Category Archives: Recovery

The Last Two Miles of Recovery

Just. 2. More. Miles.

Can you believe that as of a couple weeks ago, this injury began two years ago? It’s weird just thinking about it. Just a few weeks ago, I wondered if I was weeks, months, or maybe even years away from the end of this thing. The breakthrough came when I was walking around the streets of Manhattan, of all places. A few weeks later and the end of this journey is almost within sight.

I’ve learned not to blog about every single little healing point, because sometimes they can be fleeting or temporary. Before getting carried away and telling the world, I want to hear from someone smarter than myself. I heard that news today.

Just to backtrack, we discovered not too long ago that the majority of the setbacks were scar tissue related. Prednisone wiped them away temporarily, and then they came right back. Walking around New York helped too. The smoking gun was found when I had an injection into my pelvis. I was fortunate to work with my favorite radiologist, who I have seen an unbelievable three times. As he was performing the injection, he took an x-ray and used an ultrasound tool to see inside my hip joint. There it was, clear as day, a bright, think white line that enveloped my hip joint from end to end.

It was scar tissue alright, but it wasn’t the end of the world. The problems I had been dealing with were a result of tendons passing over the scar tissue and getting caught. That would result in inflammation and felt oddly similar to how things felt before surgery. It was a different form of hip popping syndrome, only this time it was not due to a torn labrum. I found myself recalling the philosophy from True Detective — “Time is a flat circle.” The line barely made sense when I watched the show, but it made perfect sense when I was getting that last injection.

For the first few days, the hip hurt. That was nothing to worry about. It was supposed to hurt. Then it would get a little better day by day. Sure, there were a couple bad days, and there will probably be a couple more, but the momentum was in the right direction.

Today I saw my doctor again. The good news is this scar tissue is manageable. It will never truly go away. My body will just adapt to it, and will re-build itself to accommodate it. It will probably give me a little bit of trouble in the future, but nothing like what I’ve dealt with over the last two years.

What is important is that I continue with regular, light activity. Walking works, as I’ve already found, and I can burn a few calories while I’m at it. For the next couple months, I’ll be doing a lot of walking, and maybe a little bit in the gym. That’ll break up the scar tissue and get my body to start getting used to it.

I decided to stay off the bike for a little while longer. I know I could ride right now. In fact, I would absolutely love to ride. There’s a chance that it would be no problem. The issue with me and riding is that I have only one speed. When I get on the bike, I want a workout. Rather than risk going too hard and setting myself back again, I’m going to slow it down. Now that we’re almost to September, the year is pretty much done anyway. I’ll give myself a little more healing time, and hopefully during the offseason I can gradually transition back. What’s important is that I remain patient and don’t push myself.

My doctor said he absolutely, positively expects me to get back to endurance sports again. The question is when. That depends on my body. Probably the earliest would be by the end of the year, and the latest next spring. All that matters is that I’ll be back.

Nice bridge view from the Roanoke Mountain lookout.

Don’t go anywhere, mountains. We’ll meet again soon.


I’m Walking Here!

Before heading to New York City for a non-riding vacation, I was wary. It’s no secret that to really experience New York, you have to walk for miles and miles. A couple weeks ago I was dealing with nasty scar tissue that kept me on the couch. The doctor gave me prednisone that helped clear it up temporarily, but once I got back on, the pain was starting to come back. It was gradually becoming worse last day or two before flying out.

Today is the 6th day in New York before flying back on Sunday. I’m happy to report that the trip has been an unquestionable success. We had a busy first full day, doing both the Statue of Liberty tour and the 9/11 museum. I was on my feet a lot, either walking, standing up in subways or ferry boats, or worse, standing in line. The lines were the toughest part. If I kept moving, the hip wouldn’t hurt so bad, but it could be agony when I stayed still. Anyone who has been to the Statue of Liberty knows that half the trip is waiting in line.

That first day was pretty tough, and we decided to go easy the second day. Then, after having an anniversary dinner and a beer in Eataly, my wife asked “wanna go to Times Square?”. Why not, I thought. The reason why not was because all of the walking, but I went on undeterred. We ended up getting a little lost, then wandering around the core of Times Square, then all the way over to Radio City Music Hall, and then back to Grand Central where our hotel was. I’m not sure the exact distance, but it was miles. And I felt alright.

As the week progressed, I kept walking more, and the hip kept feeling good. The strongest medicine I had to take has been Aleve, and even then I’ve felt okay for short periods without it. Now that we’re about ready to go, I’m pleased as can be that the hip feels better than it has for months.

So walking has been a breakthrough. I did not ride here, although I was tempted since this is such a terrific bike city (more on that later), but I didn’t want to tempt fate. Just being able to walk at this capacity gives me one more thing I can do when I return. I will be walking some for exercise, to put more pressure on my surgery-recovered hip, to create more bone density, and to simply get outdoors. I’ll also be able to ride sporadically, although I’m not going to push that. For some reason riding tends to inflame the scar tissue, so I’ll need baby steps to get there.

When I get back next week, an anesthesiologist will inject some cortisone into my pelvic region, which will further break up the scar tissue. I’ve seen him before pre-surgery and even then when I had a torn labrum, I noticed results. This time there will definitely be some results, but I will have to take a few days off after the shot. No complaints since I’ll need some recovery from the vacation.

Little by little, I am coming back.

Here are some NYC shots while I’m here.

Freedom Tower can be seen almost anywhere, and it is a beautiful structure.

Freedom Tower can be seen almost anywhere, and it is a beautiful structure.

This is where the ball drops on New Years in Times Square.

This is where the ball drops on New Years in Times Square.

Lady Liberty

Lady Liberty

"Starry Night" by Vincent Van Gogh.

“Starry Night” by Vincent Van Gogh.


Recovery: Smooth as Sandpaper

This sums it all up!

This sums it all up!

When I was at the Ride of Silence the other day, a friend joked that watching my recovery from afar was like watching a roller coaster from the ground. At one moment I’m up, and the next moment I’m back down. That analogy was appropriate, and would come back up again. The image above (used with permission from Adam at The Sports Physio) sums it up perfectly. We expect everything to go as smoothly and perfectly as possible, but in reality, the process can be chaotic.

After the recent setback, I had my orthopedic appointment bumped up just to play it safe. As always, he gave me some terrific advice. I cannot say enough about how much I lucked out getting Dr. Guy as a doctor.

First was the issue of the setback. We went into detail about what happened in physical therapy, and he said that absolutely shouldn’t have happened. My injury is a lot different from what therapists usually see with hips, and it has to be treated differently. Usually running in water would not be so harmful, but when I told him the low water level, he rolled his eyes. When I told him about using the recumbent step machine rather than an stationary bike, he practically gasped. Those are impact exercises. I’m not ready for those now, and there’s really no timetable for when I will be. I’ve heard as early as 6-9 months from surgery, and as late as a year. Aside from casual walking, there shouldn’t be the slightest bit of impact exercise at 16 weeks.

He also likened this experience to a roller coaster. He frankly reminded me of how he surgically went into my hip and tore into my bones and cartilage. As he put it, he made big holes so that they could fill in and heal correctly down the road. Every time I do some exercise, smaller wounds are created and they need to heal during recovery. Light exercises like swimming and spinning a bike in a low gear will do slight damage to my hip. Impact exercises will do a lot more damage, and that takes longer to recover from. That’s exactly what happened with the setback.

That’s where the roller coaster comes back. When you do a little damage each time, the hip’s condition will drop slightly after each workout, and eventually after recovery it will continue upward. The trend line will resemble the left side of the image above. If you do too much at once, the condition will plummet like a roller coaster and have to slowly climb a longer ways back.

The goal is to progress slowly and steadily. As I exercise and do a little damage, it’ll heal and the next time I can do a little more. I can swim 5 laps the first time, and then maybe 7 laps the next time. If I keep progressing in a steady direction then I will eventually get to 20 laps without pain. If I go from 5 laps to 20 laps, then I my body will take longer to recover and I’ll need rest. Without that continual progression, the recovery will take longer and the body will need more rest. That’s exactly what happened after the run and step machine. I’m now where I was shortly after I first started walking.

The doctor said that I should absolutely do no running or any impact exercises. He wants me to do a lot more swimming, which is the least impact I can put on my body right now. The next best thing is cycling. I can ride in little gears, but nothing aggressive. I’ll start with a few laps and miles, and inch my way forward. One day I’ll be recovered and can give some impact a try, but that is far from here.

I know that I have a history of being naive optimist with this injury, but after seeing the doctor, I’ve never been more confident that the trend line will continue to progress forward as it should, and not be a jumbled mess like the right hand column of the image above.

There is good news this week. It took me about three days to be pain free after the step machine. I felt no pain when riding, and no pain the day afterward. As long as I’m smart, I won’t need to cause unnecessary suffering and setbacks.


Week 15.5 Report: A Little Hiccup

First off, congrats to all of my friends who completed the Assault on Mount Mitchell this year. After having done it the last three years, it was bittersweet watching them from a distance, but I’m pretty sure I’ll be back next year.

I briefly alluded to this last week when I bailed on The Good Ride, a decision I did not make lightly, but I have been dealing with a slight setback lately. I didn’t want to get into it too much until I understood it, and frankly, I was hoping it would pass. It really materialized a few days before The Good Ride, got worse when I walked around Ikea, and then got even worse later. More on that in a second.

Things had been going swimmingly when all of a sudden I had a new guy helping me with my pool therapy. He had me ramp it up a little bit, which was fine with me. The treadmill started going faster and faster, and eventually I had to jog to keep up. I have to take some responsibility because I never told him to slow down. That’s not in my vocabulary, which may be how I got into this mess in the first place. He was a nice guy and we got to talking, so time passed with me jogging the entire time. After about 10 minutes, I was getting sore and told him I needed to stop, even though it felt great to get some exercise.

Pain will usually linger for a couple days after a heavy PT session, as it is supposed to. This time it continued well into the week without getting better. When I returned from Charlotte, it became worse. The injury felt like it did before surgery, which was not a good sign. I shut everything down until the pain subsided.

It took awhile to connect the dots, but running was most likely the culprit. I remembered that I’m not supposed to run until roughly a year after surgery. Based on when all the pain started coming back, I am convinced that the running caused the setback.

Things became a little more manageable later in the week, and I booked an appointment on Saturday for some more therapy, the first in nearly two weeks. This time it was the same guy. I explained everything that happened. He was protective, a little defensive even, and said that there was nothing in my chart that restricted running.

step thing

We decided to go easy that day. We did some stretches. At first my hip was tight, but it loosened up as I stretched it out. Afterward he had me spend a few minutes on the step machine, pictured above. This was tough, but I went through it. The therapist should know best, right? He said to do at most 7 minutes and call it a day. I left the office feeling pretty good.

The next day was excruciating pain — some of the worst I’ve felt since surgery. Luckily it was on a Sunday because I could not have worked through it, and luckily I still had a couple of my post-op painkillers remaining or I would not have gotten through the day. It was rough, and in the moment I thought I was in a full blown setback, and began wondering if the surgery was unsuccessful and that I’d need to go back under. It was a scary day.

The next morning was rough, but a lot better. It got even better as the day progressed, and the next day I was able to walk pain free again. Today feels amazing, just like it did prior to the running incident. I think the culprit this time was the step machine because it placed too much weight on my hip, which is basically the same reason the running hurt.

Based on how I feel today, I think the scare is over. I plan to take part in the Ride of Silence tomorrow, and I’m seeing my doctor on Thursday just in case. Unless he warns against it, I expect to resume my recovery. But no running, stepping, or anything else like that. Cycling will do.


Walking Before Riding

Ikea

Yesterday I had been planning on my grand return. I was going to ride in The Good Ride in Charlotte. The plan was that I would travel up with my wife, and even if I couldn’t ride, we would make a weekend out of it. Since I started back on the bike the week prior and received the green light from my doctor, riding was a good possibility. I was even considering doing the longer route depending on how I felt. There was some bad weather on the horizon, but Michael, the ride director, had done some solid meteorology and determined that the storms would happen towards the end of the event.

Unfortunately, I did not ride. And that turned out to be a good thing. There was a perfect storm of forces working against me. I forgot some stuff, had a little bout with allergies, and my hip soreness flared up. The weather was an obstacle and would have been a challenge to ride because of high winds, but it was more a mental detriment than anything. Given all my other challenges, I just couldn’t get enthused to make my grand return on a dismal day.

The reason not riding turned out to be a good thing was that I saved my legs. If I had ridden, I would have probably been holed up in the hotel room, icing my hip and probably leaving my wife helplessly bored. Instead we had a productive day, roaming around downtown Charlotte with a foray to IKEA.

For those of you who haven’t been to IKEA, just know that it is mammoth. The store is designed to funnel you through to every showroom, and by the time you’ve completed the circuit, you’ve probably walked a few miles. I’ve been walking for a couple of weeks now, but not completely painlessly. I still find myself walking with a limp, and if I spend too much time on my feet, the hip will hurt the next day. Even though I brought my cane and used the cart as a way of absorbing the weight bearing, it was still taking a toll.

This was hardly the therapy that my doctor’s or therapists prescribed, but IKEA was another way of testing the hip. I passed with flying colors on that day, however later and then today, I’ve been dealing with some soreness and a little bit of hip popping. It isn’t a setback, but more of an example of ‘two steps forward, one step back,’ which can describe most of the recovery process. The more I push, the better I will get, but progress does not equate to painlessness.

Before I start pushing it on the bike, I think I need to get to a point where I can walk without pain. I can continue riding for therapy and my doctor encouraged it, but racking up the miles at this stage of my recovery is probably not wise. Who knows, maybe next week I’ll reach another healing point and feel more confident riding. In the meantime, I’ll keep on resting and being smart. There is no deadline for my recovery. The biggest challenge is balancing my desire to exercise and ride with my physical need for rest and recuperation.


It’s Like Riding a Bike

6 Miles.

6 slow, awkward, steady, incredibly blissful miles.

I got home from work thinking that I would spend the evening tracking down my bike stuff and ride tomorrow. After all, aside from the one-mile pre-surgery ride (which I don’t count), my last ride was September 7th, 2013. That’s eight months of sitting on the couch trying to not think about riding my bike, but not a day passed where it didn’t cross my mind. Thanks to my wife, all my cycling necessities were not too hard to find.

Why do something tomorrow when I can do it today?

I kitted up, filled up a small water bottle, and got ready to take the saddle. Even though my hip has healed a great deal, it still is sore and I had to be careful. I first clipped in on the injury side, which has been my habit, and felt a twinge of soreness. That wouldn’t work. I led with my left, the stronger leg. As I first clipped in and pushed off, I was a bit wobbly. For a moment I wondered whether I would fall, something that I haven’t done in years. I got the pedals around just enough to coast down the nearest hill, and from there, I was moving. I was back.

The plan was not to ride hard. This is all about revisiting something I love, getting a feel for it again, and testing whether I feel any pain. I started out slowly, not even looking at my speed, just focusing on my cadence and pedal stroke. I intentionally rode around quiet neighborhoods with rugged roads, just because they would keep me from opening it up. This isn’t the day for me to set any records.

Riding a bike is like riding a bike. Muscle and mental memory take over. Before I knew it, I was comfortably pedaling and keeping decent form. The hip was not bothering me, but I’ve learned not to take it for granted. I kept going slow.

What a relief it was to be back on the bike again. I wanted to capture the moment, but the neighborhood was not exactly picturesque. Instead I tried to go for a picture of me looking down at the biking. I’ll need practice with my camera work too.

My first picture taken from the bike in awhile. Need practice there too.

My first picture taken from the bike in 8 months. Don’t worry. I’ll get better.

My doctor told me I’ll be sore after my first ride. I’m not now, but I expect it tomorrow, and I’ll give myself a couple days to recover. I am encouraged. For not being on the bike for so long, I surprisingly have a little bit of strength and fitness, which I can credit to my physical therapists.

This is probably the beginning of the end of my physical troubles. Sunny skies are ahead.


Ticket to Ride

bike in car

That is my bike in the messy trunk of my car, all tuned up and ready to go, sharing space with jumper cables and other junk. The one thing I missed during this long period off the bike, is I didn’t get the opportunity to complain about the weather. When I picked up the bike, there were some storms in the area. Rather than expose it to the elements with the trunk rack, I decided to keep it sheltered, and ready to ride.

Now for the good news. I AM CLEARED TO RIDE!!!

The doctor examined me, was impressed by my mobility, and said that I am okay to go. I need to go easy, not overdo it, and make sure to give myself a couple days to recover afterward. I’m still planning on heading to The Good Ride the weekend after next and most likely will ride one of the shorter routes. I’ll be the guy kitted up with an expensive Cervelo, riding with some friendly slow riders. Slow, social rides are pretty awesome.

While I have made a lot of progress, especially in the last three weeks, I still have a ways to go. He said that I should expect to be sore as I ramp up my activities, and that it’s okay to take some occasional pain pills to take the edge off. The hip has not healed completely yet, and still gets sore if I do little things like climb stairs, stand for long periods of time, or walk more than I should. I still cannot move my knee to my chest, and it’s tight when I try to move it inward.

Probably the best case scenario is that I’ll be at full activity in about 4-6 weeks. Since I’m going to be preoccupied with that whole Jeopardy experience during that time, it’ll probably be more like 8-10 weeks before I really get back. But I’m not in a hurry. If I can climb a couple mountains in the fall, then I’m good.

The “Return to Sport” for this type of injury is 6-9 months from surgery. That means that if I were a professional athlete, that’s the time period at which I’d be able to compete again. These injuries are rare in the cycling world, but they are more common in baseball and football. Percy Harvin, a Wide Receiver for the Seattle Seahawks, had surgery for a torn labrum before the season. He had to sit out the entire season and was ready for the playoffs. Lady Gaga had the same procedure, and her recovery time was about the same. Alex Rodriguez’s labrum made the sports and tabloid headlines. He recovered pretty quickly, but I suspect he had some assistance.

I would be lying if I said I wasn’t looking at the calendar and thinking of the future.

Cycling is a little different because you reap the benefits by putting the time in. I cannot be a Percy Harvin. I’ve missed an entire offseason and the beginning of the spring. If I return to the sport in the fall, I won’t have enough fitness to accomplish the things I like to do. But I’ll still put in some time, but more with a focus of getting strong next year. And yes, I have some exciting plans for next year that I’ll be sharing soon. Rest assured, I’ll be in elevation again.

For now, just being outside is going to be paradise.

The bike will stay in my car. Today wouldn’t be a good day because of the rain and some soreness from doing a lot of little things. One day, maybe tomorrow, maybe Saturday, when I feel up to it, I’ll drive somewhere flat and do some spinning. And it’ll feel amazing.