Sunday, March 29, 2009

So, I'm getting a new hip

I finally got to see the ortho doc this week, actually two of them. The first reviewed my case and performed an exam. He felt like I would likely be a good candidate for a hip resurfacing or replacement. He said an athroscopy was an option but likely wouldn't be much relief. He recommended I see a hip specialist ortho. I was able to see him the following day.

The hip specialist performed his own exam and went into more detail on my options. He was very thorough in describing the options with pluses and minuses on each and what he felt would be the better option. One option is to do nothing and continue to live with pain.
The weight-bearing portion of the femoral head (ball) and acetabulum (socket) essentially has no cartilage left due to excess bone growth from the break years ago and the severe arthritis that I've dealt with over the years. I've unknowingly had bone-on-bone grinding for quite some time, and because of this, the pain is only going to get worse. He said he could give steroid shots that would likely limit or eliminate pain for 2-3 months at a time, but it's really only a mask and wouldn't allow me to get back to an active lifestyle.

The next option is an athroscopy where a surgeon would shave off the excess bone and remove the damaged cartilage. The problem is there would really be no cartilage left over, and there isn't such a thing as artificial cartilage that could replace the removed, damaged cartilage. So, in effect the arthoscopy would be of minimal help and further surgery would have to occur at some point anyway.

That left options of hip resurfacing or a total hip replacement (or arthroplasty). He said either option would be a good choice for me. The resurfacing leaves more original bone in place and the main risk is that the femoral head could break. Judging by my x-rays he said the break had healed well and strong and would take the resurfacing nicely. The one problem he saw is that my right leg is about 3/4 inch shorter than my left due to the break. He said the resurfacing hardware could potentially add maybe 1/8 to 1/4 inch but no more.

That led to the discussion of total replacement. He said he could fix the length discrepency and I would still be able to live an active lifestyle. Fixing the leg length would also likely help some of the lower back problems I've had over the years due to my overcompensation of the leg lengths. At that point it was a fairly easy decision to decide on the total hip replacement.

I have done a lot of research over the past month and felt comfortable with either solution and in my heart knew I was going to have to have the resurfacing or the replacement done at some point. It might as well be sooner rather than later, because the pain has been getting worse each week. Medicine helps, but only so much.

The bad part. My running career is pretty much over. While the doctor said I could potentially run again, the risk of causing damage to the impant is greatly increased. The same goes for pretty much all high-impact activities like tennis, basketball, etc. He did say I would have no problem with lower-impact activities such as cycling, swimming, golf, etc. A few weeks ago when I felt things were really getting bad I had already given serious thought to switching to cycling. The fact that I can safely get into cycling after I've healed and completed rehab makes me happy. The thought of living a sedentary lifestyle is sad, so I'm more than happy to focus my efforts toward cycling when I am able.

While I would really love to run again and I'm going to miss the sport terribly, I would rather be able to use both my legs later in life without pain.

Thursday, March 19, 2009

Unable to Run - Hip Pain Revisited

After the marathon I took 4 days completely off and then slogged through 2 miles. I took it extremely slow and it still hurt but wasn't unbearable. I felt better afterward, though. Took a couple more days off and slowly ran four miles. Didn't hurt near as much and I was starting to feel better. Keep alternating days off and short, slow runs for the next week and then started building back up.

This seemed to work well, but since the latter stages of my training and certainly after the marathon I began having more and more trouble bending my right leg at the hip after runs. After the marathon I could barely reach down to untie my shoes. I just assumed my hip trauma (see previous post) was just not happy with all this running. I have lived every day of my life since the accident with pain in my hip, so I really just blew it off. For the most part, once I started running I really didn't have much pain - many times I had no pain while running. The pain was always after I finished. It would go away, sometimes with the help of ibuprofen, sometimes that wasn't required.

I generally ran 40-48 miles per week from December through mid-February. The after-run pain had increased enough to start being a concern, but I thought it was likely muscular in nature so I decided to take a week off from running. I did continue my fitness by doing elliptical work.

After the week off my hip felt a lot better but soon went back to feeling how it did in the prior couple of months. I decided to just deal with the pain and tried to ice my hip as much as possible and do more stretching. Last week after a speed-work run I felt worse than I had in years. It was painful to put much pressure on my right side and my hip was really hurting.

The next morning the pain was still evident, so then and there I decided I had to stop running and go see a doctor. I do not enjoy going to the doctor which is part of the reason I procrastinated so long.

I saw my GP last Thursday and explained the situation and he took x-rays. I knew there wasn't a whole lot he was going to tell me, but I had to see him before I could go to an orthopedic surgeon. The x-ray did show that part of my hip appeared that it is likely grinding against my pelvis. Just great. The area that appears to be grinding is at the head of the femoral neck where the new bone grew over the previous break.

The grinding does make sense as the problem. It could cause bone spurs and cartilage damage, which appears to be technically caused by
Femoroacetabular Impingement (FAI), which I have never heard of but the description and symptoms sound like what I'm experiencing. I fear there is a stress fracture on the hip, pelvis or both.

My appointment with the ortho doc is not until next week, so I've been stressing worrying about what this is going to be and what it's going to take to fix it. I want to get back to running. That's my main concern. Maybe it's just rest, but I don't figure that's going to be the answer. I'm thinking best case will be an arthroscopy where the extra bone is broken off and damaged cartilage removed. Worse cases would be either a hip resurfacing or a total hip replacement. I hope whatever the decision is allows me to run again and be able to tie my shoes without pain.

The doctor told me elliptical work is okay for the time being as long as it's not hurting to do so. I've been doing elliptical every day and I'm not any worse. I'm also prepared to do water jogging but I hope I don't have to resort to that. I have to do something to keep my cardio up or I'll go crazy and probably gain weight.

Only 5 more days until I get some answers.

My First Full Marathon

Ran my first marathon on November 16, 2008. Wanted to report back for the few who care Cheesy

I picked Tulsa because Chicago was full when I decided to run one. Tulsa is also 90 minutes drive from my house and the timing worked out well. This marathon is relatively small, though, with a little over 1,000 full 2,000 half plus various other relays, quarters, 5k, etc, for a total of 5,000 runners.

The course is very flat until around mile 22 when there is a set of pretty rough hills for 3 miles. Nice downhill finish after that. I live and run in a very hilly area so I wasn't afraid of them, but I was concerned how I would handle them at that time of the race. More on that to come.

Being my first full I didn't know what to expect. Based on my training I knew I could finish and felt confident I could meet my primary goal of sub-4 as long as I didn't crash. My training fitness, especially the speed work and LRs of >=20, also led me to believe I could set an achievable goal of 3:40 if things went really well. I also felt if things went totally perfect I could have a very slight possibility of hitting 3:30. So, my strategy was to go out with the 3:40 pace group and play it by ear.

Weather was about 38 to start, which is cold for me, being a hot weather guy, but I knew it was going warm up when the sun came out. I was prepared with a throw-away jacket and toboggan and gloves, so I figured everything would be okay.

On to the start. I lined up behind the 3:40 pacer. Mile 1 crosses the Arkansas River and ventures onto the actual Route 66 road for a short time only - about a mile. You would think a good chunk of the race would be on the road of the race's namesake, but that was not the case. Hit mile 2 and cross the river again for a long stretch of 9 miles straight down the side of the river. Between 2 and 3 I felt uncomfortably slow with the pace so I sped up just a bit and shed my jacket. I saw a guy from my hometown area and started running alongside him. I was a little faster than my planned pace but felt like I wasn't exerting much energy and was still at a very comfortable talking pace. I was reasonably consistent for a while after this. I took fluids at each station and gels at every 5 miles. I walked through the stations to make sure I took in enough fluid.

1 0:08:31
2 0:08:08
3 0:08:14

This stretch is long and boring with very few spectators, but I felt great - almost like a comfortable cruising speed. Mrs. HogFan is going to try to meet me somewhere in here but I never see her. Plenty of aid stations along the way and the weather is just perfect now. Mid-40s, sunny and no wind.

4 0:07:56
5 0:07:57
6 0:08:10
7 0:07:59
8 0:08:13
9 0:08:08
10 0:08:04
11 0:08:19

Just before mile 12 we cross the river again to make a loop and by this time the wind had picked up. Very strong breeze for the next couple of miles before turning back.

12 0:08:17
13 0:08:07 half time 1:47
14 0:08:02

Back across the river and heading north for the home stretch. Good to be out of the wind. My running buddy tells me he's going to have to back off the pace a bit. We wish each other well and I pace up just a bit. Nothing noticeable. Still feeling great. I think at this point a negative split is possible and a 3:30 is in range, even with the hills, if everything goes perfectly.

15 0:08:01
16 0:07:50
17 0:07:58
18 0:07:54

Somewhere between 18 and 19 I feel a twinge in my left calve and I swear it shoots up to my right shoulder. Oh, crap. What the hell was that. It doesn't linger but I fear it's a sign of things to come.

19 0:07:53

Approaching the next aid station and I see Mrs. HogFan. I can't tell you how happy I was to see her. I don't know how to explain it but it just did wonders for my psyche. Only a 10k left! I gave her a kiss and proceeded to the aid station. My 21 split was a little slower because I took a few extra seconds to take a gel and two waters with it. I also rubbed my calve because it was trying to cramp up. See, I knew something was wrong earlier.

20 0:08:16
21 0:08:34

The hills start. I don't walk at all through all the hills. I'm picking off runners left and right. That hill training was paying off. My body was starting to rebel, though. My calves, yes both of them, were officially cramping now. My right hamstring is starting to cramp, too. I've been getting gatorade at the stations to try to help that. Of course it's only getting worse. I keep pushing forward. At this point I'm using my quads to pull me forward, because they don't hurt at all and I actually expected them to hurt. I wasn't quite shuffling but wasn't far from it. Mrs. HogFan found me again at mile 23 but I couldn't stop this time because I was afraid I couldn't get going again Grin

I knew the hills would slow me and considering the pain I was happy with my splits during this stretch. I knew unless a miracle occurred 3:30 was out but 3:40 was definitely easily in reach.

22 0:08:23
23 0:08:50
24 0:08:56
25 0:08:43

Whew! I'm through the hills but I'm feeling worse. Trying my hardest to run as fast as I could without popping a muscle and pulling up lame. I wanted so bad to run the last mile hard but it was too much to risk with really little reward at this point. I consider myself lucky seeing the carnage at this point of the course.
26 0:08:09

The last .2 actually turns a corner and down the chute with everyone cheering. This is what I've been waiting for. Wow, what a feeling! I actually got chills (for a second I thought I was crashing - just for a second :) ) My legs are both about to quit. My right foot even cramped so bad it felt like it lifted my whole leg in some sort of weird spasm. OMG what pain!
26.2 0:02:44

Total: 3:36:03

I just stood there and rubbed my legs for a minute. Got a blanket, medal and finisher's shirt. I think I had a goofy grin on my face because I couldn't believe I just finished a full marathon. I felt like I gave it everything I could. My legs agreed.

I was very happy with my results, although I wonder what could have been if I hadn't cramped up. I still had energy that last 10k that I didn't use and was not winded even when I finished. I felt like I hydrated and fueled correctly. Maybe some salt tabs could've helped. I don't know.

I'm not sure where to go from here. Before this race I wanted to plan 2 or 3 full marathons next year, but right now I'm kind of down. My legs still hurt pretty bad and I just can't imagine running again. I'm sure those feelings will subside. I can say this one thing - what an adventure!

A little background

Finally getting around to setting up a blog. This is primarily about running and fitness but there's no telling what else I'll post about.

I've always tried to be a fit person, for as far back as I can remember. I was very active in sports when I was young. I played football, basketball, baseball and ran track. I was fairly successful and a good athlete, then at the end of m
y 9th grade year I was taking down decorations from the end-of-the-year dance.

I was on student council, so that was part of my duties. Unfortunately for me, as it turns out, we had hung decorations from the rafters of the gymnasium over 20 feet in the air. This required a scaffolding-type ladder to reach. I would take down a decoration and then some other folks
would push the ladder to the next decoration. We were almost finished when the wheels on the ladder got hung up and the ladder fell over with me in it.

I was very lucky to be alive, but that event would change my life forever. I broke my right hip completely, requiring three 5 1/2 inch screws to repair. I also shattered my right elbow, which required six pins and screws to fix, broke my left elbow as well but not as severe, and suffered a major concussion. I spent six days in the hospital and over six months learning to walk again, albeit with a limp.

At that point it was obvious I would never be able to perform the athletic activities I was used to. The doctor ruled out football right away but said I might be able to play other sports at some level someday.

I worked hard to rehab. My left arm healed first and I tried to learn to throw left-handed. I became a fair thrower but knew I would never be happy with it. Eventually after a year or so I was able to start activity with my right arm. I worked on throwing a baseball and shooting a
basketball. My competitive spirit drove me to be able to compete in some sort of activity. I worked hard all summer and decided to try basketball again. I still could not run very well and what little I could run was with a noticeable limp. I still decided to join the sophomore team.

I worked throughout the fall and got a pretty decent shot back and got better at running up and down the court, but I was not able to be real competitive. I only got in a few games and scored very little. In reality I still was
n't really healthy enough, but I started to focus on baseball.

Baseball was always the sport I excelled at. Even at a younger age I felt I would one day play college ball. I worked my right arm hard and eventually got my full throwing ability back. I had a great three years of baseball, even starting on two all-star teams at regional tournaments. But it would go no further, other than playing some recreational softball. I started working when I turned 16 and began to focus on being able to go to college.

Throughout most of my college years I did little fitness activity, because, frankly, I was
working full-time and going to college full-time. There just wasn't any time left over. I also had the screws in my hip and elbow removed, so I had to do mini-rehabs again. In '92 I moved to an office job and over the next few years gained 30+ pounds. It was sad. Then one night I was watching Dateline and they had a special on weight and low-fat foods. For some reason it clicked with me and I became a health nut. I started eating nothing but low-fat foods, so much so it drove my wife crazy because I had to read every food label.

I also started working out and eventually playing racquetball. Like everything I do, when I start something I go completely overboard with things I like. Eventually, I was playing five times or more per week, sometimes multiple times in a day (at lunch and after work). I sta
rted losing weight like crazy - so much so that my family got worried about me. I dropped somewhere in the neighborhood of 40 pounds. I looked too skinny but I felt great. I was 145 pounds and 11% body fat.

Racquetball was perfect for my hip because I only had to run short distances. I got mixed in with some other racquetballers and started playing in a league and eventually in tournaments. I got good enough to get sponsored by Ektelon and then Wilson. I certainly wasn't the best but I won and placed highly in several tournaments.

After a few years
some people in the tournament "scene" really ruined the sport for me. There were some up-and-comers and over-zealous parents who basically ruined the sport for me. It got bad enough that I stopped playing tournaments and eventually stopped playing altogether.

After racquetball I wanted to continue my fitness, so I started lifting and doing some cardio - running, steppers, etc. For about the next 10 years I was fairly consistent. I did have a few periods where I wasn't diligent about it, but I always got back into it.

I also got into wakeboarding and ATV riding and golf during this time period. I was golfing 2-3 times per week, wakeboarding at least twice a week and ATV riding one or two days. I eventually gave up wakeboarding after I moved to Dallas, because I didn't have anyone to go with. I did get more into ATV riding, though. So much so that I started motocross racing. I really loved this. The adrenaline kick from flying over jumps was just unreal. Unfortunately two emergency room trips after a few years of riding and racing and I decided to give it up.

Sometime around 2004-05 I started running a bit more than I had been. I would make it a point to run 3-5 miles after every time I lifted. I started a job where I was in NYC quite often and took the opportunity to run in Central Park. WOW! It's purely amazing to run with the crowd there.

I changed jobs in late 2007 and some of the guys I was working with were serious runners. They had multiple marathons under their belts, including sub-3 hour times. On one business trip where we all had to meet, I decided to do a morning run with them. December in Chicago with a fresh coat of snow, no less. The wind-chill was around 5 degrees and we ran for 45 minutes from downtown to the Navy Pier and back. It was exhilirating! That's when the bug hit me.

When I got home I started running more times per week. Still maxing out at 5 miles. I research the heck out of anything I get involved in or buy, and as I mentioned earlier I go full-bore into everything I do. I found the forums at and soaked in everything I could. I decided to buy a Garmin Forerunner 305 - a GPS unit that tracks distance, speed, routes, and many other things. I've always been a bad judge of distance, so I figured this would keep me honest on my runs. I went to a local running store and got a gait analysis to get proper shoes.

After a couple of weeks running in January 2008, my competitive spirit caught me again and I decided I would try to run a half marathon - the Hogeye in Fayetteville, Ark., very near where I live. I used the Smart Coach on to design a training plan and I follwed it to the letter. I even started getting up at 4:00am to do my runs.

I ran my first race in February 2008, a 10K. It was a very hilly and challenging race and matched the farthest distance I had ever run. I did run a 4-man relay in the Hogeye in my 9th grade year, shortly before my accident as it turned out. I was young and running track at the time and didn't even train for that race. We just decided to run it. Anyway, this 10K hooked me on races.

I didn't race again until the half marathon. I really didn't know anything about pacing, so I just tried to run under control but on the edge. This course is extremely hilly and tough. The first and last three miles are all hills. I finished in 1:47 and was exhausted and in pain but felt great!

This was the beginning of my new love - running. I started running every local race I had time for. Lots of 5K races mainly and one other 10K. I was always a pretty fast runner when I was young, but not really a sprinter - more of a middle distance guy. Before the accident I ran the 800 and mile-relay in track. I won the conference championship in the 800. I don't even remember my time. That reminds me, I need to go find my old ribbons for nostalgia sake.

Anyway, I made that point to make this one. The 5K seemed to be a good distance for me. My early races were in the 21-22 minute range. I was pretty happy about that. As I continued to run more and more my times got better. I eventually ran two races under 19:40, with 19:31 being my best time. For a 36-year old just getting into running I was very pleased.

Before my half marathon I had said I didn't have any interest in doing a full marathon. Well, once again my competitive spirit took over and in July I decided I wanted to run a full. I initially wanted to run Chicago, because research showed that it is very flat. Unfortunately, I was way too late and it was already full. I researched more and eventually decided to run the Tulsa Route 66 in November. I developed a training plan with the help of a local expert and began my training.

I'll post a separate report on that, but suffice it to say I did complete the race and that brings me to today. If you read this far, God bless you.