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?
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?
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!
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!
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?