I have been dealing with an injury that first manifested itself last December 2014/January 2015. It felt like a twinge here and there during or following a run (mainly in my hamstring area), but I wouldn't classify it as pain. It gradually got worse and thinking it was a muscular injury, I took the time to boost my pre & post run routines (heat, rolling, stretching, icing, strengthening, core work). It kept getting worse as I continued training for my marathon.
I began to realize that the pain I was feeling was nerve pain. I began having pain in my leg just when sitting down. But most of my leg was bothering me on and off. At the beginning of April, it flared up. I hit 41.5 miles that week and finished the week with a speed/track workout. Within a few hours, it hurt just to walk. Within a week or two, I attempted running again after seeing a chiropractor, but it began to flare up again. I decided to take a month or two off. Anything involving my leg was causing my symptoms to flare up and increase my sciatic nerve pain. So I decided I would only swim for exercise (using a pull buoy - arms only).
At the beginning of June I went and saw a Physical Therapist. That appointment was very disappointing. He didn't know what was wrong, but also didn't give me a whole lot to do either. He basically told me to keep doing what I was doing. He also pointed out that my running shoes were cute, but that it's important to get ones that are recommended by someone who knows what they're doing. Thanks dude. I actually did just that. I have flat feet and needed stability shoes. They were the most comfortable even though they were ugly black & purple shoes. Unfortunately I have big feet and needed a bigger size - it was a major bonus that the bigger size was hot pink. Haha... I'm not bitter about paying out of pocket for a physical therapy appointment....
I ran into a friend and got to talking about running & my injury. She suggested 3 Dimensional Physical Therapy and the success she's had there as they advertise working on the "active population". I scheduled an appointment and was once again disappointed to not have an answer about what was causing my pain. However, he watched me run, gave me a lot of exercises to strengthen my running muscles, balance exercises, etc. then gave me a print out with all my new exercises to do. Since he couldn't say what was wrong, he recommended running 1 mile and seeing how it felt. I was on cloud 9. Maybe I was better and had taken enough time off and allowed my body to heal!! Within hours of running 1 mile, all the symptoms were worse. I called the following work day and he wanted me to come back in. From what he was hearing, he suspected a disc injury. I went in and as he had me repeat certain motions (an increase of pain with hip flexion with increasing reps) - that supported his thinking it was a disc injury. He showed me some new exercises and stretches to do and recommended some ways to continue exercising, but that it shouldn't increase my symptoms - it was important to note how I felt later that day and the following morning. He also did a running analysis video to see if there was anything major going on with my running form - nothing major. He showed me some ways to have better posture, and that I should avoid hip flexion as that would worsen my symptoms. This was an Aha! moment as I had been doing a lot of "core" work for the past year. Starting with a 30 day abs challenge last summer, I continued to do sit ups, crunches, leg lifts and planks anywhere from 3-5 times/week. Planks were ok still, but the other things were making me worse without me realizing it.
After a month, I had found that any exercise involving my leg was exacerbating my symptoms. At that point the PT recommended seeing a different guy in the practice that specializes in the spine, but thought that it was probably time to see a surgeon and get an MRI. My hubby was ready for me to see "a real doctor" and wasn't excited about me seeing yet another physical therapist, so I researched and researched to find an orthopedic specialist who would focus on non-surgical interventions. The last thing I wanted was to see a surgeon and have him to push surgery. The guy I decided to see was booked out a month. So I waited.
Mid August I got to see the orthopedic specialist. I tried to present my symptoms in a non-biased manner. The first part of the appointment was more of a hands-on exam, which I appreciated until he came to the conclusion that it was my hamstring. He said hamstrings can take a while to heal. I asked him how long, because I hadn't run since April. Then he said - "Oh...." Then I decided to present my symptoms in a biased manner and related the information from the PT appt.'s. At that point he said, "Yeah it does sound like a disc issue. Let's schedule an MRI." After some more questions, we found out that if we had an MRI confirming a bulging disc - the treatment would be core work and that discs can take anywhere around 9 months or more to heal.
Two days later I decided to go see the physical therapist that specializes in the spine at 3 Dimensional Physical Therapy. I had felt good about doing this for over a month and after the specialist appointment, I was ready to try one last thing. This appointment was amazing. I learned that I have a core muscle not engaging properly - my transverse abdominis. When I do "core" exercises I have an important muscle that's not engaging like it should. I needed to retrain this muscle by starting with pelvic tilts and progressing my core work through exercises he showed me how to do.
He asked me, "Did you start running right after you had your baby?"
Why yes, I did. I was frustrated because I had pain in my pelvic floor/lower abs area when I tried running on a treadmill or outside. So for months I could only do the elliptical, then I was able to start doing intervals of walking/running on the treadmill.
He explained that it's important to strengthen the core BEFORE exercising.
He explained how the core muscles stabilize the spine, without those muscles engaging/being strengthened, the spine can move around easy and cause injury. He also explained that there are different degrees of disc injury and it's possible that if I had gotten an MRI, it might not have shown anything obvious. Any amount of disc irritation can irritate a nerve. He explained that I needed to re-learn/train/restore the right recruitment pattern - how & in what order my muscles engage. The physical therapist showed me how to pick up my toddler with good form (using a kettle bell weight), and other daily activities with good form including picking things up off the floor, getting things out of the cabinet, etc. After this appointment I was already noticing a difference.
Am I healed and completely better after one month? No, but I'm on the road to recovery. I know it will be a while before I am running again, but in the past month I have been feeling better and have felt very blessed. I have been able to add in flutter kick with my freestyle without an increase in symptoms. I have also started stationary biking and running on the elliptical.
I wish I had realized the importance of core work and retraining muscles after childbirth.
This article has some good information for getting started (and explains it well too). I have come to realize that there's a right way to do core work - it's important to engage the right muscles. I felt like I wanted to share my story to help promote core work (the right way) after having a baby. Hindsight is 20/20 and I wish I had a friend explain this to me, but I'm glad to be informed now and understand what I will need to continue to do in the future. The bummer is that discs never go back to how they were - core work and posture will have to be a major focus for the rest of my life.
Knowledge is power. I hope this helps or inspires someone to prevent injury.
