After my post-race blog last week, I received a lot of questions about my injury and how I got it sorted from athletes who are experiencing similar issues. I am posting one of them below and will try my best to share what I found helpful. I am no doctor, though—this is just my personal experience.
Question from reader Rich:
I just read your recent blog post and noticed that you’ve been having back and hip issues. I’ve been sidelined for the past two months with lower back problems which result in leg numbness and lack of power. Are these any of your symptoms, and if so, what have you been doing to correct the issue?
Yep, those symptoms sound pretty familiar. My back/ hip issues started when I was at camp with my Coach in Florida at the end of February. I had just raced my best half marathon and, hindsight being 20/20, I think that effort took more out of me than I gave it credit for; I traveled to Florida overnight just two days after that race and started trying to train hard straightaway. I knew I was not right but I didn’t want to be a wimpy excuse-maker, so I kept pushing through the training there even though I think I knew I was smashed. By the last day of my trip, I felt like my back was going out; it wasn’t all the way there but almost. I remember hardly being able to flip turn in that last swim.
My back has gone out on a few occasions before and it usually resolves itself in a day or two, so I didn’t even bother mentioning this to Coach. This was Monday, and by Thursday of that week I couldn’t really even step out to take a proper running step. Long story from there cut short, this tightness from my lower back through my glutes to my hamstring attachments varied in severity over the next month, and by the second week, had turned into a numbness down the backs of my legs which I felt in all three sports. It was even affecting my swimming, but the lack of power was the worst on the run—like I couldn’t really push off.
My solution: I just did my hard runs on the treadmill, where I didn’t really have to push off! That “solution” just fed my denial, however . . . Things pretty much went downhill ‘til I attempted to race Leadman in the end of March and barely made it to the finish line, since it required running uphill and that is hard when you can’t push with the backs of your legs. It was only around that time that I finally accepted that I had a problem that wasn’t going to go away on its own.
I did a number of different things to try to sort out my “situation”:
massage as normal, bodywork with my awesome chiropractor, and acupuncture.
However, I would say that it was these two things that most noticeably effected a change in my situation:
ART & shockwave therapy with Dr. John Ball: Some of the folks who wrote to me had already tried ART (Active Release Therapy), and while it may not be a cure-all, I think it is pretty darn close! So if your ART practitioner hasn’t done it for you, try another one! I have had a lot in my day, and I can say without a doubt that not all ART is created equal. There is a reason that the Olympic runners fly in to see Dr. Ball: he has seen probably everything that could be wrong with a runner and seems to know how to diagnose and fix most everything. And oftentimes the cause is probably something a whole lot different than what one would assume. I went in with an MRI of my lower back, thinking I had a “back problem,” and he said that in fact I had a “hip problem” less specific than most he had seen; in summary, he said, “this whole area is totally screwed up.” Sweet.
However, with each very-painful ART treatment (which I did 2-3x week in April) by Dr. Ball, my mobility in the problem area increased noticeably. He dug into areas that I didn’t even know were related to my running, but apparently they were! Basically he said that I had years of crappy tissue built up in my hip area that needed to be worked out; we are just now in May getting into my back.
Dr. Ball also used shockwave therapy on the problem area. This was the most painful bit of all; I was sweating profusely and truly thought I might vomit while it was happening. The idea with shockwave therapy is that the shockwaves create a trauma in the area and that stimulates blood flow/ healing where the body had long since given up trying.
Medrol Dose Pack:
Even after 3 or so weeks of treatment with Dr. Ball and increased mobility through my hips and low back, the numbness/ lack of power situation was still there. My doctor in Tucson suggested that I try a Medrol Dose Pack to get me over the hump, as the area was clearly still so inflamed that one tight thing pulling on another was creating a bad chain reaction in which he wanted to try to intervene.
Medrol is methylprednisolone, a really strong anti-inflammatory. From what I understand, it works similar to a cortisone shot, but is the best option for cases like mine in which we can’t identify a specific place to inject. Another factor I had to be wary of is that Medrol is only allowed out of competition, so I had to take my 6 days of pills finishing two weeks before my race.
I hate even taking Advil, so you know I had to be in a pretty bad way to put something in my body that has “water retention and insomnia” as side-effects. Yuck. However, I have to say that this anti-inflam did indeed get me over the hump. While it did mask a number of the symptoms while I was on it, even after I was done, things had changed for the better. It must have calmed down whatever was tweaking the nerve and making my legs numb because the numbness pretty much disappeared from this point on.
Things I didn’t try but might next time: dry needling. I know a lot of athletes who have had issues in these areas and have had success with dry needling (acupuncture-type needle pushed all the way in to create a trauma and stimulate blood flow/ healing to the problem area).
I’ve got to say that I can’t call my situation 100% perfect just yet. As I reported, it did give me a bit of trouble on the run in Ironman Australia, but it was nothing compared to where it had been a month earlier. I think we are nearly out of the woods!
Hope this helps at least a bit. Again, this is just what worked for me and I am no doctor!