PRP Injection Update!

Monday, May 7th was hopefully one of the first steps towards a leg that isn’t “clumsy”! I received a PRP injection into the long head origin point of the bicep femoris (at the ischial tuberosity, or “sit bone”) for chronic hamstring tendinopothy. A mouthful, right?

At the Fast and the Furry 5k. It’s an out and back, so I’m making my way back to the start/finish here. Look at all of the fun human/dog competitors! It is such an awesome race!

What is a PRP Injection?

PRP stands for Platelet Rich Plasma. It is created by taking blood from your arm and spun down within 17 minutes via centrifuge to capture just the platelets. The concentrated platelets are then injected back into the affected area. It has gained traction in the treatment of injured tendons, ligaments, muscles, and joints.

What is it like?

Actually, pretty darn simple! They take a pretty large vial of blood from your arm, then have you wait while it separates, then use a cold spray and local anesthetic before the PRP injection. The PRP injection itself is uncomfortable at times, despite anesthetic. Dr. Moser grabbed onto my hip pretty hard, moving it in different positions to allow the needle around to infiltrate the area. I was pretty sore the next day – sore enough that even if I knew it wasn’t an injection that I’d take a day (or two) off from training. All in all, it seemed like a fairly quick & easy procedure.

What am I hoping to gain from it?

Quite simply, I either needed to take action on my hip and gait, or I need to be okay doing 60-70% of what I’d ideally like to do, and be fine competing in local 5ks and 10ks instead of trying to get back to competing on the national marathoning scene. Nate reminded me that I placed 14th at TCM last year, even with an awkward gait and limp. I sometimes lose sight of the success I’m still able to achieve (thank you, years of accumulated training!). It’s just easy to forget when I know without these physical limitations I could be performing much better. But, isn’t that the case we are all in?

What’s next?

This marks the beginning of a dedicated therapy plan: hips, glutes, hamstrings (both, not just the PRP injected side). After 10-14 days I will start up with PT again. We’ll start with smaller range of motion exercises on the right hamstring (PRP side) and general strength and neuro-muscular re-education. Yay, more PT.

On my own, it’s dedicated strength and flexibility. It means changing 10 minutes before each run and dedicating those 10 minutes to setting my hips, “warming-up” my glutes so they are more apt to fire, etc.

I’ll go back to Dr. Moser at 6 weeks, 12 weeks, 6 months and 1 year to check the hamstring’s progress (no re-scans, just me reporting how workouts are going and if the clumsiness is persisting). He said that I should see significant progress at 6 weeks but full effects by 12 weeks. If there isn’t progress there isn’t much else we can do. Surgery isn’t an option because it isn’t a horizontal tear – it’s vertical “fraying” of the tendon and any surgery that might help that would have too much risk of irritating other tissues and creating scar tissue. Because I show some impingement pain when my femur is moved into the hip joint (and pain that went away with the lidocaine injection test), we could look at the cause of that. The impingement is not bad enough to make me a candidate for surgery, though. It just might be a part of the bigger picture/injury.

How has it gone lately?

The great news is that I was still able to train hard before the injection. Yes, some workouts are frustrating — like the 20 miler on Saturday where I made Jeff stop 4+ times so I could stretch. Or the 8 mile tempo workout that I needed to modify to 4×2 miles w/ brief recoveries. But, I can get through workouts with modification, and I know that overall I’m getting faster and more fit. I just also know that I’m approaching my limit of “how fast” I can become with this as a limiting factor.

After the injection, though, I can say that I’ve had three of the best races/workouts I’ve had in… a long time!!! First, the stroller 1/2 marathon where I only had one mile where my left leg seemed to struggle (the non-affected side, oddly). Then, the Fast and the Furry 5k with Mesa (18:22 5k w/ one water stop for Mesa and one wrap-around-a-volunteer-with-our-leash) where I didn’t have a single step of “clumsiness”. Seriously!

Afterwards. Craig just edged us out, running 18:14 with Taiga. I caught him at 2.5 miles but then Taiga had a burst of speed. Mesa didn’t pull at all during the race. I can tell she is an old dog 🙁

Then, today’s workout (Tuesday, May 22), which was 3×1 mile at tempo, 3x1k at interval pace, and 3x400m at repetition pace. And you know what? I felt smooth and in control. I averaged 5:59 for the 1 mile segments and 3:29s for the 1ks (and those just felt — smooth! Strong!). I had a smile on my face the rest of the day because 1) the workout was one of my best in recent weeks, and 2) I didn’t have to give my hip or gait any thought during the workout. I just had to run! Run hard! Not worry! 🙂 Ahh, what a great feeling!

Look at that HR! I’m not 100% certain it’s accurate as it was measured via my wrist, but I know I was able to work to max today — and I haven’t been able to do that very often because of gait inefficiencies. Here’s to working hard!
Splits from today’s workout

I’m trying not to get my hopes up, as the workout today was broken up and I’ve always been able to get through workouts with breaks, but you guys, I think I’m on to something!!!!

Upcoming: The Stillwater 1/2 marathon this upcoming Saturday. I am cautiously optimistic! It will be a great test of my hip and gait… here’s hoping it goes well!

Your turn: Are you racing over the Memorial Day weekend?

Do you have any fun non-running plans over Memorial Day?

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8 Comments

  1. Oh my gosh! Those are amazing splits on that workout!! I had some ART done on my incredibly tight hip today, so I *really* hope I can get back to serious training and competing after this injury clears up.

  2. Hey- someone pointed me in the direction of your blog. I’m dealing with high hamstring tendon issues right now- a partial, low-grade tear. I’m highly considering PRP sometime in the near future and glad to hear you had such positive results. I can’t believe you just had it and you’re already back to running, let alone racing! Granted you were running and racing before and I’m not. It’s super impressive that you were able to do all you did- I mean reading about your MRI, it sounds like you had a TON going on! But that speaks volumes for your fitness; lifetime mileage and fitness really is a big part of it.

    I too have a wonky, clumsy leg, only mine is the right leg. Honestly, the wonkiness when I try to run is the WORST. My right leg swings way out instead of straight ahead of me, probably due to compensation for the issue that’s likely been there awhile. As far as pain goes, it is more of a dull ache. It’s not bad enough for me to take NSAIDs or impact my daily life. I feel like if I wasn’t an athlete (Or right now, a person who cross trains in front of The Price is Right), I would probably be A-OK living life with this.

    I’m working with a sports chiropractor for rehab, and I’m going to see a lady next week at the local running store (she teaches a running form class and makes custom orthotics, she used to work in PT before opening that store). Unless they have a good reason why I shouldn’t get PRP, I’m probably going to opt for the injection.

    Anyway, thanks for writing up your account of it. I’d really love to connect and see how the days and weeks after it went (or I guess, are going) for you. We’re all experiments of one but it’s super hard to find people who’ve had PRP for high hamstring issues!

  3. Congratulations on your apparent success with PRP! Can you provide an update on how it has gone since then? I just had it done and plan to take it very slowly as far as getting back to running because it is pretty painful. I plan to focus on all the strength work you talked about and non-impact running (deep water mostly).

    1. I was honestly able to get back to my normal training schedule just 3 days later. It was a little tender the first day after the injection, a little less sore the second day, and I just did an easy run on the third day. I could tell a difference in my gait within the next week. I’m still in awe.

      The spot was sore after Grandma’s marathon for a little while (maybe a week), so I’m guessing when I run at higher speeds for a longer distance I do damage to the hamstring where it connects to the sit bone. But, other than that, and other than a few days here and there (maybe 5 throughout my entire TCM build-up?), I have been totally symptom free. Seriously, a miracle. I had been limping through with this for 5 years.

      How has your recovery been?

      1. You ran 3 days after a PRP injection? I’m confused how this worked since the general protocol is to not exercise for 10-14 days.

        1. Yeah, they allowed it! Basically 24 hours after I stopped feeling soreness in that area I was okay to run. I’ve heard different protocols as well… and I don’t think this is normal?… but it’s a doctor here in the TC area that does hundreds of these on athletes (including the MN Vikings). Are you looking into having this done? Or have you had it in the past? What was your experience and return to running plan?

  4. Hi Nichole,

    I am having a PRP injection this Wednesday for my chronic hamstring tendinopothy.

    Now that you are over a year out from your PRP injection are you still living pain free? Did you ever have to get a second PRP injection?

    Hooe to hear from you soon! Thabks so much for blogging about this!

    Mollie

    1. Glad you found me here! It worked really well for me. I did go in for a second injection a year later. I’d say I’m about 80% better? I think I’ll always have some issues, and some bad gait habits I’m trying to break as I waited way too long to get to the bottom of the injury, but I’m SO happy to have found PRP and to be able to run so much more normally now! Let me know how yours goes! I was able to run about 2 days later.

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