So what’s happened for the past 2 1/2 years? Where have I been? Well things have pretty much been a shit show in terms of running. Hence, out of frustration I shut the blog down because my struggles with coming back wasn’t something I liked thinking about. In hindsight, I regret not blogging about it because it would have been beneficial to have captured the details and things I’ve learned along the way. Long story short, I’m not out of the woods yet, but finally I’m on my way to recovering and being fixed.
The hamstring issues eventually did subside after much physical therapy. Wasn’t until April of 2012 was I able to start running well again to the point where I was building the mileage and speed work I wanted. I got to the point where I was planning some races, running really well, excited and enjoying everything again. Even thought about returning to the blog.
And then I developed iliac crest pain syndrome in August of 2012. This is a bizarre pain at the top of pelvis on the side where there’s a ligament. It’s another form of tendinitis or overuse (or in my case, more likely misuse). Initially, I wasn’t overly worried since I had this on my left side for a very short time and assumed this would be gone relatively soon. Plus, I was glad to see something different break rather than my hamstrings. Gave me confidence in an odd way that hamstrings were holding up. How naive I was to think this was a good sign somehow.
The only thing is, this shit didn’t go away and continued to linger until the end of the year, thereby causing me to miss all the 2012 fall races I was hoping to do. So, I got a cortisone shot not knowing what else to do. Did it help? Yeah, mostly, but was never completely gone. Just manageable.
End of the year 2012, I was ramping back up again hoping the spring would be when I’d be able to start racing again, and things certainly looked that way. I did have a lot of odd twinges that were off. Couldn’t really understand them, nor can I explain it, but looking back things never felt 100% right after recovering from hamstring tendinitis even when there weren’t any obvious problems. But more specifically, I would be running a tempo in January of 2013 and have to stop because I felt something wrong with my Achilles. I would stop to check it and there would be nothing wrong, and I was confident of that, because I knew what Achilles tendinitis felt like from experience. There would be something in my ankle, but couldn’t quite locate where it hurt when I was running. Weird pains in my right shin at times. Other things I don’t even fully remember.
Then in March 2013, the straw that broke the camels back happened. I’m the camel by the way.
I was at a wedding and when it came time to lift the bride, I was the first one to try to get her up. I felt a bunch of pops in my tail bone. Not even what I considered my back. I thought, “wow that felt weird, like nothing I ever felt before”. It didn’t hurt, so I wasn’t overly worried.
As a habit as a run, I was still incorporating pt exercises consisting of eccentric weights to prevent reoccurrence of hamstring tendinitis. Only, for whatever reason, after a short run I did the next day that totally felt off, it was as if someone was stabbing me above my ass when I tried hold any amount of weight with my leg. And oh yeah, more popping.
I dismissed it because I was still doing runs at a pace I wanted. Then all of a sudden, my right hamstring in the middle felt as if it was torn. This wasn’t tendinitis. It was too low. I didn’t know what it was, but it hurt like hell when my leg would be brought forward while running. Fine otherwise every other time and didn’t hurt to the touch.
Back to an orthopedist I went. This guy took some X-rays of my back and told me I’m basically fucked. I was convinced he didn’t know what he was talking about. He told me about a condition I had which I first learned I had in my mid 20s. To explain, I need to go back a bit.
All during high school and college I suffered extremely from back pain and sciatica issues in my right leg. In my mid 20s, when I was working and had my own health insurance that was somewhat decent, I went to see a chiropractor who wound up helping immensely with my pain. I have a low opinion of chiropractors, and if you read previous posts, you will know I think most of them are full of shit and are no better than used car salesmen. For instance, there’s one in the shopping center near me who advertises weight loss through chiropractic treatment. However, I’m sure there’s some benefits to be gotten from a chiropractor who knows what they’re doing, doesn’t believe they have all the answers to fixing any problem you throw at them, and isn’t looking to just suck you in just to make a buck. Unfortunately, the chiropractic industry, IMHO, is full of snake oil salesmen. But, I digress.
This woman, I believe, knew what she was doing. She took X-rays and explained to me about a weakness I needed to be careful about and the fact that my spine was attached to my sacrum at a lower point than most. Nothing to worry about but I needed to watch it didn’t get worse. I was 20 something, so yeah, whatever that meant. All I knew was I was feeling better, so I didn’t give it another thought.
That is, until the orthopedist was pointing to the X-ray saying something about grade 3 and that I needed to readjust my life style. Meanwhile, I was thinking, “you idiot, my back doesn’t hurt and hasn’t in almost 20 years”. I knew I had this and it never stopped me before, why now?
This orthopedist is a back specialist, so everything to him is going to look like a back problem. I’m thinking, “You jackass, I came here for a problem with my hamstring. Can we talk about that?” His response was there’s nothing wrong with your hamstring and all your prior problems are related to this. Everything for the past 2 years is because of this. What I didn’t realize at the time is the slip I had 20 years ago progresses to just over 50% off my sacrum, and recent events exacerbated it even more. This is something I was born with, and being middle age, it’s become unstable and is starting to catch up with me.
The vertebrae at the red arrow should be where the black one is
I rolled my eyes and said, listen, can you order an MRI on my hamstring so I can find out if it’s torn. He rolled his eyes in return and agreed.
Next few days, being at a loss for what’s going on and not having any answers as to why my hamstring hurt all of a sudden, I began contemplating this possibility. I googled spondylolithesis and read about it. I was shocked to read the symptoms. I realized I had symptoms I wasn’t even giving thought to. I had this burning sensation on the top of my middle two toes for longer than I can remember that felt like they were scalded with boiling water. I assumed it was from rubbing within my shoe while running. It felt as if the skin was blistered. But when I touched it, it felt fine. Couldn’t find where the skin was damaged. I didn’t understand it, but it wasn’t a major problem in my life so I gave it no thought.
I was also tripping while walking lately. I couldn’t understand why the ground was so uneven and affected me so much. But, my right foot often hit, or scraped the ground while bringing it forward.
This was the result of my nerves being compressed between my last vertebrae and sacrum. After sometime, when the hamstring issue subsided, I tried running again. My leg was not responsive in some odd way.
One day while coming home from work, I was crossing a wide street where the traffic is closer to what you’d find on a major highway in terms of the amount of cars and their speed. Everyday I would run across this street. But this time, while sprinting my legs buckled and disappeared out from beneath me. I lost control of them completely while they were still moving. I almost hit the ground, but luckily regained control as I was falling and got across the street.
Something was quite wrong and I was extremely scared. I went back to the orthopedist and we agreed an MRI on my back would make more sense than my hamstring. It showed the slip was causing severe stenosis and compressing nerves.
My MRI showing compression on the white spinal canal at the red arrow
I sent the MRI to a surgeon at hospital for special surgery. Shortly after he agreed to see me. He explained to me that nerve damage was occurring and it often becomes permanent if it’s not addressed. He recommended I get a spinal fusion which is a brutal surgery and typically takes a year to fully recover. I decided to book surgery for the fall and give myself the summer to contemplate whether or not I really wanted to go through with it.
Eventually, I was able to run again during this time, and did low mileage every alternate day. I was never able to get the pace I used to have and it felt a if I had a log tied to my lower back. I came to terms I would probably never race again, but if I was running I might learn to be content with what I could do and avoid surgery. But, I also kept thinking about how this thing is going to be getting worse, and the impact of running would be furthering my slip. I knew myself well enough that I wasn’t going to stop, even though I decided to briefly at one time or another. Some of the neurological issues were also getting worse at times, like the foot drop that was causing me to trip on occasion. I reasoned that although I was not in pain and suffering today like most who have this condition, I had no guarantee that this wouldn’t be the case 10 years from now. Down the road it may be harder to fix and being older I may not be in the condition to recover as well.
On September 27th I had my L5 vertebrae fused to S1, which is part of my sacrum. The surgeon lifted my spine and pulled it back carefully as much as he could without causing further nerve damage. I have 2 carbon steel rods implanted along with 4 titanium screws to hold things in place while the two vertebrae grow together. In addition, there is an implant in between the vertebrae and sacrum referred to as a peek cage where the disc (or what was left of it) used to be. I decided to go through with this with the expectation of being in excruciating pain during recovery based on what I’ve read from others. The surgery also requires that I be restricted from bending, twisting, and lifting anything heavier than a gallon of milk. Otherwise, the fusion is put at risk.
X-ray taken while I was still on the table post-op
The recovery over the past 5 weeks has been full of discomfort, but so far has been pretty smooth with the exception of a few bumps. I walked with a cane and back brace first 2 weeks. Day 9, I walked 1 mile in 39 minutes and I wrote it in my running log. Walking is the only form of exercise I am allowed at the moment, and it’s strongly encouraged since it helps promote the fusion to take place.
I’ve been walking as much as time allows since, and have been gradually increasing distance and time on my feet. I managed an 8 mile walk in a little over 2 hours just recently and have been averaging 6 miles per day, usually broken up in 2 walks with one in the morning and the other in the evening. This is what I will be limited to until my fusion starts to take place, and then I can start physical therapy. In 2 weeks from now I get follow up X-rays to see if there is any bone growth.
My surgeon is more optimistic than my orthopedist was and feels I will make a 100% recovery. I can starting running again after 6 months and I have vowed to take it slowly until 1 year out in order to allow my fusion to fully mature with no risk. I feel like I have very little room for error, and as a result, I’m taking a very different approach to this. I’m being extra conservative. I won’t be setting any goals or timelines, and ill race again when I’m ready.
Then I’ll break 3 hours in the marathon.