Wednesday, 30 December 2015

2015 started off with a wonderful family holiday cycling through North Vietnam.  Cycling, so I thought, would give my body a break from running and the associated groin discomfort that was becoming more frequent.  

The groin discomfort, however, continued so I greatly reduced my weekly running mileage.  That helped although the loss of strength and cardiovascular fitness became obvious during the second loop of the gruelling “Roller Coaster” 43 km run on Mount Dandenong in March 2015.

A session with my physiotherapist, Mark, resulted in a diagnosis of a form of “Osteitis Pubis” (OP).  OP is an inflammatory condition resulting from an unstable pubic symphysis joint of the pelvis.  Fortunately for me, Mark is the physio of an AFL football team and knows all about this injury which is common among young footballers.

Mark straightened the misalignment in my body and gave me some lower core strengthening exercises which made a huge difference.  I was unsure, however, whether I would be able to complete the 100km ultramarathon at Wilson’s Promontory in May 2015.   I figured I would start the event and, if necessary, I could always pull out early and cut my losses.

The Wilson’s Promontory event started out really well with me jogging the first 30km with my wife, Lis, who did the shorter 44km that day.  I had no problems with the OP on the soft running surfaces as I ran with Knox Roadrunner (KRR) mates, Brett, Grant and Adam.  The day was wonderful until we reached the 55km mark (a few kilometers north of the lighthouse).  The light was starting to fade and I tripped on a tree root and fell heavily, planting my cheek on a rock. Upon opening my eyes I saw blood dripping slowly onto the rock and I thought “This is not good”.

Checking me for concussion, my mates asked me “Who is the Prime Minister of Australia?”  Upon answering “Buggered if I know!” they yelled “That’s correct!”.

After Brett kindly played doctor and stemmed the bleeding from my cheek, we started our 25km run back through the darkness with our head torches to Tidal River which would leave only 20km to finish the 100.

It didn’t take long before I noticed that it hurt to inhale deeply so I must have bruised my ribs in the fall.  The run back turned into a fast walk – there was no pulling out – it was either walk back or stay out overnight in the bush.

The pain in my ribs left me no choice but to pull out at the 80km mark where I had some pain killers and a night’s sleep.  In the morning, Lis drove me straight to the Epworth Hospital in Richmond where x-rays revealed two broken ribs.

Lis asked the doctor also to scan my brain for concussion.  While there was no bleeding, the doctor did notice a white spot which, upon a further scan, turned out to be a “cavernous angioma” which I subsequently learned is a small blood vessel abnormality that I most likely have had from birth.  It is nothing to worry about but a neurologist will monitor it annually.

After eight weeks of rest, the ribs were fine and I gradually resumed running but the OP discomfort returned.  Doing nothing for all this time had made my core muscles weak.  

In August 2015 I ran the 14km Sydney City2Surf in the pleasing time of 1:05:07 but I knew I might be in trouble over longer distances.

The next event coming up was the Melbourne Marathon in October 2015.  With the limited time available and, trying to make up for lost time with the broken ribs, I had some very heavy training weeks and a shortened taper period.  Experiencing OP discomfort from the heavy training, I took a course of low dosage anti-inflammatories during the taper period.  Consequently, I felt good although I knew a full marathon distance would really test me.

A more sensible person would have scaled down to the half-marathon event or just jogged the full marathon but, in my stubbornness, I decided I would go all out for a personal best time (currently 3:17:42).  After all, what did I have to lose? … Big mistake!

After a fast first half of the marathon (1:36), I experienced increasing groin and abdominal pain. The wheels gradually fell off and I ended up walking the last 10km feeling totally deflated.

Subsequent attempts to run even short distances all met with pain and disappointment.  I had no option but to take my medicine and learn from my mistakes.

After a few weeks, realizing this OP problem was not going to resolve with rest alone, I had an MRI of the pelvis and returned to my physio.  He advised me that my body was way out of alignment and far from symmetrical.  

After several weekly physio sessions and a specific exercise regime, I am very gradually easing back into the running.  I can now comfortably run 10 km on soft ground although I am not yet running such distances on concrete surfaces.  I am very optimistic that I will be able to return to marathons and ultramarathons during 2016.

So what lessons I have a learned for dealing with OP?

  1. See the physiotherapist earlier rather than later – without intervention, imbalances get worse rather than better 
  2. An MRI of the pelvis provides important information about OP
  3. Do exercises as directed to build stronger muscles to stabilize the pubic symphysis joint
  4. Make more use of the foam roller
  5. Minimize impact wherever possible – e.g. run on soft surfaces and don’t run downhill
  6. Ice immediately after running to minimize inflammation
  7. Listen to my body and don’t run if I have any pelvic pain or inflammation
  8. Compression shorts help
  9. Avoid running on successive days to allow joints adequate time to recover
  10. Cross-train on non-running days
  11. Run with good form, especially when tiring – no hip-drop
  12. Enjoy running for the simple experience of running and spending quality time with friends and family – it’s not just about achieving fast times
  13. Train smarter rather than more – running is only one part of training
  14. Be thankful that I can run and never take it for granted
  15. Never take your mates and family for granted
  16. Focus on the positives and never give up!

My running goals for 2016 include one marathon and some trail ultras including the Wilson’s Promontary 100km (unfinished business!).

Thanks for taking the time to read my story.  I wish each and every one of you many blessings and all the best for 2016!

1 comment:

  1. I totally agree to 12. I've been OP sufferer for 1 year.I am marathon and ultra marathon runner jyst like you but as your faults ı have made mistakes so OP relapsed over and over.Now ı have totally healed but this time ı've lost my running motivation somehow (its hard to describe) now ı am cycling and doing fitness excercises these know the quote "no pain,no gain" bullshit' if there is a pain yea be sure there is a crappy things.