Showing posts with label piriformis syndrome. Show all posts
Showing posts with label piriformis syndrome. Show all posts

Wednesday, September 17, 2014

Scar Tissue: Pain in the Butt

Why is it that I only really seem to blog when I am injured, or excitedly returning from injury? Maybe this has just been an outlet for frustration. Not acceptable! I need to better document my running journey, for my own reflection primarily, and maybe in hope that it can be of use or inspiration to fellow runners.

So, an update. Since settling back in in St Pete, I got a part-time job at Fit-2-Run (awesome people to work with, great to connect with other local runners) and in my training, have been following the Hanson's Half-Marathon method primarily. The premise of which: fast speed work in early phase, strength workouts in middle phase, with lots of race pace-specific mileage.


I liked it, and it was working fairly well so far. I was beginning to master my tempo pace (7:20/mile) over 3 and 4 consecutive miles, and even ran a 22:50 5K in the middle of my workout. Definitely not a fast 5K race time for me, but pretty damn good for the middle of a workout, 10 months after giving birth. I was struggling a little bit with the faster (5K race pace) intervals, though.

All was going well...so, so well...and in the midst of this, my Brooks Adrenalines were starting to feel a bit different, more lumbering and too roomy. After spending some time on the camera treadmill at my workplace, I discovered two intriguing anomalies of my post-partum body:

1) My running shoe size went from size 9 down to a size 8
2) I no longer overpronate.

What?

Isn't everything supposed to get bigger after having a baby? Not smaller and more efficient? Whatever, I'll take it! So now, am in a soft, comfy neutral trainer - Brooks Glycerin 12 - and am doing speed/tempo runs in Saucony Kinvara 5 (see left). I never could wear Kinvaras before, as they were always too narrow and didn't support my pronating feet, but due to my body changes and the wider toebox in the newest model of the Kinvaras, they are perfect! Fast and light, could even be a racing flat.

I was finally starting to feel like my old running self again! Fast, confident, and had trimmed down to about 6 lbs lighter than I had weighed in years. Couldn't wait for my trip with baby Jack to NY, and the 10 miler race I was planning on running there.

Then it happened. Low back pain on the left side this time, which initially felt like I just didn't sleep well on it (with an 11 month old, it happens. A lot.) But the pain persisted, and started traveling down into my glutes and hip.

Too. Damn. Familiar.

I knew right away why this was happening: with our new family schedules and Jack needing me as soon as I walk in the door from my runs, I was neglecting my strength training, and post-run stretching/rolling. Basically I was doing little to none. And I should know better. Definitely, should know better.

So I engaged in typical foam rolling, denial that I should take it easy, icing, heating, more denial, and then two days before the race in Nyack, my cousin (an amazing massage therapist) worked on me a bit, and she suggested some strengthening exercises. Called Foundation Training, these were lower back, glute, and hamstring exercises, that would also improve my posture and stabilize my core. Great exercises, though too late for my 10 miler. The day before the race, I did a test run, which did not go well. It didn't feel exactly like before - possibly not the piriformis - but definitely hip and lower back pain. Part of me wanted to grit through it and race, but the other part knew better. So I didn't run. I moped, I cried, I watched other runners gleefully run through town on a beautiful, perfect day. And then we went into NYC as a nice consolation prize. A wonderful day! Where else could Jack and I hang out with Teddy but at the Museum of Natural History?


Upon returning to St Pete, I grappled with what to do next: see a chiropractor, see a physical therapist, find another ART practitioner? A coworker gave me a recommendation for a sports doctor who practices Manual Adhesion Release - distinct from ART in that it takes a more targeted approach to soft tissue problems by analyzing motion, rather than a shotgun approach to the symptoms. My coworker said Dr Maggio at Peak Performance Sports Therapy worked wonders on her, so I set up an appointment with him. He was able to diagnose my issue fairly quickly based on my range of motion: scar tissue buildup on my hip, interfering with proper muscle contraction in my "deep 6" muscles.


Now we get to work...his techniques are similar to ART, taking my leg through a range of motion while he works to break up the scar tissue. It hurt like hell, and afterwards I was sore in a part of my body I didn't think I could be. But I trust his assessment, and trust that the process will take time to fix my issue for the long term. He assured me that I would most likely be able to resume training for the Women's Running Half Marathon in November, my near-term goal race.

I am grounded from exercise of any kind for the rest of the week, going on 1.5 weeks of no running now. While I am, of course, going a little bit crazy (especially working at a running store), I am able to keep better perspective than before. Though I am still sore when I rotate my hip at all, my range of motion has been improving.

No less than 2 days after my first appointment with Dr Maggio, the Women's Running Half Marathon was cancelled. Very sad about this for lots of reasons, though maybe its a blessing in disguise for me. I can fully commit to getting my body healthy and stronger, so that I can make a powerful comeback at the Tomoka Marathon in March.

This injury, here is what I have learned thus far:

- Scar tissue can build up over years of muscle stress, not just from acute injuries
- Scar tissue can be cleared fairly quickly
- The "deep 6 muscles" are a real bitch to massage and treat. They are the hip's external rotator muscles and are shown below (piriformis, gemellus superior, obturatur internus, gemellus inferior, obturatur externus, quadratus femoris)
- Back pain can be attributed to hip dysfunction and muscle compensation
- Improvements in my posture and back strength will significantly help my running (once my hip is healthy)



None of these things are surprising, they do make a lot of sense. I am now committed to getting this pain in the butt healed, and committed to better strength training to prevent future injuries. Stephen and I joined LA Fitness just three blocks away from our home, and I have established a stretching routine that works with Jack's schedule. We shall soon see how the recovery goes, and how quickly my fitness returns to normal...

In other news, today I became a member of the Oiselle Flock! Very excited to be connecting with this awesome group of women in their running pursuits. It already is great to see them on Twitter, and they have been so welcoming and warm to the new members. Helps me feel less alone during my runless days. Can't wait to get my singlet, and more than that, I can't wait to be "Fit-2-Race" once again!