Wednesday, March 16, 2011

Facing the Music

meaning "to accept the unpleasant consequences of one's actions."

I am stubborn.  There, I said it.  

Piriformis pain - an advanced case coupled with a extremely tight hamstrings, IT band and some other tight muscles has me has me waddling like a penguin from point A to point B.  I know I have mentioned it countless times but in an effort to try and organize my blog a little better a brief history.

Before I was a runner or a cyclist I was a stressed out law student who spent countless hours sitting, studying and stressing.  I also wore 3 inch heels everyday.  While studying for finals in spring 2006 I experienced some of the most horrific pain radiating down the side of my left leg.  Because, as I mentioned above I am stubborn, I tend not to go to a doctor right away when experiencing pain because it always seems as soon as I go to the doctor whatever it is goes away and they just look at me like I am crazy.  Within a weeks time it went away and I concluded I must have pulled a muscle or something.   However, it returned, and returned, and returned, not only to the left leg but to the right as well.  I finally saw the doctor.  He told me it was a pinched nerve and to stop wearing heels.  WHAT!!  Stop wearing heels?  But I have closets full of beautiful shoes and you are telling me to stop wearing them?  I was stubborn and didn't.  The pain continued.  I stopped wearing heels.  The pain continued. 

By now I was starting to run so I went back to the doctor.  He told me it was sciatica.  "What is that?"  "When the sciatic nerve gets pinched between two muscles."  "Well how do I get it out?"  "Here are some stretches."  I did the stretches, it was temporary fix, but the pain would always come back.  When I researched sciatica on my own I concluded that sciatica is not a diagnosis - it is a symptom of an underlying problem with the lower back such as a herniated disc.  This is an important distinction because it is the underlying diagnosis that often needs to be treated in order to relieve sciatic nerve pain.  I went back and asked for an MRI (a horrible experience for a claustrophobic person mind you) to check for disc problems - it came back fine.

By now I have been dealing with this for two years.  The pain comes and goes - when it is gone I have free range of motion, can wear heels, run, do everything normally.  When it comes it freezes me in my tracks, has sent me to the ER more than once, keeps me from lying down, and makes the simplest tasks such as walking impossible.

More research concluded that often a particular event or injury does not cause sciatica, but rather the sciatic pain over time tends to develop as a result of general wear and tear on the structures of the lower spine.  I have found certain things that aggravate it (such as slouching, carrying heavy boxes, heels, etc) and refrain from engaging in those activities.  Funny enough it is never running that actually aggravates it, however, at times, the pain makes running impossible.  I go back to the doctor one last time and beg for anything, anything at all.  We try physical therapy, the same stretches I was already doing.  The pain still comes and goes.  He says to take anti-inflamatories.  It still comes and goes. 

Fast forward another year - I am still running, I won't let it stop me, but still battling monthly/bi-monthly episodes.  I stop talking about it as I figure it is just something I will have to live with.  From time to time people ask why I am walking funny and I just answer "back injury."  I am tired of explaining the story.  I have been to the doctor countless times and they can't help me so I conclude there is no hope and this will just be a fact of life.  I have a fairly high pain tolerance so I just push through the pain when it flares up.

In 2009 Samantha and I are talking and she asks me if I have ever tried seeing a chiropractor.  Yeah right I said, I am not letting someone crack my back, those people don't know what they are doing (please forgive my ignorance but yes, this was my mindset at the time).  She said she had felt the same way but after she had a treatment by a close friend who was a chiropractor she felt differently.  I was skeptical (very - so much so I told the chiropractor this when I saw him the first time - so sorry!) but was so sick of dealing with the pain I thought I would try anything.  I went to see him and the first few adjustments were very painful (not the actual adjustment but the aftermath) but low and behold it worked.  Come to find out I was right - sciatica is a symptom, not a diagnosis.  He stressed to me the importance of stretching, foam rolling, etc in order to keep the adjustments where they needed to be.  This means core and strength training work to make the muscles strong.  I half listened and was so happy to just feel better I thought I was cured. 

The episodes did return but this time they were more like 3-4 months a part and would only last for a week.  I decided I could defiantly live with that.  Also, as long as I made sure to not sit on the floor, sit too long, wear heels for too long, fall asleep in weird positions, slouch, lift really heavy things and thoroughly stretch after exercising I was okay. 

2010 was spend doing a lot of those forbidden things - especially sitting with all the studying.  Coupled with a complete lack of strength training and stress the pain came back tenfold.  I blogged about it here, while training for my century ride, and ultimately it was one of the factors that kept me from from finishing CIM.  I saw another chiropractor in my new city who diagnosed as "piriformis syndrome" and performed "active release therapy" on my leg.   

I *thought* the pain had subsided since CIM, given I hadn't been doing much due to studying but last week when I started training again, it came back in full force.  This time is is lingering around longer and more painful than normal.  I have spent three sleepless nights on the couch because I cannot lay down and have been pretty useless in terms of getting anything done the last few says because of the pain.  Usually by now the pain has subsided a bit but not this time and with two half marathons, a marathon and two century rides all within the next seven weeks I knew something had to be done. 

This is a condition I have been dealing with now for five years and I am tired of dealing with it, tired of complaining about it, and want it gone.  In the past I have tried to get the quick fix but realize now it will probably never go away BUT if I am diligent and proactive I can make the pain manageable.  This means committing to the daily exercises prescribed and doing that core work.  While up in Sacramento the other day I visited my old chiropractor and he said something that scared me.  My back is out of alignment - I need to commit to treatments to get it back to how it should be.  It is causing other muscles to tense and tighten because they are not being properly supported.  He said my walk was off and that I am compensating for the pain and if I continue to train at the intensity I want I will start wearing my bones out in ways they weren't meant to be "worn" which will lead to hip and knee replacements later in life which will lead to absolutely NO RUNNING OR CYCLING ever again.  On my drive home I really thought about it - sure, I can push through the pain, I have done it a million times, but is half-assing a race now worth the potential long term effects?  ABSOLUTELY not!  I would a million times over rather miss a month of running now that be told at age 45 I need a new hip and cannot run at all - all because I was too stubborn to attend to the problem.

When I got home I immediately called a new chiropractor/trainer, someone who came highly recommended as well as specializes in sports injuries and went to my first appointment today.  He conformed everything I suspected.  The good news - this can be fixed, through 5-6 weekly appointments he will be able to get my back where it needs to be, then, it will be up to me to keep it that way through daily stretching (10 minutes tops) and building up my core.  The bad new (as I expected) - healing takes time and time means slowing down.

I know I will never be 100% cured and it will be something I have to deal with for the rest of my life but I am committing to getting this problem under control and managed.  I have accepted that with anything in life, there is no quick fix, but if I want to be active later on in life I have to take care of this now - the prospect of the long term effects are just unacceptable to me.  In this post I said I was going to do things differently in 2011 and take it one day at a time yet I found myself quickly committing to a busy schedule.  So I am taking a step back and making my health my priority to ensure a lifetime of running and cycling.  Should I someday chose to stop I want it to be on my terms, NOT because I am physically unable.

So there you have it.  In my next post I will explain what this means in terms of the upcoming months but I hope after today I will never have to complain about this problem again. 
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  1. I'm so glad you are taking this seriously and seeing somebody on a regular basis! I hope you stay committed to it. I know just going to the chiropractor or even the doctor can often feel like "one more thing added to the giant plate of stuff to do" but I think it's so so important.

    Do we need to talk about all of our upcoming plans?

  2. Plans can wait, there will be other races---what's important is taking care of yourself. Like you said, you'd rather take some time off now than be getting a hip replacement at 45.

    I said this before and it's small potatoes compared to what you're going through BUT everytime my back hurts or feels naggy I start up my core routine and everything seems to feel better. I hope the treatments and yoga help you!

  3. I feel like you wrote this for me! I am in the exact same boat and said I was taking it one day at a time and before you know it I am signe dup to run 3 marathons in 8 weeks....what!?! I hope you get some relief and start to feel better! I had to drop down to the 9miler for Big Sur so just know that if want to do the same you'll have company :)

  4. best to deal with it now then make it worse. Lots of races down the road.


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