Tag Archives: recovery

A History of the Injury

Overall, I’m a positive person, an optimist. I set lofty goals, and work hard to achieve them. I’m a good news kind of guy. I like to share achievement, whether mine or others, and celebrate what human beings are able to achieve athletically.

I hate talking about bad news. Detest it. But sometimes bad news is part of life. It is a reality, and the best thing you can do is to stay positive and optimistic while going through it. That’s where I’ve been for the last year, and that’s where I am now.

When I changed doctors, I put together a brief timeline with a history of most everything that has happened. It was sobering to read, as this may very well be the most trivial and baffling cycling injury I’ve ever heard about.

The bad news continued on my mountain bike ride this past weekend. As great as it was to experience something new, around halfway through my ride, I began to feel a burning sensation in the groin. No worries, I’ve felt soreness before while riding and been able to suffer through it. I soldiered on, but the sensation became stronger.

I decided to make my way back home. Ugh, that was a hilly six miles away. The more I pedaled, the more it hurt. I took a couple breaks to massage my hip. Still painful. I made my way up the hills slowly, trying to put more power with my left side — not easy to do on a mountain bike with platform pedals.

With just a couple miles to go, I could barely pedal. I tried pushing the pedal with just my left leg. Not really possible. I had to endure the pain and make it home. By the time I was done, I was done. It was excruciating pain. I could barely walk, and had to use the cane again to get around.

This was a devastating setback, and the last thing I wanted to share on this blog. This most likely is going to lead to the next phase of my injury recovery, which I am praying will be surgery. Something is seriously messed up in my hip, and I need to get it fixed.

My Fall plans are most likely going to change dramatically. More on that as I get some answers.

I know, major bummer post. Not the kind I wanted to write.

For those who have not been following the entire saga, here is an updated version of the history I wrote for the doctor:

Climb Description
9/16/2012 Bridge to Bridge. Injury probably occurred. Mild hip pain started day after ride, got progressively worse.

9/25/2012

Saw general practitioner about hip pain. He thought it was tendinitis. Prescribed anti-inflammatory.
9/30/2012 Rode Six Gap Century with excruciating pain to begin with. Could barely move legs outward. Hip warmed up and no pain during 2nd half.
10/13/2012 Took two weeks rest. It felt a little better. Ran a 5k very slowly without much problem.
11/12/2012 Rested most of October then began training again carefully. Asheville climbing ride and it felt sore again the next day. It became worse. Got referral to Sports Med Orthopaedist, rested.
12/10/2012 First sports med appointment. Doctor thought injury was soft tissue in labrum. Got MRI.
12/17/2012 Diagnosed as stress fracture in femoral neck. Rest for weeks. Had to stop anti-inflammatory. Most of that rest was painful, took pain medicine on occasion and it didn’t help much. On crutches. Clicking and popping began during this period.
1/29/2013 Next Sports Med appointment. Still stress fracture not healed. Switched from crutches to cane.
2/19/2013 Another MRI, this time with an injection of dye. Stress fracture had healed. X-ray diagnosis: lateral labrum tear. MRI: Paralabral cyst? No visible tear.
2/27/2013 Doctor canceled appt. Saw PA instead. He gave green light to ride carefully. Clicking and popping continued. Back on anti-inflammatory.
3/27/2013 Saw doctor briefly. He thought I was getting better, can increase activity. Hip was very sore in colder weather.
4/16/2013 Broken rib. Fitness improvements, clicking and popping continue, mild pain. Doctor said get to get bone density scan.
5/10/2013 Bone density scan showed abnormally low density in femurs. T scores -2.1 and -2.3. Made diet changes.
5/21/2013 Assault on Mount Mitchell completed. Had quite a bit of pain during last several miles.
6/21/2013 Started physical therapy, gradually increased activity.
8/26/2013 After little improvement, got second opinion. He confirmed labral tear, suggested a couple other possibilities.
8/29/2013 Cortisone shot.
9/2/2013 Tour d’Apple. Slight setback afterward.
9/7/2013 First mountain bike ride. Major setback, taking break from bike.

Riding With Steroids

You read that subject correctly. I have shamelessly taken the wheel on the influence of performance enhancing substances. After a few months of annoying setbacks, I decided to turn to chemicals in order to get back to speed. Rather than continue under a cloud of suspicion, I have decided to take the path of honesty, and come clean now. I will not waste your time with regretless confessions later on Oprah’s couch.

Flashback to a couple days ago: the cold that never ends continued it’s cursed streak of not ending. This weekend is the event I’ve been looking forward to more than anything else in the fall, and I didn’t want some sniffles and a sore throat to get in the way. On the other hand, I didn’t want to punish my body and delve further into the sick, making the cold that never ends continue even longer.

I was fortunate to get a doctor appointment yesterday morning. “I’m still sick, Doc!” I said as he looked puzzled to see me again. And then I coughed. I’ve been doing a lot of that.

He did all those doctor things, and determined that the infection was gone. Even though I still felt like a mess, my condition had actually improved. That was a relief.

Could I ride this weekend? Yes, he said, but I might hate it. This was a pretty rough cold, and I could be dealing with the coughing aftermath for quite awhile. I appreciate every last bit of lung capacity when climbing a mountain, and there’s lots of training to be done to eventually complete the Parkway. Could we do anything to speed it up?

Yes, we could. The answer was drugs. He prescribed me a steroid, prednisone, which would alleviate inflammation in my airwaves. It would help with that nasty cough, and allow me to train at somewhere close to normal capacity.

My ears perked up. Steroids? Were these of the performance enhancing variety? Would I notice a difference?

Not really, he said. In fact, if taken long enough, these would have the opposite effect. I would get fat and never want to leave the couch.

Fortunately I had a cycling community to give me the real scoop. Some others had taken the same thing, and they felt that it did make a difference on the bike. They also warned me of insane appetites, water retention, bloating, and some increased energy. The good news is that after my first dosage, the cold symptoms were greatly minimized. I actually felt up to saddling up. My energy level was definitely up. I felt euphoric, which was probably a combination of the drug and finally getting out of the house. It was back to Tri-Cities for the Tuesday group ride.

As we rolled out on the 12th street extension, some of the phlegm came back. I let out a few coughs, careful not to be ‘that guy’ and overflow into the paceline. So far so good, but as I told a friend, the true test would come on the first hill. I would either tear away from the pack, or completely blow up.

Feeling good after making the turn onto Old Wire Rd, I eagerly awaited the hills. The first one was not so bad. I hung on with the pack and felt fine. On the next climb, I somehow ended up in front and kept going. I looked at my heart rate, and noticed it was about 10 beats faster than usual. The speed was faster too. What in the world? It wasn’t killing me like it normally would, so I went with it. Might as well see what these drugs can do.

I kept on maintaining the same heart rate. I looked back, and to my surprise, the pack was behind me. For real? It was then that I realized that along with my speed, lactic acid was also accumulating faster. My pace slowed, and I could feel my legs burning. Ugh. The remainder of the pack caught me, and I fell off to the side, easing up before regaining my composure.

I stayed within the pack for the rest of the way, playing it smart and not trying to show off. It was when we hit the final fast 10-miles when another symptom kicked in. All of a sudden I felt like I had a rock in my stomach, and ballooned up to 300 lbs. I was able to hang on during the entirety of the speeding downhill. It was at the next big hill that I ran out of steam. I could feel my stomach muscles punching each other. I dropped like a bad habit.

Lesson learned. Drugs are bad, m’kay. This prescription will last me until next week, after which I’ll hopefully be cold free and back on the path towards my parkway goal. I may not be totally comfortable, but I’ll be able to ride this weekend. Now that’s some news I can handle.

Edit: Apparently a couple people took this post a little seriously and accused me of being a doper. This was meant to be tongue in cheek. Prednisone is not a banned substance according to WADA.

Strava Link


Tour de Midlands, 2013, Lexington, SC

Lake Murray Dam

After all the harsh weather we’ve been dealing with, it was not comforting to see rain on the forecast for another Saturday. There was a lot of chatter in the days leading up to the event, but fortunately when we woke up that morning, there was hardly a rain cloud in the sky. It would be a day of ideal cycling weather.

This was the Tour de Midlands, one of my favorite rides in the area. I have fond memories of being a destroyer last year with a 21.5 average on the century route (ahem, with a lot of help). My expectations were far below that this year, just wanting to finish the 70-mile route respectably as my last tune-up before Mitchell.

There were plenty of familiar faces for the metric route. Jack Daniel and Kevin Lundy are good friends and strong cyclists. I decided I would try and hang with them as long as possible, but if things were getting tough, I wouldn’t hesitate to back off and either ride solo or with a slower group. I’m not in the same shape as last year, and don’t want to burn myself out.

As the three of us rolled out, we collected a large group of riders. As we crossed the Lake Murray Dam, we must have had somewhere around 20-25 riders, all pedaling together in a single paceline. That group thinned somewhat as we traversed through the hills along the eastern edge of Lake Murray. I was almost a casualty during that section, at some times hanging on for dear life.

On this day, I found that when I got to the front, I wanted to do my share and pull the group, forgetting that I’m still riding into shape. As we navigated some tough hills, I found myself at the front more often than expected. One problem is I tend to not slow the pace. That’s more me just being considerate to the rest of the group. I know it’s frustrating to get someone up front that slows everyone down.

I pulled us up a particularly challenging hill. As I saw my heart rate creep up, my legs felt like they were turning to putty. I nearly cracked on one hill. When I backed off to the rear, I felt much better. Then we were stopped at a light, and somehow when we resumed, I found myself near the front yet again. Ugh! Again, I nearly cracked on the pull, and had to back off. After a few other short pulls, I realized that I was doing myself no favors here, and went into wheelsucker mode.

I was on wheelsuck duty in our tight group.

I was on wheelsuck duty in our strong group.

When we wheeled through the town of Chapin, the group was around 7-people, and it stayed that way for the majority of the day. It was a fantastic group! Kevin, Jack, Doug and Mike did most of the work up front. There was one instance where I was up front again, but the pace slowed considerably. The rider behind me politely nudged me to the left, giving me a break, and getting the group back at their accustomed brisk pace.

At mile 58, I was nearly done. After a couple minutes of quick refueling at a rest stop, the guys were ready to go. Knowing that I was in danger of bonking, and was already riding harder than I intended, I let them go. As much as I enjoy the company and the quicker pace, it was in my best interest to ride the rest of the way solo.

The last several miles are through some hilly sections of Lexington. As I navigated the up and down rolling hills of Windmill Road, I knew there was no way I would have been able to stick with the group. By bowing out early, I saved myself the embarrassment of being dropped.

By the time I rolled in solo, it was a gorgeous, sunny, 80-degrees. I was exhausted as I sat down to some BBQ, but still felt a sense of accomplishment after having passed another test. I’m ready to tackle the big one next week.

Strava GPS

IMAGE GALLERY

Strong Legs, Weak Bones

First, let me get the good news out of the way. My recovery is going well, and the doctor cleared me for Mitchell. Fitness is snapping back, and I’m even relatively optimistic that I can do well. I will not be riding with a time in mind, but I think that based on my recent performances, I could do better than I hoped. Most likely I will be within the 8-10 hour range — slower than last year, but pretty strong given my recent injury battles.

We finally got the results from my bone scan. I suspected my bone density to be on the low side, but it still came in well below my expectations. According to the test, both of my femurs are in the osteopenic range. That means that if not improved, this condition could eventually develop into osteoporosis. As my doctor put it, this changes the dialog for the last several months. This was likely the underlying cause of the injuries, and also the likely culprit for some of the pain I endured during the recovery.

I have to give a shout to Hill Junkie and all my doctor friends who pushed me towards getting a bone scan. I had asked for one in the past, but it took some persistence to get the doctors to order the test.

The question is, what caused this? It is not normal for someone my age to lose bone density. I brushed off my laptop, and did some not-very-scientific internet diagnostics last night. Here are my conclusions:

1. No Weight Bearing Exercises. Cycling may be great exercise, but it is not great for bone strength. The doctor suggested running, walking or weightlifting. A friend suggested jumprope. I’ll be doing nothing at least for the next couple months while the hip continues to recover.

2. Diet Cola. My last remaining vice is that I drink way too many diet soft drinks. My daily routine is one in the morning, one at lunch, and sometimes one in the afternoon. If I’m feeling particularly sluggish, I’ll have one before I ride the bike. The average is probably 2-3 a day, which some recent studies have said can lead to hip deterioration. That’s a warning sign if I’ve ever heard one.

3. Thyroid Issues. A good friend of mine encouraged me to check some levels in my thyroid. I have had thyroid issues in the past, so this is a distinct possibility.

The next step is more diagnostics, and probably more supplements. I’ll be working again with my family doctor to determine my needs. There’s a chance I’ll need to see an endocrinologist.

The good news is that I caught this early. If this was a problem that went unnoticed, I would have a tough time when I turn 70.

In the meantime, I’ll continue riding my bike.


Swamp Rabbit Trail, Greenville, SC

swamp rabbit north

With a couple free days in the upstate, I needed a ride that would be interesting, and not so strenuous that it would impact my injury. Day one was washed out completely, leaving Friday as my only opportunity for some riding.

I chose the Swamp Rabbit Trail for a few reasons. First of all, I have been on the trail before, but always as a way to get somewhere else (like Paris Mountain). It is flat and pleasant, and it takes you from the heart of Greenville to the outskirts at Traveler’s Rest. Because of obstacles like road crossings, bridges, tight turns, runners and plodding mountain bikers, you really cannot get any amount of speed. On top of all that, the trail makes Greenville stand out as a southeastern cycling community, and I wanted to pay tribute by experiencing it all for myself.

I parked not too far from the Greenville Zoo to begin my journey, not realizing that this and downtown would be the most crowded sections. I navigated through the dog walkers and sightseers near the zoo, and entered the confusing downtown district area of Falls Park. This was great for warming up because no matter how much I wanted, I could not go fast. It was also frustrating because I wanted to get around everyone. There were lots of starts and stops.

The other side of Falls Park, downtown Greenville.

Falls Park, downtown Greenville.

The trails are tough to follow through downtown, and I missed a couple of them en route to the northern Swamp Rabbit Trail. Finally I picked it back up and began the trek toward Traveler’s Rest. The northern part was not nearly as crowded, and I was able to get a little speed. There were only the occasional walker and slow biker that I had to maneuver around.

While the trail is mostly flat, heading northbound is ever so slightly uphill. We are talking modest grades of 1-2%. They were made a little more difficult on this day because of a 10 mph headwind. That was enough to get the heart rate going and make this a challenging, if not overwhelming section.

As I approached Traveler’s Rest, I could see Paris Mountain in the horizon. It was tempting. I was feeling good, and the injury was not bothering me. Moreover, I had the itch to push harder. That’s the itch that I shouldn’t be scratching. As I headed north, I shelved the idea of climbing the mountain, at least going in this direction. I would head to the end of the trail and decide when I came back.

This marks near the end of the north trail.

This marks near the end of the north trail.

The trail ends unceremoniously just north of Traveler’s Rest. According to the mile markers, there are more than 20 miles of trail remaining, but apparently they are not yet paved. They will be pretty cool when (if?) they are finished, as I imagine they would drop you off not far from Caesar’s Head Mountain.

As I made my way south, my pace picked up because of the slight descent, and I had a tailwind at my back. My heart rate dropped, and I was able to appreciate the sights. This felt like coasting. No complaints.

Paris Mountain beckoned again. I was still tempted, but decided against it. When I’m in climbing shape, I’ll make up by riding up both sides. Next time.

After buzzing through Greenville’s industrial and commercial district, I was back in downtown. Now the sun was shining bright and the tourists had multiplied. My BSG kit stood out among the polo shirts, khaki shorts and cameras. Again, I just wanted to get by. There was one instance where I had to walk my bike down a steep grade because of the throng of pedestrians in front of me. That part hurt. Eventually I made it through, and was back to the zoo area.

Now south of the city, I had just a little bit of trail left to navigate. I came across the Hincapie Path. That was cool. Did he donate, or just lend his name? I’m not sure.

Hincapie path is a short section of the southbound trail.

Hincapie path is a short section of the southbound trail.

Once past the zoo and the dog park, the south trail was not as congested. In fact, it was often desolate. I was able to lay down the hammer yet again, obstructed only by the winding trail that often would bank along the road, and sometimes share space with sidewalk.

As the trail passed by Greenville Technical College, I was surprised to see a few hills. These were nothing compared to Paris Mountain, but they were enough to give me a little test. I noticed one of them had a 6% grade, nothing fierce, and the hill at the very end of the trail was at 10%. Steep grades are still a challenge for me at this stage of my training, but I’m going to have to get used to them.

The trail ended again without warning, this time at a busy intersection. As I made my way back, I realized that this was actually quite a ride. By the end, I had 31 miles, and felt pretty amazing.

Well done, Greenville. I hope the community continues to embrace the trail, and that it can be developed further. I’ll definitely be back.

Strava GPS Link

IMAGE GALLERY

The Good News Continues

Today was my first time seeing the sports med doctor in two months. He had been out of the country for my last visit, so I saw the PA.

The news was encouraging. After talking to me about my symptoms and checking my mobility, he told me he thought I was getting better. This was somewhat of a surprise, as I felt slightly better, yet had not improved as much as I had hoped. A lot of that can be attributed to the cold spell we recently suffered, which hopefully is near the end. The hip always struggles in colder weather.

What’s even better is he gave me the go ahead to increase activity and intensity. He said I can go faster and farther, but cautioned me to be careful. I should listen to my body, and make sure I am aware of my symptoms.

He also cautioned me not to go too far at once. He reminded me of the 10% rule that runners obey — not to increase weekly load by more than 10%. That will be difficult to follow to the letter since the weather has thrown a wrench in my training schedule, but in the next week or two, I should have a baseline idea of what I can handle.

Next week I will be in Spartanburg for a couple days. A few weeks later I will be in Brevard. I am okay to ride on these trips, but again, while being careful not to overdo it. He said that I should be prepared to take a day off in between rides in Brevard.

We ended by him saying to come back in 8 weeks. I did some quick math, and realized that would be towards the end of May. What about the Assault on Mount Mitchell? “Make it 6 weeks,” he said. The next appointment will be about a week and a half before the main event. While I feel it is possible, and even likely that I’ll be able to participate, the ultimate decision will be made then.

What is most encouraging is that the further along I go, the better chance I won’t require surgery. So far the recovery schedule is proving the original diagnose of a stress fracture. Since I have been riding without any setbacks, it also calms any concerns that this could have been an overuse injury.

Hips are notorious for healing slowly. I’ll just have to be patient. However difficult it still is, I’m grateful to be back on the bike for the warmer, spring weather.


The Good, the Bad, and the Angry

The Good

I’ve been long overdue for some good news. It came today. No labral tear. I repeat: NO TEAR!

My orthopaedic doctor has left the country, and my GP had the day off, so I had to smooth talk the imaging company to get the MRI results. The X-Ray results concluded that there was a likely lateral labrum tear. As I opened the envelope of the MRI report, I fully expected to find more bad news waiting for me. Not only did I expect a tear, but I thought there was an outside chance there would still be signs of the stress fracture.

The MRI definitively ruled out the stress fracture. It is gone. I won’t miss it.

The report also ruled out a tear. One thing I have to remember is that this is a radiologist’s report, and not an orthopaedic surgeon. While I have to take these results with a grain of salt, they are encouraging.

No stress fracture means no more crutches, no more cane, and most importantly, I can take Advil and anti-inflammatory drugs. It is simply amazing how much these drugs help. My pain and soreness diminished significantly with the first swallow.

The Bad

There are some other things that still need to be dealt with.

I’m reluctant to self-diagnose. I’ve learned the hard way that reading too much on the internet can sometimes do more harm than good. To be honest, I do not understand half of the report, and I agonize myself trying, but there are some things that give me cause for concern.

One issue has to do with the bone marrow in my hip. It may be related to the stress fracture, maybe not. I have no idea, and will try not to worry about it.

The other issue is that I have a small cyst in the labrum. This isn’t the cancerous type, just some swelling, which is likely the cause of the popping, snapping, and the pain. Some of my internet research shows that this type of cyst is often accompanied by a tear, so I’m not out of the woods yet, but my fingers are crossed.

This means that surgery may still be necessary, although there could be alternate methods. From what I understand, the cyst could be zapped with a shot. Physical therapy might also help work it out. While I’ll consider all options, surgery is now more of a last resort.

The Angry

When I first heard about the potential tear, I’ll be honest that I was a little miffed. Why was this not discovered months ago? If the doctor had ordered a different sort of MRI the first time, could he have seen this? Why did he give me short shrift when not seeing healing marks on the X-ray, and make me go another month on the couch?

After reflection, I’m not angry with the doctor. In fact, I feel the opposite. He actually got it right. He told me that I had a stress fracture, and that my hip labrum was ‘off.’ That appears to be the case. He said that when the fracture heals, we’d deal with the rest, which is where we’re at now.

Instead, I am diverting this anger to my recovery. I’m going to be smart, sensible, and listen to my doctor’s orders, but I am going to attack my training and recovery with vigor. This was an unfortunate and uncomfortable setback, but after riding angry, I will emerge stronger with more focus.

Ready or not, here I come.