Ow, my bum

It's been a week since my second lot of PRP injections, and boy, has it been a long and difficult week.

Apparently I did too much after my injections last time so this time Dr Kuah said, very clearly, that I was not to run or ride for two weeks. I could swim but only if I used a pool buoy. He then wrote it all down and underlined the word 'STRICTLY' on it. He was serious.

The purpose of all this is to give the tendons the best possible chance to repair. It makes sense, but that doesn't mean it's easy.

Do you know that swimming using just your arms is boring? And slow?

To be honest, the main thing that has been hard to deal with isn't being told I can't ride or run - yes, that's not fun but I can see it has a purpose. The biggest hurdle I'm facing is coming to terms with everything I'm going to miss this year.

No Canberra Marathon. No SMH Half. No state road 10k. No SMC. No Woodford to Glenbrook (there goes the chance of winning five years in a row). Highly unlikely I'll be able to do M7 Cities Marathon.

It's a bummer alright and I spent quite a few days feeling really down in the dumps. And frustrated. And I probably wasn't the most fun person to be around. (Public apology to my husband and thanks to family who went on a 'cheer up Joh' campaign on Sunday).

Physically, I think the post-injection pain has been a little worse this time. I didn't bruise as much as the first time, but sitting in a car for more than 15 minutes really hurts it. When I'm working on my computer I move around a lot (the joy of laptops) so I'm constantly changing position. I joked with my husband that I think Dr Kuah must have done something different this time in order to stop me running too soon.

I'm back doing rehab exercises and my right side is responding really well - I actually think the right side might have been OK with only one injection. As for the left side, Dr Kuah said he feels it'll probably need a third injection in four weeks, but Brent (physio) will test things out before that date and we will decide from there.

I'm hoping it doesn't need another one so I can start getting into some proper (if modified) training. Another injection means more time spent doing nothing (OK, pool-buoy swimming). Having said that, I'm obviously going to do whatever Dr Kuah and Brent recommend. They're the experts, they've got a lot of experience with high hamstring tendinopathy and I've got a lot of confidence they're giving me the best treatment and advice.

Oh I miss running. Miss, miss, miss it so much.

Lost: Motivation. Please return if found.

The longer this injury goes on the harder it is to motivate myself to get on with doing what little training I can do.

Every weekend I'm seeing races come and go. I'm seeing other runners progress and I'm feeling myself falling further and further behind. I do try to remain positive, and I can maintain a positive rhetoric and say all the things I know I should be saying, but the truth is that it frigging hurts and it sucks and I'm sick of it.

When the alarm goes off in the mornings, these days there is a great temptation to roll over and go back to sleep rather than get up and ride or go for a pointless (i.e. no specific goal) run. On Friday my massage therapist asked me how my body was feeling in general and I said I didn't know - it doesn't feel like my body. I feel unfit. I feel slow. I feel out of condition. Actually, I AM unfit, I AM slow and I AM out of condition.

There has been a great deal of swearing going on in my house as I try and deal with the frustration I'm feeling. Not only is this injury a physical struggle, it's also taking a pretty big mental toll on me. And unlike when I'm dealing with other things that stress me out, I can't go out and run to relax because the running (or lack thereof) is the cause of it.

I have to keep reminding myself that it isn't all doom and gloom. I know I am improving, it's just that the rate of that improvement is far too slow for me and my goals for this year. With Canberra Marathon off the cards in April it looks like my first chance at a marathon won't be until the end of July this year. That's half the year gone without trying to crack the 2:50 mark.

Of course, I'm also looking at the shorter races I'm missing. I really wanted to give SMH Half a good go this year, but I'm beginning to doubt I'll be in shape for it. If (when) my hamstrings ever come right it's going to be such a tough job getting back into race condition. At least when I started training with Sean last year  I had a strong endurance base and all I was really trying to develop was my speed. Now I'm starting from scratch on both counts. Insert swear word here please. Make it a bad one. 

Forgive this uninspiring post. I do try to remain upbeat and embrace all the positives in my recovery but sometimes a girl's gotta cry a little and a good blog's all about honesty, right? I love to run. I love the sense of achievement it brings when all the hard work comes together. I'm really, really missing that right now. I miss the camaraderie too. It probably sounds cliched but it's true - I love running and racing with other like-minded people. Especially at races like SMC where everyone cheers everyone else along.

Finally, some basic housekeeping:
I have my second lot of PRP injections on Wednesday after work. A week later I'll go and see Brent (physio) and we're going to do a whole lot of strength testing to see how things are progressing.

I used my Garmin for the first time in months yesterday. I've been avoiding it because I knew the figures would just depress me. I ran for 60 minutes at 4:40 pace. Better than nothing I guess and at least I can now start tracking my progress.

Everyone's looking for an answer

The amount of people who have stumbled across this blog because they've been Googling "high hamstring tendinopathy" really surprises me. For an injury that's supposedly uncommon there are lots of us searching for a successful way to treat it and get back to our running. 

With that in mind, I thought I'd post another one of the rehab/strengthening exercises I've been doing. I found this example on YouTube. One thing you've got to be aware of (and something I've been doing wrong up until starting physio with Brent) is that you're not supposed to squeeze your butt cheeks together. Instead, you've got to focus more on the outer part of the glute. If you're suffering from HHT (and yours is anything like mine), the area you're supposed to be working is the same area you get relief from when you poke it/massage it, if that makes sense. 

After my injections on Wednesday I developed quite substantial bruising at the injection sites by Friday.  Big and purply/red. Yuk. I have a photo but it's not the greatest angle! The bruises have faded now and, although the injection sites are still a bit tender, everything is feeling much, much better.

I had my first run since the injections yesterday (Sunday), which was only 30 minutes. I ran again tonight for 40 minutes and I really felt great. Much stronger and moving a lot easier. I find it hard to believe that the injections have worked so quickly (they are a gradual thing, although I read somewhere they start doing 'stuff' about 10 minutes after having them), so I'm more inclined to think the rehab exercises are doing their job. I've biked every day since Friday (couldn't do a thing on Thursday). Aero position is great because there's less weight resting on the injection sites.

I miss training. I miss racing. I miss feeling strong. I miss the tired satisfaction of completing a difficult session.

I just want to get back into it.

PRP injections

I had my first lot of PRP injections yesterday.

The whole process was pretty amazing. My husband and I went to SSMC after work (he had to come because I wouldn't have been able to drive home after the injections, especially in peak hour traffic. When I went in to see Dr Kuah, he looked at my MRI scans and talked me through what he was looking at. He said it was what he expected from someone with high hamstring tendinopathy. He then talked to me again about the PRP injections and why he recommended them. I'd already done a lot of research on them after seeing Dr Kuah last time so I was prepared to go ahead.

One important thing I did ask was about shock wave therapy, which someone else I know has been treating HHT with and has been getting good results. Dr Kuah said shockwave therapy has a good result with calcific tendinopathy (which she has) but not with what I've got. Apparently with me it may have some immediate results, but wouldn't help the tendon long-term, which it what I want/need.

To start the PRP injections I had four vials of blood taken out of my arm. This was then taken away (to a centrifuge I assume) so the plasma could be separated. While this was happening I had a local anaesthetic in both legs (just under my butt), which Dr Kuah put in with the guidance of ultrasound. I found it fascinating to watch the screen and I wanted to talk to him about it but I didn't want to distract him and make him mess up so I stayed silent!

Dr Kuah then went and 'harvested' the PRP. While I was laying on the bed in his office it was very reassuring to see signed photos from gold medal Olympians and Comm Games athletes with messages saying, "Thank you for keeping me in one piece." If they trust Dr Kuah with their bodies, I certainly do too!

The PRP injections were painless (just felt a bit of pressure) and I watched them go in on the ultrasound. This time Dr Kuah talked to me so I figured I was able to ask him about what I was looking at on the screen. He pointed out different things (I was way off - what I thought was the tendon was actually the bone) and I saw how he moved the needle around.

After the injections Dr Kuah asked if I had any pain medication at home and recommended I get Panadeine or Panadeine Extra because things were going to get a bit uncomfortable. I nodded but had no intention of getting any - I rarely take any drugs and I figured I'd be fine.

About halfway home (in peak hour traffic) the pain started to kick in a bit. My husband said we were going to the pharmacy just in case. I acquiesced.

I ended up taking one tablet but it didn't really do much. The night was uncomfortable, as was today. I didn't do any form of training because I physically couldn't. I'm walking like the tin man, it's uncomfortable sitting on my butt and I feel like I really need to stretch. This was all explained to me and expected and I'm hoping it'll be greatly improved tomorrow.

In four weeks I go back to get my second lot of injections. In between now and then I've got to keep up all my physio excercises (once the pain from the injections is gone).

I hope it's not false hope but I'm feeling a lot more positive about things now. I'm pretty sure Canberra is a goner this year (which is a bummer because it would have been my tenth Canberra Marathon and I would have become a Griffin) so I'm looking towards making the M7 Marathon in July my first one for 2013. It seems such a long way off, but better late than never.

I AM going to run sub-2:50 this year!!

Ouch my butt hurts right now.

High Hamstring Tendinopathy - uh-oh

Yep. It's back.

I was all set to go out of the year on a high - I was feeling great and I really felt I was on track for some good performances in 2013.

But once again the gods intervened. "No, no," they said. "We must throw a spanner in the works."

So they did. A big, ugly spanner that hit me on the backside. High hamstring tendinopathy - a real pain in the butt.

I had this condition a few years ago and I went through some really rough times. All up, it lasted about nine months - although I admit to trying to train and race (badly) through it (when I could run that is). It was misdiagnosed and therefore mistreated for a long time. I tried so many different things and nothing helped. Even when I had some power back in my legs I still suffered from pain in the butt - long car rides had me in tears a few times because there was nothing I could do to relieve it.

I've had an inkling something wasn't quite right for a few weeks - the first time I noticed it was after the weekend of 10-11 November. On the Saturday I rode for three hours then ran a little off the bike, testing how things were for Canberra 70.3. The next day I ran 30k, which felt fine. On the Monday both hamstrings felt tight, but I thought that was a result of the weekend's training. Ran OK that day and did an interval session on Tuesday - a few were off pace by one or two seconds but generally it was alright. I couldn't seem to loosen up all week but I put it down to the weekend as well as the fact I was working crazy long hours and sitting at my computer until past midnight, which is never good.

The next weekend (18 Nov) I was planning on doing a cruisy half marathon - not pushing it. Went round in 1:25 (and seconds) to get the win and although I didn't feel like I was pushing it hard my hamstrings were burning. Hmmm. I was starting to worry a bit. Had a massage on Sunday afternoon to try and loosen things up.

My main goal for November was the Central Coast Half Marathon on 25 November. I was looking to run this in about 1:21:30 and hoping to run pretty even splits. Very early on, I knew I was in for a tough race. There was no power in my legs at all - it feels like you're a car that has just skipped from first gear to fifth gear and no matter how much you try and accelerate there's just nothing there.

 I wanted to pull out, but I doggedly pushed on, seeing my kilometre splits getting slower and slower. Yes, it was hot and humid, but that certainly doesn't explain the time - 1:25:39 - SLOWER than the previous week and I felt I worked a lot harder to get it. Certainly nowhere near the target time. I managed to finish in third place but I was so disappointed with the race and I knew the injury had returned. I remembered the lack of power feeling only too well.

My coach recommended a physio - Brent Kirkbride at Sydney Sports Medicine Centre - and I immediately made an appointment,  crossing my fingers he'd have me on my way quickly.

My appointment was this afternoon and it was far from uplifting. High hamstring tendinopathy is relatively rare, complicated to treat and everyone's body reacts differently to the treatment so making a prognosis is difficult. There is no quick fix. For some people there is no fix.

Brent was thorough and honest and I left feeling that I was going to get the best treatment possible - whether or not that's going to make a difference remains to be seen. I've also got an appointment with a doctor in a month so we can look at PRP (platelet rich plasma) injections if the other treatment hasn't had any effect by then.

No running. No running until my body starts to work properly again and there's no pain in certain areas. At least three weeks to start with. Merry Christmas.

Tonight, when I got home from the appointment, I was upset. The tears flowed. I had been so, so happy with how the year had ended up - everything had come together in the best way possible. And then, KA-BOOM, it blew up.

I know this sounds overly dramatic and I know in the overall scheme of the world it doesn't rate as a problem at all. But for me, in my little world, it is a big thing. I desperately want to hit some good times in 2013 and that's only going to happen if I can train properly. I made the really tough decision to withdraw from Ironman next year so I could continue to build on the progress I've made since August, and now I'm afraid all that progress is going to go down the drain and I'll be back to square one.

Forgive this post - the emotion is still a bit raw. There's no point feeling sorry for myself - nothing's achieved by that - so after giving myself tonight to be down in the dumps, tomorrow begins mission "lets-do-everything-possible-to-fix-this".

Shit.
Shit shit shit shit shit.
Why can't these injuries go to people who don't want to run, huh?