2014 in the rear view mirror

I have always enjoyed heading into a new year.  It feels like a new beginning, a new start, a clean slate.   I like looking back at the year coming to a close, thinking about all the memories and accomplishments.

Unlike most years, 2014 felt like I was perpetually in limbo.  Nothing was quite right and I was always working to get out of where I was...  Never quite happy with the way things were.  Before surgery, I was waiting to get fixed.  After surgery, I was anxious to get back to "normal".  And I'm still chasing that "normal" feeling.

My one major running accomplishment for 2014 was successfully running a 5k, after a full year off from racing.  Just saying I ran a 5k, though, seems to leave out how much work it was to get there.  Seriously, not running for 8 months puts you way behind in terms of running fitness!

The 5k wasn't even much of a race worthy of a race recap.  It was my longest continuous run since Feb, so there was no glorious fist pump in meeting my goal at the finish line....other than I made it to the end.

Before the race I told myself to just take it easy.  HA HA HA.  Does anyone ever do that when they say they will?  I ran as hard as my body would let me, which was frustrating because it was &^%$ hard and slower than I felt I should be for the amount of effort.   But I had no hip pain during so that was good.

I was really, really achy afterwards.  I don't think my hip much appreciated the push of speed and pounding.  I won't be signing up for any more races anytime soon.

Since then, I've been running 3-5 miles without that nagging groin pain that plagued all of my runs before surgery, and I am still doing a lot of crosstraining and PT work to maintain hip strength.  My hips like having one rest day, sometimes two, in between runs.  This schedule works because it's very rare to get good weather multiple days in a row in the winter!   And I'm all over running in crap weather for the moment.

I usually set goals for myself for the new year.  I have no real desire to set goals this year, though.  I just want to be happy in the moment, happy for where I am.

Do you usually set new years goals, running or otherwise?

Race Day Eve

It's been a long time since I have raced.  A year exactly, as a matter of fact, as of tomorrow.  I participated in a Turkey Trot on Thanksgiving, but that was more like a laid back rolling party than a real race environment.  Tomorrow will be the first race post-op and the first in a year.  365 days.  I'd like to say that time has flown but it hasn't.

I'm not planning on really racing it, though - I mean, I just graduated from the run/walk so while I can cover the distance, there's really no point in pushing the speed.  But I'm still working on my pre-race "stuff" tonight, for old time's sake:

-Made sure I ate some good carbs.  Ok, let's be honest, it was more that I wanted an excuse to eat pizza.  It's just a 5k.

-Made an iTunes playlist.  I normally don't race with headphones on but I'm feeling that a little music will help keep me focused on not watching my Garmin the entire time.  Lead song:  Happy by Pharrell, of course.

-Charging the Garmin.  Mostly to record that it actually happened.  Like, for real.

-Picking out the outfit.  It's going to be in the 20s and windy at race time.  Somehow I need to figure out how to wear my InkNBurn holiday long sleeve and layer enough under it to stay warm.  The struggle is real, people.

-Foam roller everything.

Game on.

Happy Thanksgiving!

The autoimmune protocol diet went off the rails a little this week.  I tried eggs over the weekend and felt horrible, so I know those are a potential issue.   I wanted to try a few other things, but instead of doing it one at a time like you are supposed to, it sort of went like this:

Um, yeah.

Needless to say, I don't feel so hot.  And the ache in my hip is way worse this week than it has been in a while - this is really interesting to me, because it was the reason why I really wanted to try this elimination diet in the first place.    I was just thinking the other day how I no longer was getting any groin pain or achy feeling... and then it reappeared, the same week my diet went off the rails.  Coincidence? Related?  Hmmm.

Because I was a dumb-dumb and failed to do the reintroduction right, I'm not really sure what might be making me feel like crap, but needless to say, it could be the fact that I ate everything.

In other news, I met with my trainer and we tweaked and adjusted a few things on my list of exercises.  Here is my current list.  I call it my Glutes of Steel plan.

Bridges - 3 variations: double leg, single leg, and single leg with rotation
Clam Shells
Cable Exercises
Side planks or leg raises (I was getting too much TFL activation with the side plank variation so we're backing down to side leg raises)
Monster walks side-to-side and back at a 45 degree angle

Single leg squats
Side lunges
Bird dip with band pull
Walking lunges with medicine ball rotation:

Hop to Balance - side to side and rotation (this is basically what it sounds like - hop side to side or with a 90 degree rotation and balance on the one-legged landing)
Single leg static hip rotation
Static lunges with weight
Squats

And....then waddle out of the gym to go sit on the couch and lament how your legs no longer function properly.

In other news, this happened.  Based on my Garmin data, I estimate I walked about 1-1.5miles, and ran the rest.  WHOO!

Week two of the AIP and Continuing Rehab

The second full week of the Autoimmune Protocol Diet is behind me!  This week, I made similar breakfasts/snacks/lunches as I did last week, but I did try a few new recipes, including:  Homemade Gummies, carob brownies and sweet potato/leek soup.  All were great!  For dinners, I made chicken piccata (minus the flour), grilled chicken, and burgers.  I also navigated going out to eat twice successfully!  Grilled salmon and steamed veggies for one and a burger and sweet potato fries for the other.

I am definitely feeling more energetic and my tummy hasn't had that "ugh, I ate something that disagreed with me" yucky feeling.  However, I really miss eggs as a quick and easy meal.  And spices!  Like cumin and pepper.  Oh, and chocolate.

My surgeon cleared me for all activities at my six month check-in.  He thinks my hip flexors are my main issue, and that time will help.  Because I am not patient and don't want to just "wait", I hired a trainer to work with me.  He specializes in injury prevention and rehabbing post-injury (perfect, right!).   We met and discussed my situation and he made some observations on my remaining weaknesses and compensations.  He gave me a two week plan to follow and then we'll meet again and assess my progress.

Here is the list of exercises, to be done three times/week:

PT-type exercises

Bridges (3 versions- regular, alt leg raises, leg raise with rotation)

Clam shells

Cable exercises

Side planks

Seated hip rotation with band/chair

Monster walks to the side and back at a 45 degree angle

Strength exercises

Single leg static hip rotation; 2 sets of 10-12 each leg

Hops to balance- side to side and rotation; 2 sets of 12-15 hops each way on each leg

Side lunge- 2 sets of 12-15 each way

Bird dip with band pull; 2 sets of 15 reps with max glute squeeze

Walking lunges forward; 1 set weightless of 12-15 reps on each leg

Static lunges forward with weight; 1-2 sets of 4-8 to build muscle or 12-15 to build endurance

Squats- 2 sets of at least 10 reps

I'm looking forward to seeing if a) I can get through all of these exercises three times a week and b) if it helps!

First real week of the AIP and 6 months post-op

So, OK, this first week of the Autoimmune Diet isn't exactly over, but I'm giving you a report on this week anyway. :)

Overall, I'm still not finding sticking to the diet to be very difficult.  Though trying to do this diet through the Halloween Candy Season was tough, in the end, I was able to avoid all candy and not die of deprivation (someone brought in SNICKERS to work!).   Planning enough food so you are never starving and making hungry choices is really important.

Breakfast
I had the sweet potato, apple and pancetta hash for breakfast this week.  Better than the smoothies in terms of staying full, but not by a ton.  It's really tasty though!

Lunch
Lunch was a mix of turkey deli meat rolled up with bacon, a big ass salad or fried bananas and ham.  Yep, fried bananas with ham!  It's something my dad used to make for us when we were little and is a great combination of salty and sweet.  He used to dip the bananas in egg and breadcrumbs before frying, but in my case, I just let them fry up nekkid.  Even if you don't like the ham part, fried bananas are super yum.

Yummmmmm

Dinner
I made grilled salmon with roasted veggies,  thai basil stir fry, and a roast chicken and vegetables.  A few were enough to have leftovers, too, which is always nice... but doesn't happen very often when you live with a marathoner.

Snacks
My snacks are mostly fruit and sometimes leftover vegetables.  Not terribly exciting.  I made plantain and apple fritters once and devoured the entire thing...yum.  And I splurged and bought a box of Jackson's Honest Sweet Potato chips (fried in coconut oil!).  They are way too good and probably should not have bought 6 bags all at once.

Six month Hipaversary
Next week is my 6-month check in with the surgeon.  He'll also be taking a look at the other hip as well.  I imagine he'll finally send me for an MRA on that hip and while I want answers as to what's going on there, part of me wants to just pretend that it's nothing and ignore it entirely.

I am not exactly where I thought I would be 6 months out, but I am not entirely disappointed either.  My hip is 100% better than it was before surgery and I am about 80% of where I was before I was injured at all (oh so long ago!).

Here's what I did this week:
Sunday: Run/walk (3:1) 30 minutes, spin bike 30 minutes
Monday: Squats/lunges followed up with aqua power aerobics class
Tuesday: Upper body lifting and core work
Wednesday: Run/walk (3:1) 30 minutes
Thursday: Pilates

Tomorrow will be a rest day, Saturday another run/walk and then Sunday either a spin bike workout or maybe a hike if the weather is nice!

Trial week: Autoimmune Diet

I used this week to test out some new foods for the Autoimmune Protocol diet and not worry about being strictly compliant.  Overall, it was a lot easier than I thought it would be, likely because I am already gluten and dairy-free.

Breakfast
Breakfast is the hardest piece to figure out, with no eggs and no grains.  Ugh, what to eat??   This week I tried a smoothie:  coconut milk, berries or a banana, collagen protein powder, and glutamine.   Most days I was hungry within the hour.  :(  I tried to supplement with some roasted veggies and that was ok but I do think I need something different for breakfast that's more substantial.   Next week, I will be trying this recipe:  Sweet potato, apple and pancetta hash.

Snacks
The easiest thing was to have fruits and veggies on hand to eat.  Carrots, apples, bananas, roasted veggies, and so on.  A few times I was craving something salty/crunchy and so I had plantain chips on hand and some seaweed snacks.   Sweet was a little harder and I tried to keep my mind off of the chocolate bar I wanted to devour by having some peppermint or ginger tea.

Lunch
I had a salad with grilled chicken for lunch with balsamic vinegar/olive oil dressing and cucumbers, avocado, beets, bacon.  (because, bacon!)

Dinner
On Sunday I made pot roast and we had leftovers for a few nights.   We grilled salmon another night with roasted broccoli and acorn quash.  Last night was pork tenderloins with cherry sauce.

Oops
My husband might have bought me a cupcake for no reason and I might have eaten it.  I'm not proud.  But it was tasty.

Overall
This week really wasn't too bad.  The biggest successful strategy was to plan.  If I didn't know what I was going to eat at a certain time, I was stuck pretty much trying to convince myself to not run to the vending machine... which was way hard to ignore.  When I'm hungry, I want food, like four minutes ago.   As long as I had something reasonable ready to go, I was fine.    Weekends will be the biggest hurdle as we always go out for brunch at least one of the days.  It's our weekend "thing" and I'll need to avoid the temptation to fall into our usual habits. :)

The Autoimmune Diet

A few weeks ago, I started doing some reading on inflammation and diet, to see if I could better control my joint pain via some food modifications.  One of the biggest changes I noticed after removing gluten from my diet was that my knees were a lot less painful.  Going down stairs became easier and I could run without any knee pain.   It was pretty amazing.

During my research, I came across the autoimmune diet.  There are a few versions out there, but Sarah Ballentyne's is the most strict.  She's a scientist and her book describes all the research and studies she used to formulate what should and shouldn't be included in a diet for folks with autoimmune issues.  Even for me, it was a dense read (and my PhD thesis likely had fewer scientific references!).

In the end, it made a lot of sense.  I have two suspected autoimmune issues - gluten intolerance (though I've never been tested for Celiac's) and thyroiditis.    My hypothyroidism is on this recent downward slope - every 6-8 weeks, my meds need to be upped.  I'm tired and cranky, and sometimes I just don't feel great for no real reason.   So, starting November 1, I'm going whole hog into it.  This week is my "trial" week, to test a few things out as replacements to my usual favorites.

The diet is not intended to be permanent (thankfully!). Sarah recommends eliminating everything for some period of time, and then slowly reintroduce foods one a time to find out what may be the underlying culprit.  If my thyroid stabilizes, then great.  If my thyroid stabilizes and my joint pain decreases, then hallelujah!  And if nothing happens, well, it was something to try.

The diet is strictly no:
Grains (rice, wheat, corn, bulgur, etc)
Legumes
Nuts/seeds (and no spices or oils from nuts/seeds)
Nightshades (tomatoes, potatoes, eggplants, sweet and hot peppers)
Eggs
Dairy, including whey protein supplements
Coffee/alcohol
Added sugars

Piece of cake, right?

I am pretty sure that I am ok with much on the list, but I'll follow the experiment as recommended.

Breakfast is going to be a challenge, as I eat a lot of eggs.  Today I tried a smoothie - coconut milk, berries and collagen protein powder.  While super yummy, I was hungry again by 9:30.  Drat.

I spent yesterday cooking up a bunch of vegetables to have on hand as snacks.  Garlic baby portobella mushrooms, roasted brussels sprouts, and some baked sweet potatoes.  For dinner tonight, I came up with a pot roast idea that does not include my standard white potatoes:  garlic and Italian seasonings on a beef roast, onions, and butternut squash.   It'll be in the Crockpot for most of the day:

I'll keep this blog updated on progress and if it helps at all with the hip stuff.  Even though I love all food,  I feel it's worth trying something different and seeing if it helps.

Anyone else ever try the autoimmune diet?

My last few runs

Two weeks ago, I ran for a few minutes on the treadmill.  Not sure why since I was pretty sure it was going to suck... but I guess runners can be stubborn.

And it was OK.  Not great, not bad.  Tolerable.  

Over the next ten days, that was followed up with:

20 minutes run/walk (2 min/1 min)

20 minutes run/walk (2 min/30 seconds)

20 minutes run/walk (3 min/1 min)

and then

26 minutes run/walk (3 min/1 min for 20 min, 1 min/30 sec for 6).   This totaled about 2.4 miles at about an 11min/mile pace average for the run/walk.

Huh?

Now, none of the runs I would classify as "pain free".  Achy, some sharper pains, but nothing that made me think I needed to stop.  And my surgery hip feels fine, it's really all in the other hip.

After today's 2.4 miles, I went out for 6 miles on the ElliptiGO.  That felt great.  Wheeeee.

After the running fail three weeks ago, I upped the hip flexor stretching.  I figured that it couldn't hurt and maybe it would help some.  I stretch 2-3 times a day most days.  I had noticed that my hip had started to snap, loudly.  And often.  Now that's almost totally gone.

This one I do at work:

These two are also in the rotation:

You can also have someone push down on your hanging leg for an extra stretch.

I still get enough of an achy pain in my other hip that I'm sure the hip flexor tightness is not the only issue.  There's something functionally wrong, but maybe I am keeping things at bay with some added flexibility.  Or maybe pilates has been the key to keeping things OK.  Or this is some sort of fluke and my next run will suck again.   Who knows!  The running gods are fickle and cruel.

The ElliptiGO Review - pros and cons

I love my ElliptiGO and I'm so glad I made the investment. Even my husband has been making good use of it during marathon training.  I figured after three months, I'd breakdown the good and bad.

The workout
Pros:  It is a much tougher workout than I had imagined.  Especially on the hills around here!  I huff and puff all the way up....and my husband (who is in much better shape than I am) confirms this is the case for him too.   It makes what I do on the elliptical at the gym feel like a leisurely stroll.  My core and legs burn!  It's tougher than cycling but not as tough as running only because you do get to coast quite a bit (what goes up must come down!)... I'd say it feels a lot like track intervals.

Cons:  The only con here is that I don't feel as comfortable as I do on a bike.  It takes a lot of balance and while I can drink and signal on the bike, I almost crashed trying to wipe my nose on the 'GO other day.  So this means that I tend to do loops around the neighborhood and avoid any of the major roads.  This may get better with more experience.

Shifting
Pros:  It shifts soooo smoothly.  Because it's an internal gearing, you can shift on the fly and with tension, unlike a regular bike where you don't really want to shift when under a load like climbing a hill.

Cons:  It shifts opposite how I would expect (opposite my bike, basically).  So I have - on more than one occasion - ended up in a lower gear when I needed to be in a higher and so forth.

Maintenance
Pros:  I haven't had any issues.  I just inflate the tires and go.

Cons:  If I do ever have an issue, I haven't a CLUE how to work on it.  I have at least a working knowledge of my bike.  I'll have to hope the bike shop can bail me out. :)

Uniqueness
Pros: Cars give me SO MUCH CLEARANCE.  I don't get this but I'm sure it's partly a "what the heck is that?" phenomenon.  On the same roads, when I am on my bike, I might get a few feet of clearance.   Today, I saw someone go fully on the other side of a double yellow line to avoid me.  Hey, whatever works.

Cons: Unlike bikes, where there are shops and group rides and clubs, the ElliptiGO has very little of the social aspect.  Which is ok, I don't go to the gym to hang out with people either, but it would be nice to have a group ride as an option.

Anyone else own an ElliptiGO?

A life without running

Yeah, yeah, I can't run without pain in my not-yet-fixed hip.  And hiking this weekend was tough with the hip pain.  But I can do a lot of other things, and I am trying to not lose focus on the positive.

Here has been my schedule over the last week:
Thursday - Squats, lunges and my hip PT work
Friday - 5 miles on the ElliptiGo
Saturday - 1 hour power reformer pilates
Sunday - 4 mile hike (cut short from the 6 miles I originally wanted to do), 30 minutes on the spin bike
Monday - Elliptical, squats and pull ups/dips
Tuesday - rest and massage
Wednesday - Elliptical, squats, core and hip PT exercises

Overall, this is a pretty good week.  Nothing causes me more pain or aggravates symptoms.  My operated hip feels fantastic - little aching, decent ROM.   The other hip stays about the same.  So I call that a win.

Surgery was six months ago and while this wasn't where I thought I would be at this point, it's also not all bad.

My appointment with the surgeon to have my other hip examined is November 12th. I'm trying to not focus on it too much because I can't change anything between then and now.

Stages of a Runner's Grief: Bargaining

If I have this surgery now, I'll be able to start running in four months and I could run a half marathon by next year.

If I can run 5/10ks, I'll be happy.  I don't need to do half marathons.

If I can run 2-3 times a week, that will be fine.  At least it's something.

If I can run by next spring, then I won't miss out much trying to run through the winter.

Deja Vu

My run/walk yesterday was a complete fail.  The goal was to move from 30 seconds run/30 seconds walk to 60 seconds run for 15 intervals.   I made it to about the fifth interval before my non-operated hip started in with intense groin pain.  I felt like I was right back to July 2013 with the first hip.

Frustrating.

I am trying to not think too much about it without the definitive diagnosis, but in the back of my mind, I know my odds are not good.  Hip, hip, hooray.

About 20% of people who need surgery on one hip go on to need it in the other hip.   So a large enough percentage to make it something that's a real possibility, while being small enough that it feels like horribly bad luck.

Today I was released from physical therapy until we can determine what the course of action is for the other hip.  Because I am only allotted a certain number of sessions a year, we wanted to conserve the remaining covered by insurance for now.

In other news, I completed a three-session intro to pilates.  I really like it!  It's more strength work than stretching like yoga, and is a serious core workout.

We did some crazy ab stuff in today's session like side crunches from this position:

And whatever the heck this was called:

Have you ever tried pilates?  Did you like it?

Dartfish Running Gait Analysis

I decided to have a running gait analysis done before I got too far into the run/walk program because I knew I know I still had a lot of strength deficiencies and compensations.  But, I wanted an idea of what and where I needed to focus my efforts and how bad (or good!) my running form looked to a professional.

It was pretty simple - I warmed up on the treadmill and then ran for about 3-4 minutes while they video taped me from the front, sides and back.   From there, the trainer was able to analyze my various angles and strides and determine where things might be going wrong.

All in all, my running form is pretty solid.  I am a  forefoot striker, good knee tracking, soft landing and no pronation issues. 

Where it falls apart is with my hips. (OK, is anyone surprised? Not really, right?)  Both hips show strength issues, and on top of that, my operated hip shows a lack of flexibility/ROM.

This shows what's going on with my hips as I land.  In the top left, you can see that my right leg (operated hip) tracks almost to the center of my body, as opposed to underneath my hip (red star).   My left leg does as well a little, but not nearly as much as the right.  The screen capture is too small to see the actual measurements, so just take my word on it.   This is all hip strength related, specifically strength in the lateral (side-to-side) direction.

In the bottom right, you can also see that when I strike with my left leg, my right hip drops.  This is hip and core strength and stability.    Planks, side planks, bridges.

The other interesting thing the trainer noticed was that my stride on my operated side is more shallow - I don't get as much hip flexion nor hamstring activity (less of a knee bend) as I do on my "good" side.   He believes this is a ROM, hip flexor issue.

The non-operated hip from the side:

The operated hip:

All in all, I really got a lot out of the gait analysis.  I want to repeat the analysis in 4-5 months and see if I have made improvements.  I received a set of exercises to work on and a few tweaks to the PT exercises I have already been doing to work on the specific deficiencies.

The Dartfish program is easy to use.  I have a copy of all my images and videos on a CD that I can review at any time.

Don't call it a comeback

When you first make the plans to have surgery, your goal is to get back to where you were before you were injured.  But this is sort of a false premise to go by because you really never can "go back".  It doesn't even have to be surgery we're talking about here, lots of people have nostalgia about a prior point in life and really... you just have to let it go.   Time marches on.

So you've gone through surgery for what then?  It's to have a better future.  Or, rather,  it's to get on the path that you think will lead you to a better future.   It's a risk.  It's a gamble.  But you believe it's your best shot, so go for it.

I am at five months post-op today.  Things are good.  But different.

My repaired hip doesn't make a peep 95% of the time.   I really only notice it when I need to do something that requires a full range of motion or am in PT being reminded of the weakness of that leg.   I can hike, elliptical, lift and do pilates without issue.   I have started a run/walk program, and it feels fine during and after.

But.  Every time I've run, my other hip (you know, the good one?) has been achy.  Then it locked up in PT for a second or two.  And for the last day or so, it's been achy almost constantly.    

If I needed proof that things aren't the same after surgery, there it is.  And that's not to say that surgery somehow caused my other hip to start to have issues, at all.  But two years ago is just that - two years ago. 

And who knows, maybe the other hip will calm down and be a non-issue.  That doesn't change the fact that  I need to embrace the now and accept that is where I am.  And that everything is okay even if it's not.

Summits and trails

The last few weeks, we have tackled a bunch of the various "summits" nearby.  The hip has cooperated with 6+ miles, 3+ hours on the trails, some of which were steep and rocky.   I used to hike a lot before I got into running, so it's been nice to revisit an old hobby.   To celebrate the miles, I bought myself a new hydration pack, the Nathan Intensity Race Vest:

We've also been having some incredible weather.  A few picture from our hikes:

I've been doing the ElliptiGo pretty regularly.  It's a good workout and really does not bother the hip at all.  Though, secretly (or maybe not so secretly lol), I do wish I could ride my bike instead.   It's getting better, but still aggravates the hip flexors too much for it to be comfortable.  

The sun is already is setting earlier, so pretty soon it'll be dark when I get out of work!  This summer was such a blur. :)

The new toy: ElliptiGO

I have tried bike riding several times post-op and I've found that it's too much hip flexion and just not comfortable.  It also leaves all my hip flexors unhappy for days afterwards.  So that means that I was limited to walking/hiking and the elliptical.   In New England, we have a good six months of true "outdoor" weather and the thought of hammering away indoors this summer on the elliptical to get a good workout in was just unappealing.

I knew I could handle the elliptical motion.  So I did some reading and research and there are a lot of hippie people really happy with their ElliptiGOs.   Yeah, it's not the coolest looking piece of equipment but it seemed like a lot of fun and everyone online said they enjoyed riding it.  

My new ElliptiGO!

From their website:  We got the idea to build the ElliptiGO really out of necessity. In 2005, Bryan lost the ability to run for fitness because of hip and knee injuries. Basically, a lifetime of contact sports and endurance athletics had caught up with him and by the age of 32 he was forced to engage in low-impact exercise. As a former cyclist and Ironman triathlete, he seriously considered returning to cycling to stay fit. However, he had always found the bicycle saddle and riding position to be really uncomfortable and cycling workouts to require too much time. As a result, he started using the indoor elliptical trainer. Although he liked the exercise, he hated being locked in a gym. To solve this problem, he decided to buy a low-impact running device he could ride on the street. 

The first ride on it seriously kicked my butt.  I had to stop a mile in to catch my breath!  Most importantly, there was no hip pain at all.   I am up to almost 4 miles now and am signing up for a 10 mile charity ride in a week.

People report riding bike-like speeds -15-18mph - and distances of 50, 60, 100 miles.  Right now, this seems completely nuts!  

There are quite a few elite athletes who use the ElliptiGO for cross-training purposes.  Here's a really interesting video showing how the elliptical motion is similar to running (but obviously without the impact):

Data!

As I mentioned earlier, I have been using a BodyMedia arm band (now owned by Jawbone).  Here's what some of the data looks like (I don't wear a heart rate monitor and I am bad about recording my food, so I am not using all of the data features it has):

This is a summary of the last 7 days.  It gives you an average calories burned assessment and a summary of steps walked and how much exercise you did over that period.   It also gives you a sense of your sleep "efficiency", which is pretty accurate.  The nights when I get up at 3am and stare at the clock show up pretty clearly in their breakdown.

When you load up data, it will show you a list of "accomplishments".  I don't know what this says about me if all my accomplishments are about sleeping.  Hmmm.

On any particular day, you can look at your data by hour.  Here is my activity and steps on an hourly basis:

What I like about Body Media is that it's like having someone watch me all day and know that my decision to be lazy will be permanently recorded somewhere.  I want my numbers to be good, dammit! I've found myself opting to walk somewhere so I can be sure that I get my 10,000 steps in.  No, I'm not obsessed by data or anything.

Does anyone else use an activity tracker?  Fit Bit, Jawbone, Nike Fuel, etc?

The San Francisco Half Marathon: My final DNS

Over the winter - and pre-diagnosis - I had accepted the fact that I would just have to run through this pesky tendonitis stuff if I wanted to run.   I hit a mileage PR running through pain so why not sign up for a few races as well?   Sadly to say, I DNSed all of them.   The last one was the San Francisco half, this past weekend.  My husband ran the full marathon so I was spectator extraordinaire.

The SF Marathon has four races going on that same day - the full, TWO half marathons and a 5k.  25,000 runners!  And it was a very well-run and well-organized event.

We stayed at the Hyatt at the Embarcadero because I did not want to have to deal with getting to the starting line for a 5:30 start time.   We've stayed there before and so it was familiar territory, as well.  My husband was in the wave right after the elites, so he was officially off and running at like 5:32.  EARLY.   Even with the east coast time zone advantage, it still felt really, really early to be standing out there at o-dark-thirty.

The view from our hotel room.

Starting line.

Once he was off and running, I hung around and cheered on the remaining 8 waves of people (like I said, 25,000 runners!).    I saw the wave start that I would been in... ah well, it is what it is.  Sticking around the start line did mean that I caught the sun rise, which was lovely. 

The bay bridge sun rise

We stayed around the bay area for the rest of the week and ate a lot and drank a lot.  And I didn't do any of my physical therapy...  Back to reality now!

Needless to say, I won't be signing up for ANYTHING until the day of the race.  Signing up for races and not running them is an expensive way to get a t-shirt.  

The return to running

Yeah, ok so it was just three 30 seconds intervals and it might have been a 13 min/mile pace... but I officially RAN!

The last time I ran was February 9th.  6 months ago.

It felt really, really good.  My hip was smooth, not clunky or achy like it was towards the beginning of February.  My operated hip actually felt better than my other hip, even.  (which sort of is making me think another surgery for that hip might be in my future, but let's not think about that right now)

My surgeon's return to running program is fairly conservative.   I probably won't officially start the back-to-run program until later in the fall.  Firstly - I am still dealing with the hip flexor stuff and I don't need to tempt fate there.  Secondly - who wants to start running in AUGUST?  Talk about torture and sweat.  And lastly - I have a trip to Italy in September and I don't want to mess anything up and end up having to bail on that.  So patience for now.

Here's the plan my surgeon recommends:

So basically, the first few times out, I run a lap on the track.  That's it.   Then a lap and a half.  Then I get to graduate to TWO laps on the track.  And so on and so on.

In other news, I've started wearing a Body Media monitor.  It's like the FitBit or Nike Fuel Band but actually has skin sensors to monitor temperature and sweat so it's a little more accurate. I've found that because I am restricted in my activity, I've been having a hard time adjusting how much I eat.  (read: I'm stuffing my face when I really shouldn't be.)

Here's my last week's worth of data averaged:

You can expand each of the categories and see the breakdown daily - when you are more likely to be sedentary, when you are active, days you were particularly active, etc.   If you are a data junkie, you'll love it!

More trails. More bugs.

I did about 4 hours worth of hiking this past weekend, hitting up a few of our local trails that I hadn't been on recently.  One hosts a marathon and I always head south which is more runnable - this time I went north and was like "People RUN this??"  Talk about rocky!

One of the more runnable spots through the rock garden

Not sure why there's a chimney out in the middle of the woods

Rock walls from when this was farm land, I think

One hike started off with a bear sighting.  I've never seen a bear in real life!  He was cute.  Just meandering across the street like it was a normal Sunday.  Tra la la.  He completely ignored us.

I have been trying to find the right combination of bug repellents but these buggers are persistent.  DEET, Permethrin-infused clothes, Badger "natural" bug spray which makes me smell like a citronella candle... nothing worked.   I really need some suggestions because I expend more energy swatting bugs than I do walking.  Wait, maybe I can consider that my upper body workout?  Hmmm.

Over my mini meltdown

I suppose when you are approaching three months of post-op rehab, it's easy to have a meltdown when things seem to be going backwards.

However, it's really important to keep perspective.  Three months really isn't that long in the grand scheme of having a major surgery.

After my horrible week last week, this week has been better.  I have been having some muscle spasms in my hip flexors (TFL, psoas, adductors) so I am pretty positive most of my pain is from that.  I had a massage this week and have really worked on doing things that don't require a lot of lifting of my leg.   Still not 100% pain free, but better.

Tomorrow my therapist wants me to try to run on the treadmill.  I'm not quite sure that's a smart idea knowing that my muscles are already unhappy.  It won't be for anything more than 30 seconds or so, though, so I suppose there's really not much harm there.  I won't be starting a real return-to-running program for another month and a half (mostly because of my schedule over the next 6 weeks but also because I want to be conservative about things).  

The thought of running for 30 seconds has me breaking into a cold sweat.  What if it hurts just like it did before surgery?  What if I'm no better off after all this?  What if, what if, what if.   I think I just need to do it, get over it, and stop having doubts about whether or not I have a running future.  Right?  Right.

And what now?

I am at 11 weeks post-op, and I'm experiencing more pain this week than I have in nearly a month, maybe more.  What sort of mind f*** is that?

I have no idea what's causing it.  I haven't changed anything or increased intensity on exercises, etc.  My hip is achy and I am having a lot of groin pain for no apparent reason.  I've been icing every day after about three weeks of no ice needed and tonight I am going to have to break down and take some pain meds.

Hip flexor tendonitis?  Inflammation?

I am down to one PT session a week now so the first time I will get to see them since this all started is tomorrow.  And they better have some answers, dammit.

I did three miles walking on Monday and three miles tonight and that was about all I could handle.  Too achy and sore.

I've created a monster

Since I've been on the DL, I've kept my meds, supplements and whatnot on the side table next to the recliner.   A few weeks ago,  I gave the dog a salmon oil capsule and to my surprise he loved it, so I gave him another.  I did it a few other times as well, because it was sort of cute to see him munch on the oil cap and all that.  No harm, right?

Fast forward to now, and as I write this post, I have a dog who is whining, barking, stomping his feet because I will not give him a salmon oil cap.   First of all, the things are not cheap and second, while it was cute a week ago, this begging is sort of not cute.   Well, ok, it's still cute but it's crossing into the annoying category as well.   Plus, it's sort of ridiculous to have a dog who begs for... a pill.

"Why are you torturing me?"

Fueled by cupcakes

It's sort of amazing that I've only gained 5 lbs in the last two months since surgery.  Because, basically, cupcakes.  I could get away with that stuff when I was breaking a sweat every day, but there's really no calorie burn happening now even close to negating the constant snacking.  But, alas, they taste yummy.  And since my husband is marathon training, he gets cupcakes.  So then I HAVE to get cupcakes.

Saturday's cupcakes - lemon creme and chocolate raspberry

I have taken a few 4+ mile walks on the rail trail.   It's been a little easier to do it on the trail versus doing the longer walks around the track ('round and 'round and 'round) or around the neighborhood where in any direction there is a huge hill.   It can be a pain living out in the boonies sometimes, but we have a whole slew of different trails available within an easy driving distance.  And having access to a large rail trail system particularly like this is fantastic - it's quiet, pretty and close!

Summertime fun

We had a pretty cool spring and now the summer seems to be following in a similar path.  Typical weather for end of June/fourth of July is hot, humid, sticky weather.  It's been in the 80s with tolerable humidity and the nights are staying cool.  Amazing!  I know this won't stick around but I'm enjoying it while it lasts.

Today I went for my first bike ride post-surgery.  I'd been holding off because biking definitely had been irritating my hip flexors.  I managed 12 miles in about an hour, just a real easy pace on a flat rail trail.   No pains or aches while I was biking but yeah... the hip flexors, particularly my TFL, are cranky.  I iced afterwards and foam rolled a bit, we'll see how it feels in the morning.

After the bike ride, I still wanted to get my daily walk in, so I went for a few miles in the woods near our house.   The trail follows the river and it's so pretty.

The river runs along the right.

Some busy beavers!

Over the last 30 days, I've walked just about 32 miles.  I try to get out at least for a mile every day.  As I mentioned, the weather has really cooperated and it's been great outdoor weather.  My walking schedule from the last week:

Saturday - 3.4 mi

Thursday - 3.3 mi

Wednesday - 3.3 mi

Tuesday - 2.6 mi

Monday - 1.5 mi

Sunday - 2.5 mi

I had my two month check-in with the surgeon this week.   It wasn't much of anything, really.  I first met with the PA and he tested my range of motion, then I waited for an hour to see the surgeon and he basically tested the same things and also checked to make sure my psoas was firing ok.  Everything checked out fine and so my next appointment will be in mid-August.  

I would walk five hundred miles

I hope the Proclaimers song is now in your head. :)

Today is the 7 week mark.

Over the last 5 days, I've walked 7 miles.  That doesn't really sound like much, does it?  But it's something.  My longest walk has been 2.2 miles and I could have done more but I've been playing it conservative, trying to get a little walking in each day before I go for longer mileage.  

Physical therapy continues to be tough but I got less muscle soreness/DOMS this week than last week (don't get me wrong, I'm still SORE but relatively speaking, it's less.)  Today I walked for 1.6 miles, then I lifted upper body stuff and then I did 30 minutes in the pool doing squats and lunges and what not.  The pool has better than trying to do my land strength work on the day after PT when things are still pretty angry.

This last week or so the psoas/iliacus had been really acting up.  Like deep, sharp pains in my abdomen, near the "wing" of the hip (the iliac crest, specifically).  The physical therpaist noticed that I am way too tight through the front of my hip.  A few assessments later... and we're at the "you're using your hip flexors too much and your glutes are not firing" diagnosis.  My poor hip flexors were just getting too much of a workout!
I also notice that when my hip flexors are tight my groin/joint hurts more - like the tight muscles are squashing my poor hip joint or something, so along with the psoas pain came some increased groin pain.   This week was probably the most uncomfortable I've been in a while, but in the grand scheme of things I have to remember I am still in the early stages and the pain wasn't that bad.  Though being in any sort of pain during rehab just screws with your head.

So anyway, the therapist wants me to get up and first thing in the morning run through my set of "glute" exercises to "wake up" the muscles.   Right.  Because I am SUPER organized in the morning and totally NOT rushing out the door grabbing things as I go.  Uh huh, we'll see how this goes!

As far as the exercises at PT, here is the sheet I am currently working off of for my homework:

From the top left going clockwise:
Split squats
Side lunges
Step downs - stand on a step, drop the leg not on the step behind you, stand back up (this one really gets the glutes good)
Bird dips or Statue of Liberty
Squats (I'm doing them on the Bosu)
Hip drops - stand on a step, drop the leg not on the step (keeping the hips level, so the other leg bends a bit), stand

Things not on the sheet but still on my list for homework:
Core work - planks, side planks
Monster band lateral walks
Walking, biking, elliptical - I have been doing mostly walking because the weather has been so nice!  But I am cleared to use the indoor bike and elliptical as I can tolerate.

The next milestone will be... two months.  That seems huge!  Closer to the end than the beginning.  Hooray!

42 days

Six weeks!

I feel like the six week mark has been a milestone of sorts.  Six weeks was the longest I might have been on crutches.  Six weeks marks a significant portion of healing and with that, more freedom to do various things as well.

At six weeks:
- I can go up and down a flight of stairs without too much issue.  The psoas is still unhappy about lifting the leg going up, but nothing terrible.
- I can walk for exercise and I can add resistance on the bike (but not yet cleared to ride outside).  We also did the elliptical at therapy today.
- I sometimes find myself forgetting I had surgery.   I sat quickly the other day, not thinking about my hip, and had a nice, sharp reminder that I'm not healed enough to do things like that.  Oops.
- Standing and sitting for periods of time isn't dreadful.  Some chairs are still uncomfortable, but overall, I can get comfortable.
- I am still having some nerve issues while sleeping on my side, so I haven't yet been able to move off of sleeping on my back (which I don't like).
- My range of motion is just about perfect, except for internal and external rotation - but even those are improving daily.

Physical therapy has jumped from regaining motion and flexibility to pretty much all about strength and balance.  We've now added:

One-legged squats on a stair

Bird dips with weight

Bosu planks

Monster walks/lateral band walks

Today I felt like all my pre-op work was finally starting to pay off.  I can get though almost a full hour of leg work, and while they are still total mush by the end, the fact that I can get through it all without needing to modify anything was promising.   She's also increased the weight/resistance every session and it hasn't caused me any trouble.

And the best is - NO hip pain doing any of the exercises.

Post-surgery depression

If you're on the hip forums or chat rooms, you'll see the post-surgery blues mentioned.  Some claim it happens around week 6, some say anywhere in the 4-8 week range after surgery.   It's not surprising that a total change in your lifestyle - one that is generally difficult, isolating and with many restrictions on what you can do - would be met with sadness, frustration and depression.   People generally value their independence and now for weeks or months, you are highly dependent on others... it's tough.

That said though, it is important to try to find ways to keep your spirits up post-surgery.   There is a good amount of evidence out there that people who are happier will fare better in rehab and healing.  For example:

Depressive symptoms are a major driver of reduced immunity after hip fracture.

Depression following hip fracture is associated with greater physical frailty and poorer long term recovery post-injury.

Major depression is accompanied by immune dysregulation and activation of the inflammatory response system (IRS). 


I think staying socially connected - for me at least - helps combat the feeling of isolation after surgery.  Try to find events or social gathering that you can handle while on crutches and that won't increase your pain.   If you are missing your daily workouts, ask your therapist if there are things that you can do without causing problems - the arm bike was something I figured out would help get my heart rate up a bit without impacting my hip at all.

It's also important to ask for help if you are feeling depressed.  Don't bottle up those feelings.  It is a normal part of surgery but you don't want it to consume you in a way that will impact your healing.

How do you keep your spirits up during tough times?  

Edit - I wanted to add this recent FAI blog post, as it touches on some of the mental aspects of surgery: Hip Athroscopy Rehab - a Psychological Perspective.

We must learn to walk before we can run

Week 5 - I am cleared to ditch the crutches and walk for exericse!   Tonight's walk was just up to the corner and back, maybe 10 minutes.   Felt great!  I'll try to extend the walk each night.

Today was my first real "land" physical therapy session (Thursday is my last pool session! :sad face:).  Hoooollllleeeeee shaky legs, Batman!

Here's what we did:
Assisted leg press/hack squat with no weight

Wall ball squats

One legged bridges

Walking forward/backward/lateral with resistance

Quad "presses" 

One leg balancing on a trampoline

Planks

I am pretty sure I am going to be really sore tomorrow!

What can you do one month out of surgery?

Before surgery I found it very helpful to hear what others were able to do in the weeks post-surgery, rather than always focusing on all that you can't do.  I haven't yet set up my TRX as I had planned but I am still planning on adding that in at some point.

At four weeks, here is my standard workout/PT session:

20 minutes on the arm bike

Bridges

Lateral leg raises

Adductor work (on my back on the floor, knees bent, feet on the floor - gently drop the knee outward to the ground)

Prone leg lifts

Hamstring curls

Mini-squats

One leg balance, eyes open and closed

Calf raises

Hamstring stretch

Hip flexor stretch

That's all my PT work at the moment, then I move on to:

Planks

Modified push ups (I did these and the dips on the stairs when I was not up for going to the gym early on)

Modified dips

And then since I'm not cleared for free weights yet:

Chest press machine
Back row machine
Tricep/bicep machine