Pubic Symphysis - What Is That?

Hello Runners,

Well, this week has been a sort of "good news / bad news" injury-wise.....

As the title of this article would lead you to believe - I've "found" another underlying injury which I'm now dealing with.  Apparently, our pubic bone (lower front abdomen) doesn't "quite" connect in the center of our body.  We have cartilage there called the pubic symphysis.  And...apparently...this cartilage can get irritated and cause issues.  Official names, based on each individual case / severity is "Pubic symphysis diathesis or "Osteitis Pubius".  Pic below:




 Those little red spots are where the pubic bone from each side ends.  Between these spots is the cartilage, which for me...is now irritated/damaged.  Google says this happens when extra stress is placed on the cartilage from other muscles being too tight and pulling on it when...for instance...RUNNING.  Other cause sited is "instability", but in my case I think my tight quads and hips along with extra mid-section "twisting" with my old running style is the culprit.

My PT says now that I've solved my other injuries (psoas/iliopsoas tendon/tight quads, etc.) we now have to deal with this injury.  So...progress?  Yes, but I'm not out of the woods, and still very fragile.

It really flared up after running outside last Sunday on a dirt trail that still had some mud on it.  Running on the trail required some "side to side" movement and stabilization that I haven't needed so far in my recovery which has been on the treadmill only.

Luckily I already had an appt with the sports doc the following day.  He took a look, did an ultrasound, found the spot, and give me a prolo injection.  I tell you what....that shit REALLY hurt!  I was almost crying, but I would never tell him to stop...I need this to get better, and a little injection is not going to stop me.  Within about 10 minutes of the injection it was already feeling better...this is because the prolo injection also has Lidocaine in it, a pain reliever.  I was running on the treadmill at the office a few minutes later and it felt fine.

My prescription was to keep running every other day on the treadmill, and do the specific strength exercises I've been given (hip / core work).

So far...this has been working and I've been slowly increasing my runs.  I'm basically doing 40' of easy running with 30 second walk breaks every so often. 

The walk breaks do two things:

• Gives me a chance to fully "check-in" on how I'm feeling.  If something hurts more than it should / is getting worse, then I STOP.
• Aerobically / strength-wise is also gives me a break.  I'm WAY out of shape and my new running form focusing more on core stabilization which can get tiring (since this is new to me).  So, it gives me a break and help make sure I keep my form for the WHOLE run.
• Three runs this week.  With each run I've extended the "run intervals" from 6:00 to 10:00; walking 30 seconds between.
• Today I added an additional 5' to the end for a total of 45' running.  Whoo hoo!

Onward....

2017 Review / 2018 Plans

Hello Runners.

2017 Running Goals Review.  2018 Plans.

As a lot us do at year-end, I like to evaluate "how last year went" and make goals for the new year.  So, here we go:

2017 Evaluation:

• 2017 Goals were: Stay Injury Free/ Have Fun / Consistency / Complete first marathon / PB in 5k and Half.
• I only accomplished one of those goals:  Complete first marathon.
• Ran the RNR DC marathon in March.
• Hit the wall - hard - at mile 23.  But I did finish. So, accomplished - but not well.
• All other goals not accomplished.
• I did have two pretty good races in the Spring of 2017
• Ran my first road mile race a few seconds faster than McMillan would have predicted based on my 5k PR
• Ran my first 10 mile race about a minute faster than McMillan calculates based on my HM PR.

• So...what happened in 2017?
• Well...as my last post mentioned, I got hurt - pretty badly - in August/September and that ended my year. 
• Why did I get hurt?
• I ignored the initial "something's not right" warning signs - because I had pretty much the whole year "planned out" and was not willing to cut back.
• I had months of running daily workouts plans, weekly volume totals planned out.
• I was unwilling to adjust my plans "just because" I felt over-trained, burnt out, and had constant nagging small injuries.
• My internal 2017 goals are "results oriented"  - race performance numbers.  They are NOT process oriented.
• So - even though two of my goals were to "not get hurt", and "have fun" the race performance goals were more important to me.
• I was unwilling to adjust my weekly running plans because I thought it would affect my race time goals that "I envisioned" I could make.
• So - going forward I NEED to change my mindset to be oriented to daily goals and NOT specific race time performance.
• Process NOT Outcome.  Last year I fixated on an outcome goal like "Marathon under 3:00", and not let it go - even when I knew I should.

2018 Goals 

• ONE day at a time - now I sound like an NFL quarterback, or a MLB coach.
• But really - my goal is to evaluate how I feel today.  How did today go?  Should I adjust tomorrow's run  based on how felt today?
• EVERY DAY make sure I am doing what is best for my running and health.  Honest evaluation.
• For this to work for me - means I will NOT make a running schedule more than a week or two out.  
• This will be VERY difficult for me.  
• I make plans a LONG way out for most things in my life.  It's just the way I am.
• Obviously a coach would help.  I'm just ready to take that step (and expense).  Although that might cost less than 3-months of PT!

• The only race on my calendar is the 2018 Philly Marathon in November.  
• I had signed up for the 2017 race, but got hurt.  
• The race organizers were nice enough to allow me to apply my registration fee to the 2018 race.  I have NO time goal.

• I HOPE I will be able to complete other races throughout the year.
• I HOPE I will be able to go into each race WITHOUT a "planned" finish time.  Just go race and the outcome is what it is (back to that "one day at a time" thing).

•  I will TRY to not compare myself to others or my prior self.
• At this point I don't know what I'm capable of this year.
• I have to get 100% healthy first.  I don't know what this year will bring.  And, I have to be okay with that.

"Hope" and "Try" are not the usual black and white goals I make for myself.  But, that is where I'm at.  This year will definitely be evolving as I get back to full strength and implement the things I've learned from the injury last year.  "One day at a time", that's the motto.

Onward....

Starting The Rebuilding Process

Hello Runners.

So...quick long catch up, haven't posted here in quite a while.

Injures:

• In October I started getting proper (running expert PT) treatment for:
• Iliopsoas tendon tear (attachment to thigh bone)
• Psoas strain (2" - 3" below belt)
• "Sports hernia" (which is actually pretty tough to define) 
• All on the left side.
• Treatments
• PRP and prolotherapy injections on the tendon
• Prolotherapy injection on psoas and hernia areas
• On-going rehab
• Crap load of daily stretching
• PT evaluation showed that I'm super stiff and inflexible
• Butt load of hip and core work every other day.
• Turns out I've haven't been the best at keeping good form for my strength work
• Doing it correctly now - I was actually really weak.
• I'm getting a lot stronger, have more flexibility, and feeling better - but definitely "not out of the woods".
• This week I've been able to run every other day.
• My "runs" have been intervals of  "2' easy with :30 walk breaks".
• Slowly increasing the repeats - today I got up to 12, which is about 3 miles of running.
• Warning for all you kids out there:
• I should have seen this coming.
• I ignored smaller aches and pains earlier in 2017
• I adjusted (somewhat) my running gait to avoid "where it hurts"
• If I would have taken the warning signs seriously, I probably could have avoided most of the injuries.

Running Form Evaluation (Video Analysis):

•  My running form was NOT good.
• I "assumed" that since my racing times are decent I must be doing something right.
• I "imagined" my form is good and that I'm doing my strength work correctly.
• I over-stride
• I lean forward from the waist
• I don't/can't use my glutes when I run (because I lean forward at the waist, they can't engage)
• I hold my arms high and swing them "across" my body.
•  So - as I've started back to running I'm focusing on:
• Engaging my core and keeping my hips "forward" - straight line from ankles to head.
• I now know what this feels like, thanks to continued evaluation from PT.
• Arms low and swing from hips.
• Chest out / shoulders back / head over my shoulders
• Land foot more "under" my body.
• Extend my my leg back at "push off" using my glutes.
• This is only possible now that I've increased my hip flexibility

• My main focus going forward is to keep good running form.
• It's actually not very hard to do now, since I'm only doing easy runs while I heal.
• I'm sure it will be harder to do when my runs get longer and/or faster.

While hurt I've gone thru some depression and listlessness - just don't feel myself having to sit around.

Feel like I've finally made a turn for the better.  Cautious optimism.

Onward....