What A Pain In My Butt

In one of my previous posts I wrote how happy I was about last season.  My key races went extremely well and I was having a blast racing.  Well, I left (a little) something out. During the latter part of my season, I was experiencing constant pain in my right hip.  It started in mid-August and slowly got worse…and worse…and worse.  I tried it all, physical therapy, which included strength work, stretching, modalities, and dry-needling.  I also tried massage, icing and of course, rest.  Some things eased the pain slightly, but once I pushed it, the pain came right back with a vengeance.  The initial pain was not unbearable, and I just pushed through it during the later races, knowing that the off-season was close and I would figure it all out. Classic mindset of the professional triathlete.

Finally, the off-season started after my final race, Ironman Austin 70.3, in October. The pain intensified to the point I was unable to hike with my kids, and perform daily routines. All of it was just not good; physically or mentally.  I visited a sports doctor who ordered an MRA. I will skip any elaborate descriptions of the medical terminology for two reasons; first I would probably get it all wrong and secondly, I’d bore you.  So, let’s keep it simple. In short, an MRA is an MRI where they also inject a dye into my hip, because this is the only way to diagnose a labral tear, and although I was hoping for a stress fracture (which doesn’t require surgery), it was likely a labral tear (which requires surgery).

And, unfortunately as expected, the results from the MRA provided a diagnosis of a labral tear likely due to a femoral acetabular impingement (FAI). I still didn’t know exactly what I was dealing with, but I knew I had a labral tear and it was tough news to hear; there were a lot of tears shed.  A lot is unknown about laberal tears of the hip, and some believe that you can compete and return to racing without surgery. That just a lot of rest and strength work can overcome the issue. The other camp believes that surgery is the only way to fully correct the problem if you want to return to competitive sports.  I never imagined I would be having to decide between surgery and “waiting and seeing”.  Worse, living in Montana, there are few surgeons who can even perform the surgery that I needed, and even fewer that are experienced with endurance athletes.  So even if surgery was my chosen route, I still needed to find a doctor and then I needed to schedule surgery immediately if I wanted to have any chance of racing in 2015.  More tears.

Tim Messner, a physical therapist at Active Physical Therapy in Missoula, is a massively important part of my team. So much so, I can give him a wealth of credit for being one of the reasons for much of my success over the last few years.  I see him on a regular basis regardless if I’m injured or not, and he incorporates strength specific exercises into my training program.  Fortunately, Tim had experience working with Dr. Brian Mitchell, of Spokane, Washington, who I found to have a great reputation.  Dr. Mitchell’s practice focuses on hip work, and he has an immense amount of expertise dealing with labral tears and hip arthroscopy.   Suddenly, I had some hope for 2015! Gifts come in strange places and way.  The tears had dissipated some, but the unknown still made for a few tearful sessions of concern.

I met with Dr. Mitchell near the end of November and he was extremely helpful and provided great immediate insight. He was able to explain my diagnosis clearly and in layman terms, and he gave my options. Additionally, he understood that I was an athlete, and if 2015 was going to happen, I needed the procedure to done as soon as possible.  I learned through this whole process that there are many types of labral tears. The length of the surgery and subsequent recovery depended on the type of labral tear, and the differences are quite dramatic, in that a minor labral tear might only keep you out 4-5 months, and a major tear could sideline you for a year….or more! Fortunately, my tear was minor, and my hip was in good shape otherwise, so Dr. Mitchell was very optimistic that, with proper rehab, I could return to competing by the summer of 2015.  Very positive news!  Considering my comfort and trust in Dr. Mitchell, and the overall diagnosis, I did not wait long to commit to surgery.

Thad and I arrived for surgery the morning of December 12th, and after all the surgery preparation was completed, the procedure lasted all of 26 minutes, wow!  Keeping it simple, Dr. Mitchell went into my right hip arthroscopically, shaved down my hip bone 2mm, cleaned and prepped around the labrum and reattached the labrum to the bone with 2 sutures.

We returned to Missoula the same day as the surgery.  The labrum was reattached but I faced a long road ahead of rest, recovery and rehab.  I was on crutches for three weeks as I progressed to weight bearing and normal gait.  I used a CPM (continuous passive motion) machine for 6 hours a day for two weeks, which constantly moved my leg/hip and is proven to speed up recovery and decrease scar tissue.  I loved and hated that thing, hated it because I can’t sit that long, but loved it because at least I felt like I was doing something!  The day after surgery I even started “spinning” on the bike for 20 minutes; no resistance, but again, I felt like I was making progress.

My post surgery hangout, on the CPM machine or icing.

My post surgery hangout, on the CPM machine or icing.

Ok, the truth. I am not a sit around and chill kinda girl.  With that said, I am super thankful for all the help and support from friends and family who made meals for us and took the boys after school, dropping them off, picking them up and just being there for us.  Of course, Thad was amazing. He was a single dad for about two weeks! Worse (and best), he only got upset if I tried to do anything and jeopardized my recovery in any way.

Slowly I was able to do more. For three months, Tim and the crew at Active Physical Therapy worked with me three times a week.  I will say it again, I am very thankful to have had such a great team, they really helped me get back to training.  I had to wait three weeks post-surgery before I could get back in the pool, and couldn’t start kicking until about 5 weeks.  Since then, I have spent a lot of time in the water, which considering my swim weaknesses, the increased water time has been one of the real positives of this experience.  I have a fun crew I swim with and I feel like I’ve made improvement and most importantly, I’m really enjoying swimming!

Doing my rehab at Active Physical Therapy.

Doing my rehab at Active Physical Therapy.

When people would ask me why I workout or train or race, my answer had always been that it is for my mental health more than anything; exercise is my drug of choice.  That became more evident than ever this past winter. Training is my outlet, it keeps me balanced and it helps me deal with all of life’s stresses.  With that said, this past winter wasn’t easy for me or those around me.  I just wasn’t my normal me, I struggled and I shed a lot of tears. My husband, coach and close friends can confirm all of this…unfortunately.  It didn’t help that Missoula winters are cold with very little sunshine. Sun, I love the sun!  When I listened to music while doing rehab, a few songs stuck out that gave me that “feel good, I can do this” kinda of feeling. Going to try avoid sounding cheesy (probably too late!), but “Over the Rainbow” by Israel Kamakawiwo’ole, and the Beatles’ “Here Comes the Sun” just seem to give me that motivation and inspiration to train harder and push to meet my goals again. Soon, I started to feel like my “normal” self again, which was a real relief.

In March, Dr. Mitchell gave me clearance to really start pushing and increasing the intensity level of my training. Yeeepeee! For the past month, I have really been feeling like an athlete again. My fitness is increasing rapidly, and I am close to where I was at this time in 2014, which is feels incredible to say, after everything that took place during the off-season.

Pre first track workout the other day with my Posse, so awesome to be back!

Pre first track workout the other day with my Posse, so awesome to be back!

This spring, just after Dr. Mitchell cleared me for significant training, I spent some time biking with my good friend, and fellow professional triathlete, Charisa Wernick near her home in Carlsbad, California. While there, I was biking up Palomar Mountain, and suddenly, I felt strong, it was a turning point moment.  Although I’m still focusing on increasing my mileage and intensity during runs, I really look forward to racing again.  Overall, the past five months have honestly given me a whole new perspective for 2015. The thought of traveling to races, and being able to give it my best, be competitive and have fun is a joyous thought. Being away from the sport made me realize how much I still love triathlon racing. I am going to continue to charge towards my goal of qualifying for World 70.3 championships this year, but if for some reason I don’t quite make it, that will be ok too; I am just so thankful for each day that I am able to swim, bike, and run, especially without pain!1

1By the way, Thad and I couldn’t figure out a title for this blog and my 8 year old walked in and suggested “Pain in the Butt” since it has been a huge pain, I went with it!