At Four Thousand Feet

Today I accomplished something that, four months ago, seemed far beyond my reach. I broke through a barrier of sorts – reaching and surpassing a little number that has toyed with me for weeks now.

I ran for over 10 consecutive miles. And not only that. I ran 100% pain free.

When diagnosed with a hip labral tear back in September, I established the “10 mile, pain free” standard as a benchmark. How (and why) I settled upon that number I do not know. Yet in my mind I equated running 10 miles with full and total recovery.

After talking things through with a specialist down in Boston, I knew that there was a slight (but very real) possibility that I’d never run long distances again without surgery. Nevertheless, I pressed on, building up my mileage in baby steps.

Who’d have known that today was to be the day?

Not even the most devious of ice patches on the mean (and terribly plowed, I might add) streets of Manchester could have dampened my spirits.

Dare I start setting running goals for the year?

When I met with the doctor down in Boston last month, I was told that it could take as long as nine months for me to start running pain-free again. It’s been just under nine weeks since I sustained my hip injury. Imagine my surprise when I was able to crank out 3.3 miles on the treadmill last night. Although I have been incorporating short stretches of trail running into my hiking as of late, this represents the longest distance that I’ve been able to continuously run in over two months.

I’d be lying if I were to classify the workout as “pain-free” – the discomfort is still there. What’s most remarkable to me, however, is that the pain has gone from being absolutely debilitating to, well… more of a nuisance than anything else. A manageable annoyance. It no longer appears to be affecting my stride, and by focusing on my posture and cadence I’m able to draw attention away from the nagging hip at times.

While it certainly feels wonderful to hit this milestone, I know that I still have a long way to go. Running is wholly about enjoyment for me. I refuse to let it become something that I detest simply because I’m pushing through pain. As tedious as low-impact exercise machines can be, I’m confident that they’ve contributed significantly to my progress – and I will continue to suffer through my 2+ hour elliptical/arc trainer workouts until I’ve recovered enough to run entirely pain-free.

Thank goodness for hiking on the weekends! I could never be a 7-day gym rat.

Three trip reports/hiking albums to come this week. I can’t believe I’ve fallen so terribly behind. Here’s a quick picture from the Willey Range, courtesy of my friend Dr Wu. To think that all of the snow we had two weekends ago has now entirely melted…

Some positive news on the hip front. This past Monday I met with my orthopedist down in Nashua. While I was unable to actually view the MRI images for myself (the office gave them to me on a disc, which I rather foolishly left behind at my parents’ house), the doctor did inform me that my labral tear is quite small. Given its size, this could very well mean that the injury may become asymptomatic with time. I’m hopeful for this outcome, but at the same time realize that medical research is indicating that these tears can never heal on their own.

Next week I am meeting with a highly regarded orthopedic surgeon down in Boston to discuss further treatment plans. My primary concern at this point has to do with potentially causing long-term damage to my hip if I choose not to get the tear repaired. Although there is no definitive answer as of yet, certain doctors believe that labral tears put one at a much higher risk for developing premature arthritis – and I certainly do not want to have to undergo a hip replacement at 35. That being said, I would like to avoid surgery if at all possible. Therefore, if recommended I will most likely pursue a conservative treatment route at first. If this means additional recovery time, so be it.

Enough of that. The most important outcome of my visit was the fact that I was given the go ahead to start exercising again! Low impact at first (elliptical, bike, etc.), with an eventual build up to full activity as the pain subsides.

Although running is still completely out of the picture, each and every day I’m noticing considerable improvement in my hip. Walking is almost pain free for me now, and my joint flexibility is steadily returning. This past weekend I went for my first walk of over 1 mile in 17 days – 3 miles in the pouring rain through horse fields and on a gentle, wooded trail. By the end of it I was completely drenched, but nonetheless absolutely ecstatic to with my progress. The next day I was able to push myself to 4.5 miles. The weather was just perfect, and I found myself pining for the mountains quite a bit. It’s difficult to think that I’ve been away from the Whites for over a month now. Ah well, at least I got to spend some quality time with my dogs:

Last night I hit another milestone – 30 minutes on the elliptical followed by 20 on the arc trainer with next to no pain. Usually I find exercise machines (with the exception of treadmills, which I have a marvelous ability to zone out on) remarkably tedious, but I was so excited to finally get my heart rate up that the workout flew by. I averaged 178 BPM for the entire 50 minutes, which was just excellent. It’s good to know that my fitness level has not deteriorated too much…

Finally, things are starting to take a turn for the better. Dare I say that life is pretty good?

After two weeks of uncertainty, excessive (mind-numbing, going-absolutely-crazy-sitting-alone-in-my-apartment) rest, and a scary MRI (involving a very long needle to inject contrast dye directly into my hip joint), I finally have a diagnosis: hip labral tear. The acetabular labrum is a ring of cartilage that surrounds the hip joint. Since the blood supply to the area is very limited, injuries to the cartilage are permanent. It’s possible that with additional rest, the injury will become asymptomatic with time. However, if things do not get better, it’s likely that I’ll need surgery in order to return to my former activity levels.

The good news is that the doctor has cleared me to hike/run as much as is tolerable. As of this morning, I’m able to walk with only very slight pain, so I’m hopeful that I’ll be able to do a small hike this coming weekend. Running is still out of the question, though.

At this point, I’m hoping that I’ll recover to the point of not needing surgery. That being said, I’m not sure if I could exist happily with the thought of never being able to run nor hike long distances ever again. I’m at a bit of a loss for what to do, but perhaps it’s too early to be worrying about these sorts of things.

I’m not really sure where to begin. Perhaps with the facts. Last Wednesday, I was out trail running after work as usual. About 11 miles into my run, I suddenly started experiencing pain in my hip. Not knowing what could be causing the issue, I stupidly pushed on for about a mile or so. The pain did not subside. Starting to realize that the problem was more serious than I’d anticipated, I immediately stopped.

Yesterday I went to see the doctor. Although she cannot make a final diagnosis until I have an MRI done (hopefully later this week, but I’m having a terribly rough time making an appointment), it’s looking like I have a stress fracture in my hip. I’ve been told to restrict my movement as much as possible – even walking (though it’s not like I can really walk as it is without limping) – until a solid diagnosis is made.

The past week has been one of the toughest I’ve experienced in recent years. Hiking and running are my life, and the thought of having to take months off to recover is simply overwhelming. The fact that I’m currently on vacation is making things even tougher to bear, as I have little to take my mind off the injury. I’m the sort of person who thrives on being outside and being active. Sitting around in my tiny little apartment, far away from the trails and mountains, is proving to be immensely difficult.

Nevertheless, I’m trying my very best to think positively. There’s something to be said about being proactive and visiting the doctor as soon as I did – and I hope this will lead to a speedier recovery time. It’s also silly of me to jump to conclusions and assume that I do have a stress fracture at this point. I’m hoping and praying with all of my might that this is not the case.

Until I know more, I cannot say when I’ll be back out on the trails again. It could be as soon as two weeks, or it could take months. Regardless, I’m fortunate to have such kind, concerned, supportive, and caring friends to help me through this. Thank you to all for being there for me during this very difficult time.

Fingers crossed for good news later in the week…