Monday, November 17, 2014

A Diagnosis

Since my last post, a fair bit has happened on the injury front. After improving gradually for a while, I decided to test the waters with a couple of faster pick ups during a run, and straight away, the injury flared up to the point where I could barely walk the next day. The sharp stabbing pain in the abdominals that caused my drop at Surf Coast Century was back, along with the pain radiating down through my abductor, and a general soreness throughout the pubic region.

So I finally bit the bullet, and made an appointment with a sports physician, who referred me for an MRI. I got the scan done at the amazing Imaging @ Olympic Park, a fairly new facility located underneath AAMI Park. When the scans came back, the doctor was amazed at the quality of images generated by their state of the art machinery, and commented that 18 months ago my injury probably would not have been picked up by lesser equipment. So anyone who needs an MRI, I would totally recommend paying the extra cost to get it done properly.

The MRI report found that I have mild tearing of the insertion points where the main abdominal and abductor muscles attach to the pubic bone, a condition known as Athletic Pubalgia. This is causing the tendons to become inflamed, and pain being referred back up through the abdominals and down through the abductor. It is also causing a stress reaction to the pubic bone, resulting in inflammation and fluid build up in the marrow.


Location of the injury

The injury is really common in American NFL and ice hockey players where there involves sharp twisting and turning, so it appears that the culprit in my case was probably the stairwell repeats I was doing in my office building. At the bottom of each flight, I would be landing on my left foot and pivoting around to go down the next flight. At over 4000 stairs a session, this was a lot of stress on that area.

In serious cases, the injury may require surgical repair, and sometimes an abductor release, but given that I am at the lower end of the scale, that shouldn't be necessary, So to treat it, I am on a course of anti-inflammatorys, along with regular massage and icing of the area every night. I can still run, but have to make sure I start and finish each run really slowly, and keep the tempo well in my aerobic range. So far I have been really disciplined with this, to the point where the pain is steadily decreasing, and I have also been able to slowly build up my mileage.

I am pretty confident now I will still be able to run Two Bays, although I'm unlikely to be anywhere near my peak and will probably still be carrying some pain. The plan is to run really conservatively early, run a small positive split (2:35/2:45), and hopefully sneak under 5:20.

Unfortunately, the injury flared up at the time Cradle Mountain entries opened, so I didn't enter and that race is now off the table for 2015. I have already entered for Roller Coaster in March, and TNF100 again in May, and the lottery for Western States in America in June. That is a very long shot to get in - less than 5% chance I think - so most likely it will be a nice rest after TNF, and then get ready for another crack at Surf Coast.