Second opinion on MRI reveals stress fracture in my pelvis, not my hip. No running for 3 to 4 months.

The headline says it all, right?

Last week, I got an MRI and my physical therapist told me it was a stress reaction in my hip and said no running for a month.

Today (Wednesday the 9th), I got a second opinion from my new primary care physician, Dr. Mark Hutchens of Texas Sports & Family - this is a guy who deals mainly with athletes. He asked me some questions, poked around some in my groin area and said, matter of factly, "what you have is a stress fracture in your pelvis."

Me: "Are you sure? How do you know? How much time will I have to miss?" (What a dumb question to ask a doctor, right? What do I mean, 'Are you sure?' I guess that's like asking a cook if he is sure that mayonnaise has egg in it.)

Doc: "I'd say you need complete rest for at least 3 to 4 months, though I've seen some stress fractures like the one you have take much longer. Here I can show you the MRI."

(No more running? I love running, and I really  love running in Austin. You might as well tell me to stop breathing. But I digress.)

The doc pops my MRI on the computer screen and shows me the area of concern. He started talking about swollen bone marrow and all kinds of gobbedly-gook. I'm looking at the film and its clear as day: Yep, its my pelvis, not my hip. Yep, there is some discoloration at the place of the stress fracture.

I told the doc that I've had this weird sensation/pain in my groin since, umm, 2008 - three years! - where it hurts to squeeze my legs together, hurts to do situps or any kind of ab work, hurts to roll over in bed, hurts to play with my son while on my knees. I told him about the cramps I get in my inner quads on any run longer than 2 hours (like marathons!). I told him that when I walk up slight inclines, I really have to think about lifting my left leg to help me power up hills.

(Since 2008, I've run six marathons. And none have gone well. If you've read my blog, you've read that I tend to start getting cramps at Mile 15 and things just get worse and worse. I don't cramp up so much in training - maybe because I don't taper and I dont give my hip/groin/pelvis enough time to get stiff like they get in the days leading up to a race.)

He said most, if not all of my problems stem from my pelvis injury. He said that probably explains why my quad muscles cramp up so much when they get tired. Then he wondered why I took so long to get this problem fixed. 

I told him I just thought I was tired and things would get better with a good taper.

"Well," he said, "I guess you'll have plenty of time to taper now."

Hip checked! Stress reaction shelves my running plans for about a month

Picture of my hip as doc administers  iodine.

Maybe I'm not crazy.

The disaster in Chicago. Running a minute slower than normal on a Thanksgiving 5k. A subpar half-marathon finish at the 3M Half Marathon. Then another marathon disaster, this time at the Austin Marathon.

During each of the above-mentioned runs - and sometimes during the training leading up to the race, something odd would happen and I wouldnt feel myself.  Not real pain, per se. Just some weakness in my left leg, like I couldnt push off, couldnt power through things.

I just figured things would get better after a good taper, or with better weather.

Six days after running Austin, I went out for a 10.5-mile run. At about the 8-mile mark, I stop for water. When I tried to start running again, it was like someone had poured some poison or a vat of acid in my legs, especially my left one. My hips felt so stiff. I was averaging about a 7:30 min/mile before the water stop at Mile 8, and I was lucky to run 9:00 min/mile the last two miles. The weakness was the same that I'd felt at the Austin and Chicago marathons, the weakness I would feel before the cramps would start.

I set up an MRI for my hip, which was last Thursday. I'm a little claustrophobic, so laying in that tube with those weird noises going off was way worse than any needle I saw that day.

But things would only get worse. My physical therapist was given the results of my MRI on my back and hip and emailed them to me Friday. Here is part of that email:

"You have a disc herniation L4-5, L2-3 subtle disc bulge but no herniation.  No labrum[sic] tear in the hip, but noted stress reactive change.  Beginning phase of a stress fracture.  So, no running."

 What? What? I called my physical therapist and asked what this meant. Stress reaction? Herniated disc? Subltle bulging disc?

"Yep," she said. "You need to take off from running for 4 to 6 weeks."

On the one hand, I am not too happy about not running. Especially not running for at least a month. But on the other hand, at least I can now begin to understand why some of my races suck so bad. I don't like to make excuses, but I knew something was wrong with me. How else to explain 13-, 14-, and 15-minute miles at the end of the Austin and Chicago marathons? Marathons where cramping begin at Mile 15. Mile 15!

How else to explain a 20-minute 5K on Thanksgiving when a year earlier, I'd run a 19:08 5K on a much hillier course?

The thing is, I couldn't explain it. But a hip/back issue kinda makes sense. And I now remember when I probably hurt myself. Last June, I twisted my left knee running in a new pair of shoes (that I don't wear anymore). Instead of resting, I limped my way through some of the most painful runs I've ever had, putting a lot of pressure on other parts of my body - and apparently my hip took more of the pounding that it should have.Since then, I've also had this weird groin pain, where it hurts to squeeze my legs together or roll over in bed sometimes.  Stretching after a long or hard run also induces cramps in my inner thighs.

That's the only thing I can think of. In short races, I've lacked explosion, and in long races, I use other parts of my leg to overcompensate for my weakened hip and by Mile 15, both of my legs are cramping.

Again, I didn't feel pain during races and training runs, just an inordinate amount of stiffness - and lots of pain afterward. My back? That was a surprise, though from time to time, it gets achy and stiff, but again, I just figured that malady would go away with a good taper. (This still doesnt explain how I can run decent in training, but my marathons are just terrible. But maybe when you add the stress of a race to stressful joints, you get what I've got in marathons.)

I'm still going to get a second opinion to nail things down - but for now, no running. Its the first significant time I'll go without running in three years. I'll miss the Cap 10K coming up a the end of the month, but hopefully, I get myself healed.

Guess I've got more time to work on the cabernets part of 5ksandcabernets!
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Update...3:34 p.m. Monday...

I've scheduled a second opinion for my back and hip for Wednesday. Maybe they will just tell me to sit out two or three weeks, or run only two or three times a week instead of everyday. Fingers crossed!

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Update: A second opinion on the MRI revealed a stress fracture in my pelvis. Ouch!

An interesting revelation

When I've had cramps in long races, they usually start in my inside right thigh.

They start there, I try to stretch, try to hydrate more, and things get worse and worse and pretty soon, I'm sick to my stomach from too many fluids, and worse, my whole leg starts pulsating and then the spasms start and then we are talking 12 and 13 minute miles.

But maybe these "cramps" I'm having are not really cramps at all.

My long run last Saturday called for 6 miles out, 5 1-minute hill repeats, and 6 miles back. (They didn't tell us before the run, but the 12-miler was actually 13 miles. Sneaky, sneaky!)

Sure enough, my inner right thigh started bothering me when the hills started. I stretched some during the hills, at mile 8, and again at mile 10. Because I'd held back the first half of the run, I was strong enough to do the last three miles in under 24 minutes.

Still, I was kinda bummed about my right thigh. Good thing the marathon training people from Lukes Locker had a doc on hand answering questions afterwards. I told him about my malady and he said its probably not a cramp at all, but most likely an adductor injury that has been brought on by overuse.

Hmmmm.

He said I should stretch much more than I am now - groin, quads, back - then he told me to ice as much as I could and sent me on my way.

Even though this advice was pretty simple, it's got me excited. This injury always flares up on any run I do longer than 90 minutes. I can be running an 8-something-minute mile, and then this thing grips my inner right thigh and all of a sudden, an 8-minute-mile may as well be a 4-minute mile.

But if I can keep stretching, do some leg weights to strengthen my quads, then maybe, just maybe...

What's that Boston Qualifying time for me?

Better not get too far ahead of myself.

On the road again

This morning, I ran for the first time in 16 days, a week sooner than the doctor told me I should run, but just in time for my psyche and my waistline.
I knew it was going to be a good morning when I slipped on my Asics 2130s. My feet were like, "Where have you been, good friend." It was like wrapping your body in a blanket you've just taken out of the dryer. Ahhh.
I did four miles. From the first step, I felt great. My legs were just alive. Springy. Bouncy. Pick your adjective.
Once my lungs caught up, it felt like I was floating on the Trinity Trails.
I had to work to not run too fast. At one point, I looked at my Garmin for my mile pace and it said "7:50" Ohhhh, my. (Sorry, Dick Enberg).
I ended up doing four miles in an 8:25 pace.
From time to time, I felt a slight twinge in my right Achilles. And I mean slight. (Like when I feel my phone vibrating in my pocket sometimes, but it's really not vibrating.) Lets call it a phantom twinge.
At the end of the run, I had some soreness in my knees. But not to worry. My knees get this way for two reasons. 1) Because of the cold. (It was in the high 30s this morning where I run in Fort Worth) and 2) It's time for some new shoes.
Yeah, that's it. It's time for some new shoes.
Hooray.
Anyway, earlier in the year, I set a goal of running 1,600 miles this year. Well, after a 16-day hiatus, I may have to adjust that figure. Here is where I am so far.



My Final four picks: North Carolina, Kansas, Stanford, and UCLA are still in the tournament. But a lot of my other picks lost. In fact, I am next to last in our office pool tournament. Guess this wasn't my year after all.

The phone call you never want to get

A little after 1 a.m. Saturday morning, my cell phone rings. It's my brother, Cedric. I don't answer it because my brother has called me before after midnight and usually he is returning my phone call or just wanting to talk about sports. Though, I remember thinking he'd never called this late. But he didn't leave a message, so I figured it could not be too bad.
About 10 a.m. Saturday, I went out for a 10-mile run (more on that later). When I got back, I had a voice mail from my sister, Casey. “Kevin,” she said, “your little brother was admitted to the hospital last night. He was complaining of chest pains. It's something with his heart.”
Casey was actually in the hospital room with Cedric. So she passed the phone to him.
“Hey, dude, what happened?” I asked him.
“Man,” he said, sounding groggy from just waking up. “My chest just started hurting and my arm felt weird, so Robert (his best friend) took me in to get it looked at. I'm okay.”
Well, of course, I had to see for myself. So I made the 40-minute drive to the hospital and you know all kinds of things raced through my mind. My family doesn't have a history of heart problems. There have been some strokes, to be sure. An aneurysm. But no heart stoppages.
Cedric was sitting up laughing when I got to his hospital room. A medic told him he the lining around his heart might be inflamed, though they'd need to do a chest echo a week later to be sure. Thought it might be stress-related. Cedric is going through a divorce, and working two jobs _ one of which includes trying to run his own newspaper. The nurse also told him it could be heart burn. All of his tests came back fine, his blood work was fine. They released him a few hours later, told him to get some rest, get rid of the stress, and take aspirin.
Hopefully, this doesn't turn out to be anything serious.
Running update: I ran 10 miles Saturday in just a little more than 1:30. It was my longest run since I did 12 miles on Feb. 9. It started off as my worst run ever. My right leg was killing me. And before the run, I had a Cliff Bar that didn't agree with my stomach. But I gutted it out, started feeling better at mile 4 and finished ok. My right leg is still giving me all kinds of problems. It might be shin splints, though it seems to be weird that it is just on one leg. I didn't run Sunday or Monday morning. This is turning out to be my worst injury ever. A call to my physician is on the horizon.
A special visitor: My 7-month old son, Noah, and his mother, Nancy, came to visit me Saturday night. They'll be here for a week. They look great. Noah definitely has Nancy's eyes, but he has my nose and cheeks. He eats a lot.