will depend on your doctor’s/PT’s orders – you may not be able to kick at all, or you may be able to do a light flutter. Invest in a pull buoy if they’re not available at your pool (usually between $5 and $10), and pull away. This is also a great time to work on stroke drills – fingertip drag, distance per stroke, single arm, catch up, rhythm, etc.

Some lower body injuries may still allow you to pool run. If you’ve been given the go to do this, and are wondering where the heck to start (or looking for pool running workout ideas!), check out two of my previous posts: Pool Running, and Pool Running Part II.

(5) Core stability: Although it will depend on what your injury was, you may very well be able to keep up your core work! Again, check with your medical team. Your regular routine may need to be modified a bit – typically the rapid, jerking movements may be best if skipped. There will also be some trial and error involved… you may find you can do planks just fine using only your “good leg”, or that Russian Twists use too much quad muscle to do comfortable.

(6) Physical therapy: This should probably be #1. If you have been ordered physical therapy, I can’t stress how important it is to keep up your exercises as prescribed!!! It may be tedious. It may be time consuming. But your physical therapists have been through four years of an undergraduate education, a competitive admissions process to their masters or doctoral program, and an additional 2 to 3 years of education. PLUS passing the National Physical Therapy Exam, as well as state certification exams. Read: they know their ****. They can determine proper exercises based on your current status, and help you advance them as you improve in recovery.

(7) Diet: No hate mail for this one please!! Truth be told, if you’re used to putting in Ironman worthy workouts every day and you’re now limited to 40 minutes on the arm ergometer, you may need to adjust your diet a bit. If your maintenance calories had been 3800… well, they’re probably not right now. Calories in = calories out… capisci?

On the flip side, if you’ve been down at that racing weight for maybe a little to long, or are one of those people who struggles to maintain a healthy weight, this could be your easy fix. If calories/eating/weight while injured is causing a great deal of anxiety, it may be worth checking in with a sports dietitian or sports psychologist for good measure.

^^ I can’t wait for the day I can get back to THIS! ^^ It was my first full triathlon (and first tri podium finish!) and I will do what it takes – even if that means being patient – to get back there!

In terms of other crutching tips… there are a couple things I would like to add:

• Backpack. Or those nice little drawstring bags. Keep one with you at all times!
• Travel coffee mugs. Lovely reader Brynna recommends the Contigo brand because she can throw them in her bag, and they don’t leak a drop! Unfortunately, most of the [ridiculous too] many mugs I have aren’t that leak-proof. I just picked up a Thermos brand “Stainless King Travel Tumbler” at CostCo, and honestly I’m pretty sure it could withstand a bomb. Put it in your above mentioned backpack and you’re good to go!
• Remove floor rugs and their best attempts to trip you up.
• Under-arm crutch padding… OR forearm crutches. There are some nasty injury/wound pictures lying within my iPhoto albums, but I’m glad I didn’t take one of my rib cage post-crutches. Rubbed. Raw.

Being injured is never fun. Ever. But keep your head in the game, and remind yourself that this just a speed bump in your life, not a road block. Do what you can do safely, and you will be back in action before you know it!

Reader Qs:

What do you do to stay fit/sane while you’re injured? Do you have any crutch-success tips to add?

-E

*This post has been added to Train on Top archives, where you can find other articles on training, cross training, nutrition, and injury prevention.

1. I feel kind of badass…

A buddy of mine the other day told me I was tough as nails, and have the hardware to prove it. It was just kind of a nice reminder that this hasn’t, and won’t take me down. I am still that little feisty redhead… just have to turn the fire down for a little while.

“We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed.”
- 2 Corinthians 4:8-9

2. I am way behind on Christmas…

Christmas is in less than 48 hours. I just finished wrapping all my gifts at 5pm tonight. I just finished making the rest of my gifts this afternoon. (They are very Pinterest inspired… I’m actually tackling that “post-surgery crafts” board!) Oh and by the way we are heading out of town tomorrow morning. Wooops!

Luckily there are quite a few people who I am doing gift exchanges with after Christmas… Which means I will still have time to shop for for them when I get home on Monday. Not going to lie: don’t hate the fact that everything will be on sale!

3. Not working out is not working out…

At least mentally. It’s not even so much the I’m going to blow up into the size of a baby whale thing… calories in vs. calories out is something I know how to balance. But it’s just having all this TIME on my hands to do NOTHING!! Previously, my day was taken up with practice > work > eat > sleep > repeat. Right now my work is on hold (I work at a University… winter break), and going to practice obviously isn’t happening if I’m only able to do toe-touch weight bearing. It just feels like too much couch time, and it makes me frustrated. Maybe I just need to bulk up my “non-active to do list“.

BUT… for full disclosure I do still get to go to the gym. My doc is thoroughly encouraging to use the arm ergometer, and I’ve been getting “better” at it day by day. But it kind of feels like waiting to watch ice freeze… and it’s obviously not what I’m used to. I miss squats!!!!! (<- whining voice)

________________________________________________________

Post-surgery update:

It has only been 9 days… but it feels like it has been 3 weeks. Several changes worth noting:

Physical Therapy: Those exercises that were so hard last week? Not so hard anymore! I can do all of them unassisted, and with much less difficulty/pain than before. Today I booked PT for about 6 weeks out, and am excited to get started with it and start makin’ some progress!

Post-Op Appointment: Was this morning, and it went very well! Healing and rehab is all on track. My wound is closing nicely (and I will be able to get in the POOL on Monday!!!! So you better not here me giving a Friday Confessional next week saying “the pool is so boring!” Trust me. I’ll take it.) I will go back for xrays at the end of my six weeks (January 25th… yeah, it has been circled on the calendar for a month) and pray that the above “fresh Christmas tree cut” on my femur has fully healed!

Forearm Crutches: … have honestly changed my life. Up until my post-op appointment today I was using the traditional, under the arm crutches. And I’m pretty sure my skin was rubbed almost all the way down to my rib bones!! They make sheepskin coverings for the underarm crutch pads to help reduce friction, but I was literally wincing with every step and didn’t think the little lamby skins would cut it. If you have ever been on crutches for an extended period of time and experienced this rubbed-raw sensation, you have my deepest sympathy.

So today then, I talked to my doctor about forearm crutches. He said more and more athletes are choosing them, and they tend to work out even for non-weight bearing assistance because our breed (so to speak ) already has greater arm strength. Yeah… after all this hand cycling and upper body only weights, I’d like to think I have some arm strength!!

Reader Qs:

Any additions you can give me for this non-active to do list?

Have you ever been on crutches? What for, and did you burn off all your underarm skin?

Any big holiday plays / Santa Shuffle 10Ks / extravagant field trips planned?

Take care, be good to yourself, and be safe if you’re hitting the roads.
-E

1. Sick chick.

And I don’t mean sick in the way cool / sick / tight / wicked / sweet / dope / fresh / anything that doesn’t actually mean “awesome”  but yet is somehow used interchangeably. Between last Wednesday (on my birthday. Not sweet, nor dope.) and this Monday, my temperature was bobbing between 102.5 and 100.7. What started out as a Dx of strep throat turned to a prescription for amoxicillin that wasn’t making me feel any better (or cooler). Turns out that I had pneumonia, which may or may not have been due to the strep that was or was not even there to begin with. So I’ve spent a lot of time here:

Influenza test -> Strep test -> cute note from “Kathryn” en español!

By the fireplace, under the covers, in the dark. (Creeper.)

Thankfully, since going back to the clinic on Monday and confirming pneumonia with the chest x-rays, they switched me to levoflaxacin and I’m feeling 97% better. My grandma has had pneumonia so many times and I never had any idea how miserable she felt!! It was I imagine a collapsed lung feels like. (My surgeon would not have been impressed with that come Wednesday….)

2. Five days until they cut my leg off.

Yes, the countdown is going strong. With all this sick business over the last week, I can tell you I was pissed bummed about missing gym time. And I have no problem fully admitting to hitting the gym the second my doctor said “I guess if you’re feeling bett…..” I have been asked multiple times by several friends:

You just can’t give it a rest, can you?!

Not today my friend. And I will tell you what… when you have two months of ass-to-couch time staring you down, you can make whatever decision you want concerning your last five days. But as long as I have been given the green light to exercise, and am not by any chance contagious, I will sweat it out until the very last possible minute.

3. I am actually scared to death for surgery.

Sure, it’s easy to look brave behind words… to say well, you can’t always chose the cards you’re dealt and there’s no way around it, so let’s do this thing! Slowly over this last week, the reality of the lifestyle changes I’m about to face has really started to set in. We have such a small amount of snow right now here in Minneapolis, and I know it’s only a matter of time before mother nature decides to unload 2 feet on us. Thinking about crutching out to my car and trying to scrape it off… thinking about crutching downstairs to/from my apartment… thinking about how the DUCK do I carry a coffee cup!?!?! All hitting the fan.

This is a rough estimate of the procedure they are doing… which I wrote more about in this post.

The wedge that you can see gets removed, leaving a brand new, fresh surface that needs to heal together. Along with the bone healing around the screws. And plate running along the lateral side of the femur. Not to mention there is a big unpredictable tumor chunk that has, until this point, proven to do whatever the heck it wants…

It never asked me if I liked the question “Why do you walk with a limp?” (No.) It never asked me if I wanted to run just one last marathon. (I started my list when I was 10.) It never asked me how I felt about crutches when it’s -20°, icy, and snowing. (Can I take coffee with me? No? Ok, angry.) It never asked me if ever wanted to sleep on my left side again. (How about just through the night?) It never asked me how I felt being left out of any/all plyometrics. (Like I’m defective.) It never asked me how it feels to explain what fibrous dysplasia is 100billion times and have every single person you just explained it to look at you and still not get it. (#GTFOH)

4. I feel super selfish.

Reread last paragraph. I can think of an equal 100billion ways it could probably be worse.

5. The Hand Crank…

- Is really kind of harder than you’d think.
- Burns like 1/3rd of the calories you can burn while running, and still feels kind of harder than you’d think.
- Is quite possibly more boring than pool running…
- Unless you find a good song that you can get krunk to crank to… in which case it might not be so bad.
- I’m going to need a lot of new songs on my iPod.
- Is kind of lonely, since there are only two in the gym (attitude correction: there are two in the gym!) and I don’t see anyone else on them.
- Which may be a blessing in disguise because I’ll never have to wait for it.
- Unless it snows two feet, in which case my butt ain’t gettin to the gym in the first place.
- Mmmm yep, still waiting for that attitude / perspective / expectations adjustment.

And that my chicostix… is about five things more than I’ve ‘fessed up to until today. And it does feel BETTER. Especially number 4. It’s good to get things off your chest….

#feelsgoodman

(1000 bonus points for the right reference.)

Reader Qs: Your turn!

-E

Days until….

• My birthday!!: 1 day
• My new HOUSE!!!!: 2 days
• My best friend finally home from 6 months in Mérida, Venezuela: 3 days
• First two UMN gymnastics meets: 5 days, and 12 days
• I get to see my padre: 14 days
• SURGERY!! Can I get an aaaaamen?!: 15 days
• Christmas: 26 days (yikes!! better get to shoppin…)
• Post-op follow up appointment: 30 days
• Start of 2012: 33 days
• Possible last day of crutches? (hopefully earlier!!): 57 days (ayyye.)

Meanwhile… I think it’s about time to check in with my goals from 2011, and start thinking ahead to 2012!

Reader Qs:

Are you currently “counting down” to anything? How are you doing on your 2011 goals?

-E

Alternate title: “they’re cutting my leg off, taking a cheese wedge slice out, and putting me back together.”

Alternate alternate title: “about damn time.”

Enough emails have come in that I thought it was time for a bit of clarification. (FIRST clarification!! NO. They’re not amputating my leg. )

Depending on how long you’ve been around DrTriRunner, you may have all // only bits and pieces // or none of my past medical history. I definitely don’t expect anyone to click on each of these links and read the entire posts, but it has ALL been documented. And what a trip for me to go back and read through them! Here is the Cliff Notes version of this entire journey since 2008…

• Sophomore year of college – was living in Boston, MA – running xc – 4 marathons under my belt and registered for #5, Boston, the following April.
• October 22nd, 2008 - Found out I have fibrous dysplasia (FD). Found out my femoral neck was fractured 2/3rds of the way through. Hahha love my title for this one: “Adam and Eve Played Me.”
• November 3rd, 2008 – Surgery was discussed with treatment team in Boston. Option 1: a surgery with a shorter rehab and greater chance of returning to running, but not necessarily a “long term fix”. Option 2: surgery with a longer rehab, lesser chance of running again, but possibly more permanent. I was still hopeful that surgery would not happen at all! If I did, it would be at home in Minneapolis over Christmas break.
• December 12th, 2008 – Written on the flight home to Minneapolis. Still praying that I wouldn’t need surgery.
• December 13th, 2008 – Post pre-op appointment, probably written in tears. I remember how devastated I was to find out I needed surgery!! Decided on option 1 with the quicker rehab and better chances of being an “athlete” again.
• December 17th, 2008 – Two days post-op. Hit heavy by Vistaril so I’m not sure how coherent that post was. Lots of cute pictures of IVs being pulled out and “learning to crutch.”
• December 21st, 2008 – Funny.. I remember being AMPED because I got to SHOVEL SNOW. Weight bearing activity baby!! It’s all about the little steps.
• December 21st, 2008 – One week post-op report. Able to use the stationary bike (next to no resistance) with minimal pain.
• December 31st, 2008 – Two weeks post-op. Able to swim and pool run once the incision had healed. I remember being amazed at how quickly [I thought] progress was happening…
• January 25th, 2009 – First post-op follow up appointment, which led to me being…
• February 6th, 2009 – Cleared to run!! Ohhh that joyous letter. I hung it up on my dorm room wall. Serious. Keep in mind – this was only cleared to run 2 x 10 minutes every other day. Although I’m pretty sure on that day that I had made up: I was still running Boston 09…
• March 10th, 2009 – Progress was going well..? By March 10th, I was up to a 10K at 7:46 avg per mile. And that was my easy pace back then.
• March 14th, 2009 – A memorable 9 miler doing the last part of the Boston course backwards, with my best friend riding along on her bike. Progress, but with the marathon a little over a month from then, that should have been telling me something about “race readiness”…
• April 20th, 2009 – 113th Annual Boston Marathon. Dumb decisions were made, and lessons were learned. There’s a reason I didn’t post from April until August… Moved back to Minneapolis in the mean time and transfered back to the University of Minnesota.
• August 15th, 2009 – [Mostly] Successfully trained for 2009 Twin Cities Marathon! Had a wonderful training group and felt fast and strong for pretty much all of training. Dropped mileage probably 25% to 30% from pre-surgery averages. Did the first 20 miler of the training block that day. I wrote in this post that the recovery process had felt “slow” … looking back, doing a 20 miler eight months after having a major hip surgery doesn’t really sound that slow…?
• September 5th, 2009 – Did my last triathlon of the summer. Froze my ass off on the bike. Took 2nd in my AG and ?? overall. I remember not being able to feel anything knee down until the last mile of the run!
• September 10th, 2009 – Did the double header of the Victory Memorial 10K/5K. Ran a slower than usual 10K and used the 5K as a cool down… but somehow took 2nd and 1st AG in each. So in my mind… I’m sure that meant recovery was on schedule, right? I also remember that during this photo <– right before the 10K start, I was thinking my hip felt a little “off.” #SOML.
• September 24th, 2009 – Spent the day at the hospital in radiology. That little “off” feeling quickly returned to the same feelings I was having pre-surgery. I knew something was up, and that something was likely no good… At this point I was trained up to the 4th 20 miler of the 2009 Twin Cities Marathon.
• September 25th, 2009 – That rainy, dreary photo at the start of the post set the stage for what was to come. I got a phone call from my doctor that morning saying the images taken the day prior showed positive for a fracture. The same fracture line in my femoral neck that was there way back in October of 2008. Now the question was, did it ever really heal, or did it recently refracture? Was it a matter of the intensity, distance, the fibrous dysplasia, or all three combined?
• October 2nd, 2009 – Pulled out of the Twin Cities marathon. My mom and I watched and cheered on my fellow teammates and training partners, and it was h.a.r.d. I want to say I was just excited for them and the culmination of the many miles put into this race, but the honest thoughts in my mind were how badly I wanted to be out there racing. Back on a no-running, non-weight bearing XT prescription.
• 
• October 30th, 2009 – After great debate, my insurance finally cleared a bone growth stimulator, which I used 30 minutes every day. I wrote that it was a “gift from my orthopedic Santa.”
• November 15h, 2009 – Somewhere in here I was cleared to run again. By the 15th I had done three half hour runs, all at easy pace, indoors on the dreadmill.
• All of 2010 – Essentially a year with a shitton of cross training. Never got back to the “old normal” running mileage from pre-surgery days, which I justified because I was focusing more on triathlon. Lots of swimming and biking, and “medium” amounts of running. March 17th took 3rd overall in the Get Lucky 7K. Finished behind Jenny Wilcox and Amy Lyons, so I was happy to be in their speedy company. Raced New Bri Tri on June 5th and Manitou on June 13th - had an off race in New Brighton, but Manitou went well and took 2nd. Played a hard core game of road kill during the run and passed 68 people! That felt good, but also remember my left lower leg hurting like $#!& after the race.
• July 7th, 2010 – Sure enough.. tibial stress fracture. A compensation injury from having a left leg that is one half inch shorter than the right. Was SO eƒƒing fed up with all these injuries creeping in due to my hip issue, but humbled at the same time that even on my worst days, I still had so much to be thankful for. Posted a bible passage that day: “Be joyful in hope, patient in affliction, and faithful in prayer.” – Romans 12:12. Important one to remember… every. single. day.
• September 22nd, 2010 – Started hitting the weights a little harder, thanks to my wonderful coach at the time, Mrs. Jodi Jones. Tibia had plans of it’s own and was taking its sweet damn time to heal. (read: it wasn’t…)
• October & November 2010 – Ran the Monster Dash half marathon at the end of October as a “fun run” but didn’t race it. Got hit by a truck mono for over a month and really impacted training and fitness. From that point until now, I’ve honestly never run over 30 mpw.
• January through August 2011 – stayed between 10 and 20 mpw, but running felt like it was on a slow decline. On April 22nd I %!&@#*> in a Friday Confessional that “running hated me”, and my body was definitely feeling that. Stuck with the cross training and strength, minimal swimming (oops!) and a LOT of biking. Put in more miles on the QRoo this summer than ever before.
• August through October 2011 – The slow decline turned to big freaking decline, and there were days when I felt like I could barely put weight on my left leg at all. Got my butt back in to see my treatment team, and we knew we needed to take action. My fracture from way back in October of 2008 was STILL not healed – something called a non-union fracture. It had never healed. A second surgery was definitely in order and it was just a matter of determining what the procedure would be, who would do the surgery, and when would be the right time.
• October through now 2011 - continued to go all over for treatment. MRIs, injections, cortisone, x-rays, CTs, you name it.

So… bringing us to the present – we finally have come to the conclusion that the best surgical procedure is a “valgus producing sub-trochanteric femoral osteotomy” … ironically, the same “option #2″ that was recommended (and decided against) way back in 2008. The option with a longer recovery time and a lesser chance of returning to running. I’m scheduled to go under the knife on December 14th, 2011 – exactly one day short of three years after my first surgery. And I’m am so excited to get. this. over. with.

In terms of outcomes for…

• time in hospital
• time on crutches
• rehab  time
• prospects for returning to running
• prospects for returning to distance running
• prospects for returning to racing

… a lot of that is still up in the air. It would be awesome if my recovery went as quickly as the first surgery, but that will be a day-by-day process. And covered in a post to come!

Aaaahhhhhh. I feel better. You might not if you read that whole thing… but I give you mad props if you made it all the way through.

This post is beyond long enough, but I just wanted to bring everyone up to speed. (And it was a good project I could do while in a post-turkey coma!) The prayers and good wishes many of you have sent this way, and the support you all provide? You all are my angels, and on this day of thanksgiving, I want to let you know how THANKFUL I am for all of you.

Reader Qs:

Have you ever dealt with an ongoing injury or illness? How did it affect your training/racing/life, and how do you deal with it now? Did you have a good thanksgiving, and what is your favorite kind of pie?

Happy thanksgiving!!

-Erika

First of all, THANK YOU for all of the comments, texts, facebook messages, and emails that were sent regarding the last post. It’s either a really simple subject to talk about (with doctors, God, and um.. that’s it) or a kind of difficult subject to talk about (anybody not included in in category #1). The other day I realized… one of the things that puts it in that “difficult to talk about” category is that other than my doctors, no one really knows much about fibrous dysplasia. My doctors are great, but I can’t call them at 3am when I’m freaking out because I rolled onto my left side and woke up from pain. I can’t call them when I’m stressed about the amount of time this is taking to decide on a surgical procedure. And I definitely can’t call them and cry about missing practice or racing or my team. (p.s. If you want to know a little about it, I sent this article to my dad, mom, and sister. It’s an inanutshell kind of article about fibrous dysplasia. Short and simple.)

But please believe me dear friends and family, the support you are giving me is something that I appreciate beyond words.

Updates and such to be continued…

Secondly No – I didn’t accidentally OD on pamidronte. I know it’s Wednesday. But we’re going to pretend this is a Three Thoughts Thursday, because that’s really all I got for you right now. (Plus, tomorrow has other plans. )

1 // Giveaway tomorrow!!

2 // Pinterest. Nuff said. You can follow my pins (is that even how that works…?) or just check em out. I know Mrs. Lindsey Cotter found me somehow. The other three followers? One is a TC blogger, one is the saviour who sent me a new iPod, and one is myself. Total of 4. Balllller.

3 // Please answer poll below. Topic of upcoming post…

Again –  I don’t know how to put into words the appreciation I have for all the support you guys have given. I kind of feel like this…

 Bear hug. ^_^

I don’t know where this little animal love came from. Sorry little critters… not going back to being a vegetarian!

Take care, make sure to come back tomorrow for the giveaway, and remember: Life is too short for bad coffee.

-E

I have let myself become far too familiar with their Orthopedic Oncology department. I shouldn’t be able to tell you the first and last names of the three doctors there with that specialty, I shouldn’t have let myself get sucked in to the research they’ve done and the studies they’ve published, or get emotional over the testimonials from Mayo patients around the world. But I can, I did, and I did again.

Inspired, because they are a worldwide leader in medical care, research, and education. They have more than 56,000 scientists, physicians, students, and allied health staff.

Comforted, because they have a philosophy that the patient comes first, and they live by it. Reading their Value Statements is like sipping a pumpkin spice latte in front of a crackling fire. Because after reading different patients’ stories, I know I will be taken care of.

Terrified, because reading those same patients’ stories puts me in their shoes. Terrified because it makes me a patient who will be telling a story. Terrified because only good stories are turned into testimonials. Terrified because not all stories are fairy tails.

Disquieted, because I have never been in this situation before. Because I don’t know what the outcome will be. Because I feel selfish for being scared, when it could still be so much worse. Because I feel like I have no control over any single part of the situation. Because yeah, they change lives, but they can’t change things back to the way they used to be.

Sorry if this seems like a big downer post… and especially one that came out of nowhere. I tried for a long time to not talk about this at all on the blog, but I realized that writing about it and being honest is some of my best therapy. Especially when running is out. I’m not sure if I want sympathy or validation or just to simply get it out of my system… but what you get right now is pretty much just raw, unedited, me.

There’s still a lot up in the air about procedures and dates and first vs. second vs. third opinions. The only opinion I currently have is that I want to get it over and done with and move on. Right now I’m left with way too much free time to ponder the what ifs, the could bes, and the used to bes.

It is also effing with my sleeping schedule… which is why I’m writing this at 3am. Going to try to fall back asleep now.

-E

[Disclaimer - if you don't like needles, there is a needle picture coming! It's teeny tiny though. And no blood.]

(Marking nerve landmarks. Please ignore unfortunate/awkward position of the hand.) Last week I had the pleasure of being on the receiving end of an EMG, or Electromyography. That E_G sequence may look familiar to you, as in ECG (electrocardiogram), EEG (electroencephalogram), EKG (same as ECG). An electrocardiogram is for monitoring your heart, and an electroencephalogram for picking up electrical activity of the brain. (Question for you Dr. Greg or anyone else who can answer… why is an EMG -graphy, and ECG and EEG are -gram?)

So then, what is an EMG?

An EMG, or electromyography, is a diagnostic test used to evaluate the health and functioning of motor neurons and the muscles they stimulate. You can use electrodes placed on the surface of the skin to detect or transmit electrical signals, and/or you can do a needle EMG, in which case a needle is placed directly into the muscle and records electrical activity. I was fortunate enough to do BOTH, because really, who doesn’t want to be shocked and skewered by their doctor?

The electrodes were moved around as he shocked different nerves. A made-me-jump shock at my elbow felt like a finger tap on the medial side of my palm. Hmmmm….)

Your doctor may order an EMG if you are experiencing tingling, numbness, loss of motor control, weakness, pain, or cramping. An EMG may be used for preliminary testing for muscular dystrophy, polymyositis, myasthenia gravis, carpal tunnel syndrome, amyotrophic lateral sclerosis or a herniated disk in the spine. Putting my sarcasm aside for a minute – I am very thankful that I have none of these are my diagnosis, and honestly and deeply do appreciate my health.

A neurologist typically reads the graphs/charts created during the EMG, and will go over it with your doctor, who will go over it with YOU. There are really only two outcomes: normal tells you you’re fine, but doesn’t solve the question/issue you were trying to solve by doing an EMG in the first place… and abnormal tells you you have more testing to do.

And that, my friends, is more than I’m sure you ever wanted to know about electromyography.

(Needle EMG! It was honestly the size of an acupuncture needle… teeny!) If you’re wondering why I was getting an EMG in the first place, it’s a long story that I’m about to make really short. A couple Sundays ago, I was in the middle of a pull set (in the pool) when I realized water was flooding through my left hand. No matter how hard I focused on it, I couldn’t keep the fingers on my left hand together. I was only about 1,000m into the workout, and it was a pretty easy swim to begin with, so I was reasonably frustrated and confused. (Imagine trying to kayak with a paddle full of holes!!) No pain, just weakness and lack of motor control. If you have ever come in from a winter run and you can’t coax your fingers to turn a door key or untie a shoelace, that’s exactly how my fingers felt (/feel). Fortunately, I already had an appointment scheduled with my sports med doc anyways for later that week, so I was able to get in and get her (doctor’s) opinion relatively quickly.

However, the issue is still not resolved, as I haven’t been able to successfully swim more than 1000m before losing strength in my left hand. (I know – cry me a river. But even if you don’t love swimming, you’d probably miss it too if you’re used to swimming on a regular schedule!) It’s mostly affecting the extensors and the pinky and ring finger, which to me sounds like an impinged ulnar nerve. The person reading the EMG had the same consensus, and now, I think, it’s just a waiting game.

Reader Qs:

Have you ever had an EMG, ECG, or EEG? If so, why was it ordered, and what did it show?

See … Mondays aren’t really so bad. You get to learn something new, and you don’t even need to sit through a whole semester of PHAR 5201! Make the start of the week a good one!

-E

I’ll tell you what it looks like to me – a healthy, happy, solid right tibia. Which sounds about right… I had a pain-free, speedy 5K on Tuesday the 24th (May), and any tibial pain I was feeling a while ago seems to be gone. (**NOTE** That’s not my leg. The CD from my radiologist doesn’t work on a MAC?! Grrr….)

So then at my doctors appointment last Thursday the 26th, why did my doctor order no running or elliptical for three weeks?

STRESS REACTION.

While I wouldn’t wish a stress fracture on anyone, I’m sure there are quite a few of you out there reading and shaking your head with sadness because you too are familiar with this diagnosis. Stress fractures are in the top 5 most common injuries reported by runners, and have been said to account for up to half of the skeletal injuries reported by military recruits. Contributing factors to stress fractures commonly cited include: age, sex, lean body mass, low bone mineral density, low body weight, late onset of menarche, history of stress fractures, disordered eating, and low dietary calcium intake. However, conclusive evidence regarding the pathophisiology and epidemiology of stress fractures is “lacking” considering many studies are short term and use a small population sample. Nonetheless, the one common thread seems to be participation in repetitive, weight-bearing activity. (1) Oh, hey running!

(Nov. 2008 – femoral neck fracture) So what exactly is a stress fracture? A tiny crack in the bone, resulting from repetitive stress or loading. Often caused by doing “too much, too soon” (coughcough 10% rule!), weakened bones (osteoporosis, osteopenia), sex (women, especially with a history of amenorrhea or oligomenorrhea), and faulty biomechanics (leg length discrepancies, heavy heal strikes, etc.). Presents with pain, swelling, tenderness in a specific spot (the “hot spot”), increases in these symptoms with activity and decreases with rest, and earlier onset of these symptoms with each successive exercise bout or workout. Typical treatment is every athlete’s most dreaded prescription – rest. And possibly crutches or the boot of doom. (2)

A stress reaction then, in short, is the precursor to all of this. You are toeing the dangerous line of developing a stress fracture, but haven’t gotten there quite yet. Which apparently, is the case with my left tibia.

Three weeks of no running was [IMO] certainly a conservative measure, but truthfully my running had become so sporadic at that point that I didn’t really care. Some days it was great, some days it hurt. The mandate of “no elliptical” was an attempt to remove any unnecessary loading on the bone and speed up the process of recovery, and the prescription to bike and swim my butt off was to any ounce of sanity left, not to mention not be disowned from my family (or fired from work) for grouchiness!

Following this three-week-reset I’m going in for a running analysis (Wednesday the 15th) and hopefully will develop a plan with my sports-med team to come back to running (and racing!) safely, and solidly. I’ve been doing all of my treatment for quite a while now at the Institute of Athletic Medicine, and I can say with 100% honesty (and zero persuasion) that I LOVE them. They are honest, direct, proactive, and do what needs to be done!

With a little insight from a couple close freinds/family, I’ve realized lately that ever since my hip surgery in December of 2008 I haven’t been quite the same person.  Aside from the cascade of injuries since that date, my “psychology has been off”. My highs aren’t as high, and my lows… well, they’re definitely more apparent. Everything I think of in my history is separated into a “then” (pre-surgery) and ”now” (post). So I finally asked my doctor lastlast Thursday,

Do you think I’ll ever go back to being a “real” runner again? Like the girl who just wakes up and runs out the door, and doesn’t think anything of it? Do you think I’ll ever be able to run another marathon?

And her response?

Yes. Absolutely. But will you be able to exclusively be a runner, and not do anything else? No.

Seeing as how I’m slightly invested in this triathlon thing, I guess I can roll with that. I’m not sure if her “yes” included being able to run marathons again or not, but for now I’ll just take things one step at a time.

(Manitou Tri – June 2010)  Regarding racing: my three-week hiatus unfortunately extends past June 12th, which is the date of the Manitou Triathlon. This is hands down one of my top three favorite Minnesota races, and “bummed” doesn’t exactly exemplify how I feel about missing it. My plan until my legs are race ready is to volunteer (and relay!!) my butt off. I’m definitely not ready to leave the Minnesota Tri community yet.

READER Qs:

Have you ever had a stress fracture, or a stress reaction? Any local readers racing Manitou?Anybody interested in a TRI RELAY!? What is your next race coming up? What is your favorite form of cross training when “on the mend”?

Take luck mis amigos (+1,000 if you know the reference!!!!),

-E

(1) Kelsey, J. L., Bachrach, L. K., Procter-Gray, E., Nieves, J., Greendale, G. A., Sowers, M., & … Cobb, K. L. (2007). Risk Factors for Stress Fracture among Young Female Cross-Country Runners. Medicine & Science in Sports & Exercise, 39(9), 1457-1463. doi: 10.1249/mss.0b013e318074e54b

(2) Mayo Clinic. (2010, December 7). Stress fractures. Retrieved from http://www.mayoclinic.com/health/stress-fractures/DS00556

Let’s go.

Cryotherapy is the method of reducing pain or swelling with the use of ice or cold temperature. Cryo = involving or producing cold, especially “extreme” cold. From Greek kruos – ‘frost‘. For whatever reason, I think I must like this whole cold therapy concept, because I have tried just about EVERY product out there. This should come as a shock because in my book, the #2 worst feeling in the world (next to #1 – being lonely – haha!!) is being COLD!! Maybe cold therapy is different in that it serves a purpose, whereas standing on Hennepin Ave for an hour in -18° windchill to watch the Holidazzle does not.

Um… anyways. If you wander on over to the search bar on the right and type in the word “ice” you will see that I’ve experimented quite a bit. Actually, I think the search bar looks for “ice” in any part of a word, like nice or twice, so that’s an inaccurate representation. But for proof, there is definitely photo documentation from April 6th, 2008 of frozen corn ice packs. I’ve used frozen peas, a bag of frozen meatballs, frozen… water (ice cubes? really?), the dixie cup method, school lunch ice packs, and the mother of all, the ice bath.

Now, in my experimentation, I have faced two separate problems. 1) the source of kruos and its’ ability to remain cold, and 2) the method of transportation. Referring to the above image, you will see that I attempted the Hair Band method of affixation. While in a static, non-moving position, the Head Band works just fine. However, if you feel the need to move for any reason – run to answer the phone, get up to use the restroom, walking around the kitchen making dinner, etc. – your S.O.L.

Using a hair band or not, most icing is done while sitting down. Well that’s dandy – hopefully you’re elevating too like the doc’ told you. But sometimes the recommendation is to ice, oh, 5 times a day for example. Unless it’s your JOB to do recovery and ice on and off all day, chances are you need to be up and active, regardless of your little “inflammation”. I introduce to you…

ARCTIC EASE

While they don’t claim to give you back muscles like Mr. Lats over here… they provide a cold therapy wrap or pad that accomplishes BOTH of the two stated problems above. They STAY PUT and they STAY COLD! I was going to attempt to put all of my feelings for Arctic Ease into a concise and coherent paragraph, but my passion was just too strong. Thankfully, they did it for me!

Arctic Ease wraps and pads are an incredibly simple but effective alternative to traditional cold therapy. They absorb heat energy from the body to cool the covered area. The absorbed heat is then lost to evaporation, which allows for hours of targeted cold therapy. Arctic Ease is ready to use right out of the package — no refrigeration is necessary. And mobility isn’t limited since Arctic Ease conforms to the affected area without the need for clips or tape. Arctic Ease is reusable, odorless and environmentally friendly.

I wish I were exaggerating. Having a cold therapy fetish is not something I’d recommend you list on your resume. Or your match.com profile. But this stuff is GOOD! I wish I’d thought to take some action shots the several times I’ve used them, but whattya know I was out and about being active! No, not exactly resting or elevating, but icing AND compression in one! Score.

Best of all, you have a chance to try Arctic Ease. The cost? 15 seconds of your time to leave a comment with one of the following:

1. What do you most frequently have to ice? I had to ice my groin/hip flexor after surgery. It wasn’t so much inconvenient as awkward. Definitely not something I’d try on the go with a leaking+melting bag of ice…
2. Go to Arctic Ease’s website, and tell me something cool you learned! Other than what I’m contributing – The optimal temperature for effective cold therapy is above 59° F (15°C).*
3. Tweet this giveaway OR mention it on your blog! You can just link it to http://drtrirunner.com since I think those ityURLs are tacky. Make sure you include @SperlyTriRunner if you’re tweeting so I can see it! (You don’t have to follow me, but you’re more than welcome to if you want!)

If you want more than one chance to win, make sure you comment for each item individually! The giveaway is open until ONE WEEK from right now. (Tuesday November 2nd, 6:50 pm CENTRAL)

And there you have it compadres! After reading my buddy Jaime’s post today… I know where he definitely will not be icing with these! (Please note that this link contains PG13 material.) That kid nearly broke my face from laughing so hard!

I hope everyone has a wonderful week ahead, and if you live in Minnesota (or Chicago I hear?) you haven’t been BLOWN away!! 81 mph wind gusts says the Chicago AP. Psh…. adversity training.

-E