Tuesday, March 29, 2011

Looking for a Surgeon: Labral Tear

At the end of a busy racing month last August (11 races), I finished my first 5000 meter track race in 30 years just like many of the other races that month; with a very sore left hip and glute. I had to hobble to the track's infield, sit down, and think about another poor race and a hip joint that just wasn't right. Then I had to try to stand up and move with a painful hip that just didn't even want to cooperate enough to help me walk easily to my car. I knew it was time to realize that I couldn't run through the pain any more and I had to think about the possibility that something was so very wrong that just wouldn't fix itself no matter how hard I tried.

I had been wondering if I had a labral tear in my hip and wrote this post last September. It pretty much sums up what a labral tear is, so I do not have to repeat it. What I can say is that my MRI images show that I have a possible small labral tear in the superior (front) labrum, as well as another possible small tear in the posterior labrum. I guess that they can't tell if I have a hip impingement until they do surgery, but I bet they find that too. The report says I have mild degenerative changes in both hips. So I am looking for an experienced surgeon. Here is my thread on Letsrun.com. There are numerous threads all over the internet that I am scouring for advice and recommendations. Unfortunately the first doctor I called doesn't even have an appointment available for a consultation until August. I definitely want surgery, but don't want to wait that long! Anyhow, it is fun playing with the images taken during my MRI. I don't know how to read them, but it is interesting to see your internal muscles and bones, particularly the ones that have caused me so many problems.

This new book from the author of The Entrepreneurial Patient blog is a must read book for anyone with hip problems and is thinking about about arthroscopic hip surgery or has had arthroscopic hip surgery for a labral tear or FAI.

Wednesday, March 23, 2011

Looking Forward

Here is one of those iconic pictures of the great Jim Ryun showing his head slightly askew, pumping arms, powerful stride, and eyes glued on the goal of reaching the finish line in first place. The picture is about Jim Ryun, and not many people may notice the "other guy". Well, I never did. However,  I was recently informed that the other guy is a runner named Glenn Ogden, whose name didn't ring any bells with me, even though I consider myself a student of the sport. I was surprised to find out that Glenn Ogden was a 1965 graduate of The Stony Brook School on Long Island, the same small college prep school that I attended. Here is the caption I found for the photo:

Glenn Ogden ’65 was one of the finest runners in school history.  After a Hall of Fame career for the Blue and White he attended the University of Missouri where he won 2 Conference Championships for the Tigers and set the 2 mile record with a time of 8:46.0.  In the above photo Ogden is running against one of the biggest names in the history of American sports: Jim Ryun.  In 1964 Ryun became the 1st high schooler to smash the 4 minute mile barrier by running a blazing 3:59.0 as a junior.  His litany of accomplishments include being a 3-time Olympian, setting the mile and 2 mile world records as a 19-year-old and being named Sports Illustrated’s “Sportsman of the Year.”

Stony Brook for many years had a strong and stellar tradition as a running powerhouse with many accomplished running "stars" and "no" I was not one of them (history here).  After a little searching I noticed that Glenn was ranked 9th in the USA at 5000 meters in 1966 (former Wheaton College teammate Dan Henderson was ranked 9th in 1984 and 8th in 1985). The all-time USA rankings in the men's 5000 meters can be found here. Another outstanding Stony Brook and national class runner Robin Lingle preceded Glenn at Missouri. Lingle would later coach at Missouri and then return to coach at Stony Brook. It was interesting to find out more about that old photo and discover the connections to my own running past!

As much as a runner looks forward to finishing a race, I am looking forward to Monday when I finally find out results of the MRI I had over a week ago. I hope the doctors can finally tell me what is wrong with my hip. I also hope to find out whether surgery will correct things (it better). I have my ideas about what they will find. I put my money on hearing the words "labral tear" and "hip impingement". I do hope they offer hope for me that I can be fixed. I have completely given up on even trying to run any more. It just doesn't work. I was so excited to finally get warm enough weather last week to go out biking. I took out my mountain bike and it felt good so I did about an hour, but that night the "nerve pain" came again all down my left side and stayed with me throughout the next day. I was hoping that at least I could bike, but I guess I can't even do that. It seems the only exercise I can do to work on my endurance is kettlebells. Yesterday, I set a new PR doing kettlebell swings. I did 1250 swings with my 50 pound kettlebell. It feels good to do these, but the only problem is I now get blisters on my hands instead of my feet.

I have had lots of conversations and  feedback online with other runners that have had labral tears and so much of what I have experienced matches up to their stories. The best description offered me explaining labral tears and their cause and damage comes from runner, cyclist, kickbiker-footbiker, and chiropractor Jamie Whitlock, (also runs the No Gears Needed blog). He wrote me this:

Labral tears would be a surgical fix. If that is the problem I would think that it was result of an imbalance. The muscles of the pelvis/hip, especially the psoas, are so prone to tightening, then you get a weakened Glute Medius, which is a stabilizer of the pelvis, and you are rocking side to side vs. gliding forward. This puts undo pressure on the hip joint itself, and shazaam internal destruction in or around the joint....All the muscles around that area, TFL, of course the ITB, G Med, Psoas, Piriformis all culprits!
That about sums up most of my trouble muscles and imbalance problems and tells about what I expect the MRI to show, "internal destruction in or around the joint."

Tuesday, March 15, 2011

To Live up to your Potential

"...to me the object is not to beat someone, but merely to live up to your potential. If you do, then you will end up winning a lot..."  Frank Shorter

After a training run with Frank Shorter at Brookdale Farm in Hollis.
Back in 1977, when I graduated from The Stony Brook School we could put a quote or two by our yearbook photo. I found a running quote that also was a life philosophy quote from Olympic 1972 gold and 1976 silver medalist in the marathon, Frank Shorter. I included this quote and I frequently recall it to help me pursue a proper "winning" attitude. I couldn't remember where it came from, until I recently found the original article again online in the May 24, 1976 Sports Illustrated article, "In the Long Run it's Shorter" by Frank Deford. This is a great article.

I also recently discovered that a classic running book from 1980 titled The Marathoners by Hal Hidgon has been released for the Kindle. I borrowed this book from a library many years ago, but it was nice to find the Kindle version for just $2.99 and it was worth a reread. It highlights the stories of Frank Shorter and his victory in the 1972 Olympic Marathon as well as Bill Rodgers and his 1975 victory in the Boston Marathon. These two runners and their standout feats lit the fires for the running boom in the 1970s. They are two champions of the sport.

Hal Higdon then tells about the women responsible for challenging the norms of the time concerning women running marathons. In particular he highlights Gayle Barron who won the 1978 Boston Marathon. She may not be as well know today, but she epitomized the female pioneer runners and marathoners of the 1970s who kept stepping forward to win races and bring down records.

Gayle Barron after the 1978 Falmouth Road Race
Talking with Gayle and getting her autograph after that race.
Gary Bjorklund was another great track and marathon runner from the 1970s; one who was eager to replace Rodgers and Shorter at the top of the running  pack.He is well known for making the Olympic Team in the 10000 meters in 1976 despite losing a track shoe in the race.

Gary Bjorlund and Bill Rodgers at the NYC Marathon.

Gary Bjorklund

If you want to learn some great  running history or be inspired again by the racing of these great runners, then I suggest you read this Kindle book.

On another note, of the numerous emails and notes of support I received back in 2000 during the hullabaloo when the Nashua School Superintendent would not let me take a personal day to run the Boston Marathon, I recall that one of the emails sent my way came from Hal Higdon himself!

Saturday, March 5, 2011

Ryan Hall: Running with Joy

One of the greatest running quotes of all time comes from the Oscar winning movie Chariots of Fire.As you may recall, in this movie based on the 1924 Olympics, Scottish runner Eric Liddell disqualifies himself from the 100 meters because he refuses to run on the Sabbath. A teammate gives up his spot on the 400 meters so that Eric has a chance at winning a medal. During this final scene in the movie, as Eric Liddell throws his head back towards the heavens and races towards the finish line we hear his words proclaim, "I believe God made me for a purpose, but he also made me fast. And when I run I feel His pleasure."

Non-runners don't get it, but that quote so perfectly encapsulates the joy of running that many so perfectly feel and pursue. I think it has become so ingrained in my soul, that I continue to want to "feel" this joy despite injuries and pain that tell me that maybe my running days might possibly be over. When people tell me that I should just quit and find something else to do, I can't. I think running is so written into my DNA. I just want to run and it is one of the profound ways that I can experience the pleasures of being a human.

This week I read Ryan Hall's new book Running with Joy: My Daily Journey to the Marathonon my Kindle. This book is a journal-like build-up of the 14 weeks prior to Hall's running of the 2010 Boston Marathon. In it Ryan details his workouts, his thoughts and doubts, his routines, and his spiritual thinking. Much has been said about Ryan Hall and the decisions he has made as a runner and particularly his spiritual thinking. This year, he even walked away from his long-time coach so he could coach himself with God's guidance. This sent the running message boards into a frenzy. So what is up with Ryan Hall?

Ryan is open and honest in his book as he dishes out his daily thoughts. If you want to know his training schedule and routines, it is here. What is interesting is his chronicles of doubts along the way. Who knew that a world-class runner hurt as much as us normal runners? If you want to get to know more about Ryan's life, this really isn't a biography. Most of the background information in the story has been written elsewhere. This is more of a snapshot of a period of time. He does break apart from the journal routine to give specific short passages on training and other running related issues. These are interesting, but not thoroughly in-depth. We learn he does self-massage with rollers or massage balls, but it would be real interesting to learn the specifics and routines. Fourteen weeks is a short amount of time and we learn a little bit about his running wife, Sarah, but not a whole lot. In fact I found this short blog entry by Ryan Hall to be more entertaining than just the basics in the book. What we are left with is a running and spiritual journal.

The first book on running I ever received was a book given to me when I was about 10 years old called "Running the Race" (1968). I still have it. It was a book about great Olympic athletes and their challenges and triumphs. Many of the stories reflected on the spiritual lives of these champions. I was nothing but a run-around-the-neighborhood kid when I first read the book, but the stories of Jesse Owens, Jim Ryan, Kip Keino, Roger Bannister, Paavo Nurmi, Emil Zapotek, and others certainly influenced the future decisions I made to become a runner.

The next two running books I  read when I started running in ninth grade were the biographies of Jim Ryan and Kip Keino, both runners who integrated running and faith. Other books, such as Meb Keflezighi's recent biography tell about a strong faith, but Ryan's book is something different all-together. A non-runner reading the book may find the descriptions of his workouts indecipherable, likewise a non-believer may find his spiritual thoughts and devotional writings incomprehensible. I admire Ryan Hall, for letting us take a glimpse into his thinking processes. I am not sure he did the best job articulating his goals, but I think his thinking was a work in progress. It may just be the journal format, or the fact that we are seeing his thinking more than his actions beyond the running. Or maybe his dream is just too heavenly too describe. I think it comes down to Ryan wanting to feel God's joy when he races. He wants to rediscover that joy he had when winning the Olympic Trials marathon in New York City, finger pointing to the sky, full of run in the final strides, during that overwhelming championship run.

It then becomes a struggle for Ryan to develop a plan for racing. Do you run to win or do you run to feel God's pleasure? What if God's pleasure is for him to win? What if is is not? Ryan tries to make sense of his thinking and in today's world where winning is usually everything, what should be Ryan's mindset? Some people will probably pour hate on the book because of Ryan's spiritual inclinations. Some will not get it at all. Some will see a champion who is trying to keep his head on straight and not let fame interfere with personal growth. Others may delight in reading about Ryan Hall's spiritual path. Even if you read the book and don't enjoy it, at least you know that the profits from the book will be going to Ryan's Hall Steps Foundation.

Here are some interesting quotes I bookmarked (don't know what pages as it is a Kindle)

"I still compare myself to others. But I am getting closer. This is not what running should be about at its fullest. Running should be a pure flood of joy. Comparing myself to others is empty and vain. I rob myself of the goodness and joy of running every time I do it."

"I really struggle with the concept of having only one winner. I don't want to tell kids that if they do their best, work hard, and sacrifice, they will accomplish their dreams. If their dream is to win the Super Bowl they will probably never accomplish it. Instead, I want to encourage kids to focus, work hard, and dream big because the journey is what matters. To dream and live a life of devotion is better than to never dream at all. As we pursue our dreams, we realize the abundant life."

"I feel that it would be robbing those who are interested in my running to not share what it is that makes me tick and about the journey that I am on. I realize that everyone may not agree with everything I believe in, and that's alright. I think we all need to extend the grace to one another to allow people to be who they are and way what makes them who they are."

Running with Joy website and blog.

But if you really want to experience what I think Ryan Hall is trying to articulate in this book, just re-watch the ending to Chariots of Fire.

Wednesday, March 2, 2011

No Improvements-Need another MRI

 I have been having the best of therapy on my hip. I feel better walking and moving around than I have in years. Most of my muscle pain is gone and I don't even think about it most days. I just cannot run.

The last two weeks of running since having to stop halfway through a trial 8 miler were a grand total of 8 miles. I get on the treadmill every few days and start off running and feeling great. My stride is more balanced, my leg seems straighter, and my foot points forward. I get to the first mile and think it will be a breakthrough day. Then I start getting twinges and the inside and front of my hip starts hurting and feeling like it is pulling, so I have to stop. The last four runs were 1.62 miles, 1.89 miles, 1.89 miles again, and then 1.70 miles. That is my limit, after that my hip hurts for a day or two. I was wearing an SI joint belt for runs since January and didn't wear it on the 2nd to last run which just made my lower back hurt too.

Today I went back to the Physiatrist to  see what he recommended. In January, he wanted me to have another cortisone shot, this time in the si joint. I didn't have it because my physical therapy was going so well. I also told him that if I put a kettlebell on top of my quad and did leg lifts that my left leg struggled with this (getting weakness and pain in the same spots) and I would get a clicking in the hip each time the weight descended. He thinks it is time for an MRI again (I tried twice in the fall, but bailed out due to claustrophobia). He thinks there is an impingement in the hip, that the labrum is torn, or a piece of the labrum is torn off causing the troubles. I agree as this has gone on for more than half a year. It is not a simple muscle injury. I think that the orthotics and PT have helped fix my stride, but the structure of my hip can't handle it (and maybe that is why my stride went wonky in the first place).

I have no problem with the thought of getting surgery if that will fix things, but I have a major problem with getting into a casket-like MRI and remaining still for an hour. Hopefully this time I can make it through. He is going to give me some meds, but I'd prefer to be knocked out completely. The good news is he is prescribing an MRI with contrast injection. One thing I have read about torn labrums and MRIs is that the doctor needs one with the contrast injection to get a good read. The previous two did not have that prescribed, even though I asked for it, and I knew that if I made it through the MRI they would just have to do another one anyhow with the contrast solution to get that good reading. So I will sit and wait for a call from the hospital to schedule a date for the MRI. As much as I want to get running again, that is balanced by how much I dislike the thought of an MRI. Maybe they need to do an MRI of my brain!

This new book from the author of The Entrepreneurial Patient blog is a must read book for anyone with hip problems and is thinking about about arthroscopic hip surgery or has had arthroscopic hip surgery for a labral tear or FAI.