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Sunday, January 1, 2012

Breaking point

  On an overcast day in the fall of 2005, I finished our team's 3k time trial, second on the team, in what was a decent time for me.  I should have been pleased.  Instead, I stepped off the track into the infield, and told Coach Mitchell what I'd known since the season had started a couple weeks earlier: I'm done.  My proximal right shin, just a couple inches beneath my knee and towards the outside (in such a weird spot that couldn't possibly be a stress fracture...right?), had ached with every step of the time trial.  I couldn't ignore it anymore, I couldn't keep pushing because I knew I was fit, because this was my senior year, because this was supposed to be a good year, because I'd run further and farther all summer than I ever had before in my life.  A couple of weeks later, I laid on the table at the imaging facility and watched a giant white hot spot of tracer form on the image of my right tibia that was displayed on screen, precisely over the area that had gradually rendered me a limping mess over the past month.  My denial was over; the hopes for a strong senior year cross country season that had been my singular focus through miles upon miles over the summer were dashed.  I remember crutching into the training room later that day, with an aircast enclosing my shin (Given that it hurts to walk still, I'm making you non-weight bearing, Dr. Jain had told me).  Most of the team was travelling to their meet that day, but our assistant coach, Doug, had stayed in Buffalo.  Words weren't needed; he enveloped me into his arms and let me gently cry on his shoulder.  The world would go on, my career wasn't over, but still, in that moment, cold reality had set in.

  That stress fracture certainly wasn't my first injury, but it was the first one that kept me out of competition, occurred when I was fit, and prevented me from running entirely for more than a few weeks.  I spent the fall graduating from crutches and the pool, to walking and the bike, to the elliptical, and finally to running again.  Baby steps at first, of course.  Two weeks of non-weight bearing and five total weeks in the aircast had withered my right calf down to a shadow of its formerly infamously muscular self.  Gradually, I was able to keep up on runs, and I began workouts again.  I was going to redshirt indoor track to get back into shape, and then take a crack at outdoor.  Sometime in late winter, I started to ignore shin pain again- this time further down and on the inside, likely a result of my weak and never rehabbed calf.  This time, though, I did quit early enough; the MRI showed nothing.  I bought new shoes and tried to start running again.  In the meantime, I'd met Dave and we'd started dating; the start of a new relationship was making me fat and happy, anyways.  One chilly, drizzly Sunday, we'd headed out on a run together.  Two miles in, I felt a slight pain on the outside of my right knee.  I dismissed it and tried to keep going for a bit, but it kept getting worse.  We turned around and headed back, but the damage was done.  The next day, I woke up and couldn't walk down the stairs.  An ice pick was stabbing me in the side of the knee.  Just some IT band syndrome that should clear up in a few days, I'd thought at the time, spring track isn't out.

   Well, days turned into weeks.  Weeks turned into months.  I didn't run that spring.  I barely ran that summer.  Last ditch attempts by my orthopedist in late August left me pumped full of Medrol and cortisone just in time for cross country.  I wasn't cured, but at least I could now sort of run.  Seven months off, though, had left me pathetically out of shape and ten pounds heavier.  As primed and fit as I'd been the previous fall, when I'd been denied my final xc season, was as beaten and unprepared I was the following year, when I had nothing left to lose.  My ITB syndrome would come back that fall (somehow, I could race, but couldn't run more than ten steps afterwards without the all too familiar stabbing pain).  I managed to scratch and claw my way back onto the travel team, but that was about it.  The season was subpar, but I'd made it through.  Somewhere along the line, after months of frustration with shots and doctors and every antiinflammatory in the books destroying my stomach lining, I somehow discovered that wrapping my knee made it so I could run.

   I went with it.  The weight began to come off, running started to feel good again, and I started to look forward to indoor track.  I managed to make it to one meet, and ran my first decent (for me) race in a couple of years.  Still, this time, I was denying ominous signs from my left shin.  Two weeks after my fellow fifth year senior roommate Kate was diagnosed with her second metatarsal stress fracture, this time on the opposite foot, I was diagnosed with my second tibial stress fracture, this time on the opposite leg.  We commiserated in our boots (and bought each other cakes, it was a good winter for baked goods).  We also both refused to give up.  Kate would make her great comeback that spring to score in the 800 at our conference meet; I would scratch and claw my way to a 5k time within 10 seconds of what I'd run two years ago, moving from last at the mile to 14th (out of 23 or so, don't be too impressed) on a baking hot day in Miami, Ohio in my last collegiate race at the same meet.  I was done with injuries, I decided.  Or so I thought.

  The first several post-collegiate years (of running, I was still in grad school) were filled with road racing, club team racing, some successes, and some inconsistencies.  Tendonopathies became my nemesis.  A couple months for the peroneals shortly after finishing my last spring track season in 2007.  A consistent last summer and fall, followed by angry distal hamstring tendons.  A few weeks off, followed by a consistent winter and early spring in 2008.  A 5k pr.  A 10k pr, followed by sharp foot pain halfway through an 8 mile run two days later.  Several more months for the posterior tibial tendon.  Finally, a consistent fall and early winter.  I began ignoring the pain that was developing my left butt in early 2009.  Bursitis, I thought, or tendonitis at the hamstring attachment.  My right shin began to hurt again.  Shinsplints.  March of 2009 brought Johnny's Running of the Green, which still, to this date, was probably one of my best running races.  Being in shape, for me, meant that I was more willing to ignore the warning signs.  As the spring wore on, the hip and shin pain worsened.  I wanted to take another crack at a half marathon, something I'd been too fragile to train for since 2005.  The running days decreased; the cross training days increased.  I tried running once a week, and couldn't do it.  I still ran the Lilac 10k, but ran horribly.  I still tried to deny that anything serious was wrong.  I took a couple weeks off, then tried to run again.  Nothing was better.

  Finally, in early June, I reached the breaking point.  There was no pleasure in running anymore, only pain and frustration, and a hip that was seriously concerning me, as well as a very tender shin.  I found myself back at the orthopedist's office, this time bothering a different PA.  "How long have you gone without running?"  A couple weeks.  I tried yesterday, and made it five minutes.  My hip and shin killed.  "Well, those five minutes set you back another two weeks.  You just need to not run."  I know that, buddy, but I also know myself, and I know that something's seriously screwed up.  I need to know how long not to run for.  And did I not mention that there's anterior hip pain, too?  Want to miss something potentially career-threatening in a 24 year old?  Begrudgingly, the PA sent me down the hall to the x-ray room.  The hip looked fine on x-ray; the shin showed a lump at the site of my chronic pain.  "Could be the muscle attachment pulling at the bone.  Could be a healing stress fracture.  Just wait until it doesn't hurt anymore."  Finally, I managed to convince him that I needed a hip MRI.  Two mornings later, the test was completed.  By noon, the PA had left me a voicemail.  "Your MRI showed a fracture line on the ischial tuberosity, as well as some hamstring tendon thickening near the attachment.  We should probably move your follow up visit up.  Whatever you do, don't run."  Now do you believe me?? 


    I met with the orthopedist a short time afterwards.  He showed me my MRI picture, which revealed a little line, oriented vertically across my sit bone (I broke my ass, as I liked to put it), not even the orientation that would make sense for a hamstring tendon avulsion.  This wasn't a normal overuse running injury; typically, it's seen in adolescent male soccer players, sprinters, or hurdlers as a traumatic injury, in which the hamstring forcefully contracts and pulls a piece of bone off the still-maturing growth plate to which it attaches.  What the...?  Dr. Little, in his 30+ years of experience, wasn't even sure what to make of it.  "You didn't fall back at any point?  Are you sure you didn't fall?"  Either way, the bottom line was twelve weeks of no running, only swimming and biking.  And thus, my triathlon career was born.  That cloud's silver lining became so much more.  Looking back, it wasn't the 5k pr, the 10k pr, etc that's brought me where I am today.  It's been the low points that did it- stepping off the track after that 3k time trial six years ago, glaring at the training room doctor who asked me if I liked any other sports when my IT band wouldn't heal, getting asked by a couple of  fellow runners on the canal path if I needed help when my left hip and right shin were preventing me from running even remotely normally.  Compared to what some have faced, my injuries to date have been minor (bike crashes, anyone?); in the great scheme of life to date, I've been very, very fortunate (knock on wood).  As much as I've learned from the experiences I have had (and from my professional knowledge), I know that staying 100% healthy when training for an Ironman is a daunting task, even to the most careful athletes.  But, our muscles heal stronger after we break them down in training, and those that persist in the face of injury and setback, in the end, will have more preparation and strength to face what lies ahead.
Signs you're an absolute badass: you win Kona with a leg that looks like it went through a meat grinder, while smiling.  Suck up your ass fracture, Hansen!

  

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