Saturday, May 4, 2013

The S-Word and the F-Word

More clues for the puzzle:

I decided to keep my appointment with the sports medicine doctor.  I have thrown a couple thousand dollars at my injuries at this point and really felt I was just about to throw a couple hundred more down the sinkhole.  But that said, I had taken a lot of time off and things weren't dramatically improving.  My knee out of no where started tweaking the week before.  It seemed like a reasonable step to take next.

I imagined it would take me an hour to tell the poor doctor my history because it is hard to sum up 6 MONTHS of trying this and that.  I tried not to be "that patient" and kept things pretty succinct.  She poked at this and prodded at that and had me push back against her in several different positions.  Hop on this foot.  Hop on that foot.  Pop a squat.

She threw me a curve I was not expecting.  She said:
I suspect you had a stress fracture of your pubic ramus but I'm pretty sure it has healed up.

Say what?

I gave her a look of total trepidation because it hadn't hurt that bad.  But you know, I am not licensed to practice sports medicine so who am I to judge?  Since I can hop on one leg with no pain, she thought it had healed.  But it never hurt through any of this at any point to hop on one leg so I was skeptical.  She said it sometimes manifests as vague pain here or there.  Since I could hop on one leg she didn't think I needed to image it at this point.

She also pointed out I have a pelvic misalignment which I am well aware of from my chiropractor(s) and even sports massage therapist.  Me left hip tends to sit higher and it is rotated downward slightly.  She felt this was a reason all of my muscles and tendons have been out of whack.  Rx for this:  More physical therapy but this time with someone who can do "Manual pelvic alignment mobilizations."  I need more core strength but she felt my glute strength wasn't bad.  Yay, personal training!  And yes, we're also working on core strength now.  I am not sure why none of my practitioners in the past have not tried to fix this misalignment.  I am told it is functional issue and not a structural one.

Final verdict:
Left knee patellofemoral pain syndrome
Left knee IT Band syndrome
Pelvic misalignment
Tight right adductors
 ? previous right pubic ramus stress fracture

It is a wonder I haven't self combusted the last 6 months.  Oh, wait.  I did.

She gave me the names and numbers of some physical therapists she liked. The ones she really liked are not so convenient location-wise so I made an appointment with a practice she knew was really good but she couldn't give me a name of someone to ask for specifically.  Talking it over with my husband (who needs a blog name, by the way) it may be worth sucking it up and spending 2 hours travel time per visit or trolling busy streets for parking/paying to park in a structure to see someone she named specifically.  "You've come all this way and spent all this money, you should just go to the best at this point," he said.  I have an appointment Monday with the non-specified person close to home and I will call the other places to see how long the wait is to see someone who was specifically recommended.

I have been on two 1.2 mile runs this week. The first went pretty well.  Minimal pain and only a slight hint of adductor tightness post run.  The second one didn't go as swell.  I had left knee pain the last few minutes and I felt as if my adductor was tweaking a little more post-run than the first time out.

I googled "pubic ramus stress fracture" and actually found a runner who had one diagnosed through a MRI but they could STILL HOP ON ONE LEG AND NOT FEEL PAIN.  Hmm.  I wanted to laugh at her when she first said that was what she thought it was.  Mainly because she diagnosed it off my tightness/pain symptoms which quite frankly I am still experiencing, and yet she said it had healed because I could hop on one leg.  But now I am beginning to think that maybe I am one of the freaks who has a stress fracture and can still hop on my leg with no issues.  The more I think about it, the more it actually makes sense.  This "tight muscle" has not let up in six months even with multiple two week and a six week break.

On the other hand, I found an article on pelvic misalignment which says:
"If you notice that you stretch and stretch and stretch but can't seem to get a muscle to relax, chances are you have a misalignment."  Also, "The hamstrings may become chronically tight; The adductors may get strained; The hip flexors may become chronically tight..."  All of the above is exactly me all the time.

So I obviously need to address the pelvic misalignment but I am debating demanding having some imaging done now.  The sports medicine doctor cleared me to run 3 miles/3x a week for now but I obviously don't want to run if there is a fracture.  All of my issues could stem from one or both of these main problems and I'm not entirely sure what is what at this point.

10 comments: said...

oh MAN! I had no idea that you were battling with so many injuries. I can't believe that its gone on for so long. I'm so sorry girl! Hopefully now that you know more you can address the issues. Here's hoping!

Ann (bunnygirl) said...

Wow, all the symptoms described in that article sound like me! I've spent thousands of dollars in co-pays over the 13 years I've been running, and finally gave up on physical therapy because no one ever actually fixed anything. I guess I need to keep trying.

Good luck finding someone who can really help and not just take your money and your time.

naomi said...

I'm glad you were able to get some conclusion to the mysteries that have been plaguing you for the past few months. I went to PT for pelvic misalignment in 2009. It's a lot of weird stretches etc. But I agree with E to see the dr's rec. Has our chiro not adjusted your hips for pelvic misalignment before? She does that for me almost every visit.

Alisa said...

Yikes! I had stress fractures in college for months without knowing it and I was walking etc, so I totally think its possible (but let's hope not)!

I am kinda taking the same tactic your hubby suggested, I got a referral for one of the top sports ortho guys and I'm going with it :). Not that inconvenient but time wise I'm sure I won't be able to get a convenient time to get there.

We are both athletic enough and enjoy our racing not to see the best :)

Kristen said...

After years of searching, and doctors and xrays alignment is the root of my back pain all these years. My right hip tilts forward and I have to get it re-aligned. It is holding longer and longer on its own but it still slips. I have the exact same feeling - a muscle that cannot be stretched.

I agree with the husband - you have come this far, it is worth it for your health to see the best doctor you can otherwise you might keept struggling and from someone who has been dealing with this issue for years now the sooner you can get it checked out the better.

I hope you are able to find relief soon. I can greatly sympathize with the pain and frustration you are having.

A said...

I feel so frustrated for you right now. :( Hoping you get some relief soon.

Rabbits' Guy said...

Ugh - good luck! I did not see any suggestions for a husband blog name so in your case let me suggest Mr. Wonderful.

If I had what you have, BL would have put me in the "home" long ago!

SF Road Warrior said...

Don't remember where you are or if you still need it, but I have been dealing with some similar stuff (though it hasn't gone on as long) & I can recommend some great people in SF if you need them.

Being hurt sucks. Feel better!

Shan Salas said...

Having an injury is a total pain in the neck. It is something we can't avoid, particularly those who are active in sports. Chances of being injured are at its highest if one doesn't follow proper warmup exercises. I hope that your chiropractor can help you fully recover from your injury soon. _Shan@

Novak Jim said...

You should do something for the strength of pelvic floor like sit, stand, lie on your back with your knees, close your eyes imagine what muscles you would tighten and then you can feel your pelvic floor muscles working.
physical therapy center