Keeping Those Fitness Level Up

Short of being given the green light to commence running again – which may or may not happen when I see the NHS Physio in a couple of weeks time – the final stage of my recovery from the sacral ala fracture occurred yesterday when I was able to, unaided by a wall to prop me up, put my trousers on whilst standing up. This had either been physically impossible or too painful from the moment of the breakdown seven weeks ago. so I’d always needed a chair handy when putting on clothes or shoes – a fairly tedious state of affairs.

This simple act completed the rehabilitation that saw me six weeks ago wondering if I’d ever walk properly again without intense pain, to being able to cycle, to being able to use the elliptical trainer, to being able to walk fairly pain free, to being able to walk normally and forget that I’ve still an ailment that prevents me from running. From what I’ve read I believe it takes 6-8 weeks for the fracture to heal, so in theory, eight weeks is next Monday – six days away. I’m not going to push it though and will seek advice from the Physio first. Ideally I’d like X-Rays to prove the bone is 100% back to how it should be, but I’m pessimistic the NHS will allow me this luxury.

November has, in terms of days when I’ve exercised, been highly productive, with just two days where I’ve neither been on the elliptical trainer nor out on the bike. Those two days rest came just after I last posted on here and were thanks to working on the last F1 race of 2014 at Abu Dhabi. The day after that finale I was out on the bike, finally tackling the Witham Wheelers inspired ’13 Hills of Belvoir’ ride that I’d intended to ride on at least two earlier occasions. With an extra hill to take me out of Grantham in the opening miles, it was a challenging but enjoyable ride of 65 miles, tackled, without a stop (Despite what the erroneous Garmin Edge 810 data may imply), in a whisper over 17 mph average. The hardest part of the ride was getting some feeling into my fingers for it was a cold morning – the feet remained numb for most of the day. I wasn’t feeling in fantastic shape but enjoyed the challenge of the hills, one of which at least – Terrace Hill – appears in the 100 Greatest Cycling Climbs bible of hills to climb in the British Isles. It’s not a hugely difficult climb, but as a resident of Lincolnshire, I am very grateful for any vertical challenges in the vicinity of where I live.

The next five days were spent on the elliptical trainer: just an hour on the Tuesday when I was covering the final F1 test of the year (Again in Abu Dhabi); Wednesday I doubled up and fitted in two 45 minute sessions around the demands of work and family. Thursday saw an old favourite from the early years of the 21st Century – the high resistance pyramids session, which reminded the quads that they are still fairly weak. Two hours on the machine on Friday was followed by a late evening hour on the Saturday – the whole week’s effort brought to me courtesy of the 1998 Tour de France and the torrid tale of EPO abuse and rider strikes that afflicted the Festina Tour.

Sunday morning saw me ride for the first time as a paid up member of Witham Wheelers (At least I assume I am – the application was put in the post some days earlier). I’d planned to go out in the same group as last time but a mis-reading of the rides going out on their website meant I found myself in the slightly slower Intermediate group. I wasn’t too upset at this as they were planning a longer ride of around 65 miles, the group was fairly small, which meant I was better able to get to know each of the riders, and I was rapidly going downhill with a cold, so a fairly sedate pace (Save for the couple of hills where I couldn’t resist pushing on the pedals) was just what the doctor ordered (Well (s)he’d probably suggest rest, but (s)he isn’t living in the real world of an exercise addict…) A thoroughly pleasant ride was made all the better by some unseasonably warm, sunny, weather for the last day of Autumn.

The first day of Winter saw an unplanned day off thanks to the cold which rendered me largely useless. Bringing this up to date, today I ignored the streaming nose, aching legs, and tight chest, to put 90 more minutes on the elliptical trainer. It probably wasn’t the wisest thing to do, but I felt no worse after than I did beforehand, so hopefully no damage done.

Weather depending it will be more of the same for the next couple of weeks – mostly elliptical trainer with the odd bike ride thrown in. Hopefully the Physio will give me that green light to commence running. If they do, it’s going to be a slow, drawn out affair, but I’d love to be running before Christmas, even if it is just for a handful of minutes.

 

An Unexpected Break

Pretty much no matter what happened after the Robin Hood Half Marathon I had every intention to ease up on the running through October. With the PB there I’d achieved everything I’d wanted to over the year – the elusive sub 2:45 the only exception, but even then I was very happy with the personal best that had left me a two forty something marathon runner for the first time. The plan was to do pretty much nothing but easy paced runs, enjoying social runs with the club and no plans to race unless something came about that caught my eye.

The immediate aftermath of the half marathon went entirely to plan. The day after: an easy six miles with no issues at all; a day later just three and a half miles at easy pace with my brother who had come all the way from Montreal to enjoy the delights of Wyndham Park (Not strictly true). The next day I was at a loose end so I made my first visit to the Grantham Running Club Wednesday night group and enjoyed an easy paced 12 miles.

I was working at home on the Japanese GP which meant early wake up calls. By Thursday evening I realised I wasn’t tired enough to be able to get myself to sleep at a reasonable hour to wake in the middle of the night, so I chose to run again with Grantham Running Club. It was another easy paced 12 miles with a couple of quicker miles thrown in the end. Still I was feeling good, if a little tired.

Friday was a day off from running, but I went out again Saturday afternoon for a seven and a half mile easy paced run. The legs felt better as the run went on, but I noted that there was some slight sciatica pains in the right glute and the Piraformis felt tight – as did the right neck and shoulder which I put down to working too long at the desk. Sunday – and after a fairly tragic Grand Prix which saw the serious injury suffered by Jules Bianchi – I had to get out for a few miles to clear the head.

From the off I sensed things were not as they should and I should have stopped. What kept me going was that the run was going to be short (under five miles), the right hip ache subsided after a mile and the pace suggested nothing too much was amiss. Worrying signals though appeared later in the run when I appeared to get a weird spasm at the top of the right glute that lasted a minute or two then subsided.

Fatigue from the Japanese Grand Prix set in and coupled with the right glute / hip / Piraformis and lower back giving some trouble, I took a couple of days off. I next ran on the Wednesday and managed seven and a half unhappy miles. The aches and pains didn’t slow me, but I was getting nagging aches in the glute and on the outside of the hip. I knew something wasn’t right but couldn’t figure out what was going on. I’m no stranger to running with hip and lower back pain – it’s been a perennial struggle over the years when I’ve more often than not had something going on, but this felt different and I could feel the problem cascading into a wealth of issues.

With that run done and another Grand Prix (the Russian) to work on, I decided to take another four days off. Normally with that length of rest I’d expect significant improvement from a problem which hadn’t actually caused enough pain to slow me when I ran. On the Monday following the Russian GP I headed out on the morning on what was meant to be a familiar and easy 10km run. Before I went out I did a lot of massage to try and free up the tightness that still felt prevalent in the hip. I noted that the Sacroiliac joint felt quite sore, but didn’t think that much of it as it often does when the whole hip and back area is giving trouble.

The first three miles were fairly uneventful, save for some nagging, somewhat strange, aches in differing parts of the right glute and hip. The fourth mile saw me struggle a touch, I found it slightly harder to run, but was still not overly concerned as I’d clocked the quickest mile of the four at 7:05. I stopped for a quick toilet break in Wyndham Park and leaving the cubicle I set off again and things felt a fair amount more difficult but still the pace suggested nothing too much was amiss, going faster yet with a 7:01 mile.

I stopped at the traffic lights to cross the road at five and a half miles, less than a mile from home. I ran around 100 more yards when suddenly a searing pain ran through and around my right hip and into the upper glute which saw me stop dead in my tracks. Instinctively I went to stretch for a few seconds then tried to run on, which, about as quickly as it took me to try and push off with the right leg for the first time, I realised was a really impossible affair. Although I sensed the injury was potentially serious as I limped slowly and painfully the remaining half a mile home, I was surprisingly calm despite having resigned myself to a lengthy spell away from running.

Sometimes when you pull up injured when running, a couple of hours later the pain disappears and you already think that, with a bit of luck, you’ll be back running again the next day, or, at worst, in two or three. This was clearly not one of those injuries. I was in a world of hurt, downing Voltarol, just about able to hobble around the house with the right leg feeling like it was going to give way completely. By the evening and I was using walls to prop me up when trying to move around the house. I was crawling up the stairs. My wife was threatening to drive me to casualty.

I stubbornly refused her suggestion, convincing myself that things would improve in a couple of days. A couple of days later and things hadn’t got any worse, but they were certainly little better. Nevertheless the instinct to do any kind of exercise overwhelmed me and I found myself out in the shed on Old Faithful, my elliptical trainer purchased back in 2001 when I was struggling with injuries that restricted my running. I used it a lot for around five years until I passed it on to my parents who in turn returned it back to me earlier in this year. The display may not work any more, it’s a little rusty here and there, but the German built machine still runs true and is usually great cross training when running isn’t possible. Except this time.

The pain in the hip and glute was bad from the off and gradually grew in intensity until it was only just bearable to continue, and even then I barely managed 35 minutes before grinding to a halt, then hobbling incredibly slowly and painfully back into the house. The trainer was super painful; walking was worse than the trainer. I was pretty miserable. I had to find something to do.

Saviour of sorts came in the bicycle which I went out on the Friday – four days after the injury kicked in. I managed 31 miles. There was some discomfort, especially when I had to leave the saddle on the climbs, but it was tolerable and easier than walking, so I figured this was acceptable exercise. I went out the next day and managed 39 miles – the right hip area became really painful at around halfway and for a while I thought I’d have to abandon the ride. Strangely though the pain subsided and I felt nothing more from twenty miles to the finish. It was only when I climbed off the bike and began hobbling around again I was reminded that this injury was going nowhere fast.

I managed 45 minutes on the elliptical trainer on the Sunday. It wasn’t as painful as the first time on the trainer, but bad enough compared to cycling that this wasn’t a viable exercise at the moment. Walking though was the biggest pain of all – a miserable hour or two limping around Meadowhall Shopping Centre was not a memory I’ll remember too fondly.

That next week I got out on the bike a couple of times – again there was some soreness but nothing too unbearable. The same couldn’t be said for the walk to the doctors I finally made that week, which was fairly tortuous. When the doctor saw me she thought I was either physically disabled or injured. I explained it was the latter. I have a fairly dim experience with GPs and sporting injuries, but my doctor was decisive and effective, firstly giving me some far stronger painkillers to try and at least have me walking a bit better and secondly requesting an MRI be done on my back and pelvis to see if something was amiss.

I was also scheduled to have a sports massage that week which I attended. It was a painful affair as always, although the most painful bits were shuffling around on the bed. The glute medius was highlighted as the main area that seemed amiss which struck a cord as my injury book at home highlighted that if the glute medius was injured – the simple act of putting on trousers whilst standing would be difficult. For me it was nigh on impossible.

I concluded in my mind at that moment I’d torn my gluteus medius and was looking at a 6-8 week lay off from running. Cycling was the only really viable option, and that week I went out twice – firstly a 39 mile ride where the hip was quite sore, then a couple of days later an hour’s criterium style multiple laps of the housing estate I live on. This 1.2 loop may sound monotonous to the extreme but it was actually good fun, and to my surprise when I uploaded the event to Strava, I hadn’t been the first to ride the circuit I thought I’d created.

So much fun it was, the following week on the Monday I cycled three hours of this circuit, two hours before lunch and an hour afterwards. The wind was strong and I struggled, but at least I was exercising and the hip / glute wasn’t too painful. The weather was then too bad to ride for a few days so it was Saturday before I exercised again – a start of a new month – November would, I hoped, be a fresh start after the calamities of October. I intended to exercise regularly but at mostly low intensity to mimic the base training I had intended to begin if I were running before marathon training began in earnest in January.

I went back on the elliptical trainer, where the pain was bearable but not great, I was happy to manage an hour. That Sunday I went out on a late morning bike ride before work on a 45 mile loop. In the opening miles I caught and rode with a guy from Witham Wheelers, the local cycling club, who suggested that I should try out a Sunday ride with them.

The next day and I went out on a longer ride – 68 miles – which was a bit of a ramp up from what I had done before. The good news was that the hip / glute pain was markedly less evident both on and off the bike. I put it down to some massage I’d done the evening before when I thought I felt something release. The less positive news was that I died a thousand deaths on the hills in the final quarter of the ride – a reminder that whilst I was running fit, this doesn’t convert wholly to other sports.

This day (November 3rd) marked a definite sea change to the status of the injury. The hip ached for the following week when walking, but I was able to walk the kids to and from school with just a moderate limp and none of the searing pains that had frequently stopped me in my tracks. I was also able to go on the elliptical trainer every day for the rest of the week – three sessions of an hour, one of an ninety minutes, and on the Sunday two hours. This would have been impossible a week earlier; now aside from the Tuesday and the Sunday, there was virtually no discomfort at all when exercising. I was much happier – aside from running, I could exercise when I wanted and with little pain.

Monday November 10th and following another hour on the trainer on Monday, Tuesday morning saw an early trip to the hospital for the MRI scan – happily just a few weeks after it was requested (I was expecting it to be in the New Year). By now I was walking with no difficulty at all and just the occasional ache in the glute. The scan itself was uneventful save for the torture of trying to stay perfectly still for twenty minutes – a task for a notorious fidget that proved a monumental battle of mind over body.  I celebrated the scan with a 38 mile ride on the hills of Belvoir – again ache free except on the hills.

The results of the scan were actually with the doctor later that day, alas I couldn’t get an appointment to have them revealed for another eight days. Wednesday and Thursday saw 90 minutes on the trainer; Friday and Saturday, two hours. With no pain at all in the hip I relished the only discomfort being the fatigue in the quads which were clearly being worked in ways that they aren’t normally when running. I was spurred on by watching old videos of the Tour de France, each 90s EPO fueled ride keeping me both amused, yet inspired, to continue exercising.

Sunday morning saw my debut with Witham Wheelers. I’ve not ridden with a bike club for 14 years and even then I only ever went out with a handful of riders. It was soon apparent as we waited in town on a misty, murky morning, that this is a popular club and it was going to be a proper group ride. I had the option of an intermediate or faster group. I went on the advice of the guy who I met a couple of weeks earlier and went with the speedier cyclists. The 57 or so miles flew by, After taking a few miles to get use to pack riding etiquette I loved riding in a pack and the speed benefits that produced. I took my turns at the front and was surprised that, for the most part, I was able to comfortably keep up the pace, especially on the hills. The mid way coffee stop was something of a culture shock for a runner, the notion of stopping mid-run for 30 minutes before continuing on your way would be absurd, yet this is apparently very much part of cycling culture. The last ten miles of the ride were a blur as the hammer was put down by the quicker riders. I hung on as best I could – struggling a touch with a cross wind, but it was a thrill to be working out hard with no pain.

Bringing this up to date, Monday and Tuesday saw two hours again on the trainer on each day – by now the quads were begging for some relief. I’d planned on the Wednesday to give them one last trial with a 65 mile hilly ride, but just a mile after setting off my mechanical luck ran out and I punctured. Fortunately I was close to a bike shop to get the punctured inner tube replaced (I had tried, but failed). No sooner had the air gone in the new tyre it escaped again with another puncture. By the time I was good to finally ride, there weren’t enough daylight hours left to ride 65 miles so I went back to the 40 mile route I rode a week earlier. To cap an unhappy ride the Garmin decided to have a paddy and all data was lost, so my determined efforts on some of the Strava segments will forever remain unknown.

After the ride it was off to the doctors to discuss the results of the MRI scan. The results were interesting and not what I’d expected. The spine was essentially okay save for some mild degeneration here and there. I almost lost interest until I read the final couple of sentences:

“Pelvis and Sacroiliac Joints: The SI Joints themselves are normal. There is however an oblique fracture running through the right sacral ala, extending from the superior aspect of the right SI joint, down and across to the right S1 neural foramen.”

A FRACTURE!!! No wonder it had hurt! The doctor explained that it was a fairly small bone and that there was little that could be done except let it heal naturally. She requested a bone density scan because typically this type of fracture doesn’t occur in young adults. She asked lots of questions about whether I smoked or drank too much, suffered from eating disorders (all more or less negative) and whether I was a regular user of steroids (I’ve never knowingly taken any banned substances was the stock answer given). She focused on the corticosteroid Prednisolone which rang a bell for reasons I couldn’t at the time fathom, so much so I asked her to check my prescription history, which proved negative. It was only when I left did I realise that Prednisolone was the substance that cyclist Chris Froome infamously received a Theraputic Use Exemption for earlier this year when he was suffering a bit during a race. I’d confused his medical history with my own.

I will get physiotherapy to rehabilitate fully, perhaps also to see if there were muscular reasons that caused the break. Running is off the menu until I get the all clear, which is mentally quite challenging as I am walking now normally and it is tempting to see if everything is okay. Hopefully it won’t be too long before I can get those trainers on again – in the mean time I have a cycling club to join and other dreams to pursue, a good time maybe to start that training for the Ironman I’ve promised I’ll complete. In some ways the news hasn’t changed my mindset from when I believed I had a torn glute, the change is that I need to wait until the fracture has healed completely, otherwise it will could be a re-break and the cycle continues. Information is fairly scant on the internet about the injury, I’ve read anything from six weeks to nine months – I very much hope it is not the latter, but if it is, then I am resigned to the wait.

Hopefully I’ll come back stronger, but I’ll just be happy to come back.