The 26 year niggle

I posted recently about a recent injury which the physios and consultants have found very difficult to get to the bottom of. There’s no pun, the injury is in my groin and thigh area, not my bottom!

In truth, I’ve been running hurt for at least six months and I have openly spoken of burnout and how it impacted both my mental and physical health in the second half of 2019. The physio was very frank that a body creaking under the mental stress of burnout was always going to be vulnerable and that has certainly been the case here.

I was diagnosed with an inflamed hip flexor in late October last year, just before the New York City Marathon. 26.2 punishing miles on 3 November did not help and I’d been struggling since then. However, I was still able to run, albeit not with freedom and definitely with my aerobic fitness compromised by the previously mentioned burnout. Simply, running was not much fun.

Ironically, the 15 miles I did on the morning of Saturday 11 January was as good and easy as I’d felt in ages. However, when I ran two days later, my inner groin just felt very sore.

Acknowledging I’d been exhausted, I rested for a week. OK, I’ll be honest, I had flu for a week!! Nonetheless I did rest and fully expected to feel nothing of it again when I got back out there the following weekend. Within a mile, it was still right there. Stubbornly, I continued to run through the next week with the thought that I would run through it as a minor niggle as I have so often. But this was not proving to be the case.

By 25 January I gave up the ghost and quickly sought a physio referral. It was already a confusing injury in so much that it wasn’t painful at all if I wasn’t running and, even when I was, it was probably no more than 3-4 out of 10 on the pain spectrum. However, it was consistently there in the background, niggling enough for me to know I’d be doing damage to continue on it.

The pain seemed reticent to localise anywhere, moving between groin, inner thigh and sometimes hip. Frankly, the physio was as confused as me and referred me to one of the country’s top sports rheumatology consultants.

He was confused enough to order me straight into an MRI scanner.

And that was that. In terms of fitness, I have been under orders, for close to a month, to do no impact work whatsoever and, unusually, I have listened.

The best case scenario was a stress fracture which, by now, would likely have healed. Barring that, the worst outcome would be degeneration of the hip. And to be honest, I didn’t really want a ‘still confused’ option.

By the time I reached the clinic last Friday morning, I was quietly optimistic, strangely calm, and had even stayed away from Dr Google. To be honest, Dr Google and an injured groin may throw up some shocking results!

And then came the bombshell… well, maybe just a shell. NO stress fracture (well that’s good I suppose). I do have some wear and tear around the hip but at this stage it is minor enough to not be of interest to him (mmm, ok?).

What I do seem to have done, however, is to misplace one of my intervertebral discs, which is a bit careless of me really! That is to say that the L5-S1 disc has worn away pretty much completely.

What’s more I seem to have managed to misplace my L5-S1 (let’s just call it my disc) without any real discernible back pain. How spectacular.

But actually, I did have a lot of pain about 26 years ago in the summer of 1993, long enough ago that I’d forgotten about it. It was in the early stages of my mental illness and being flat on my back for the best part of 2 months seemed a convenient excuse to avoid failing all of my first year exams although I would fail them the next year.

However, it was serious enough to hospitalise me in Birmingham Orthopaedic Hospital and to keep me sleeping downstairs on the floor for the best part of a week. However, Diazepam and Voltarol eventually saw to the pain and that was that. Before the end of the summer, I recovered enough to be fit for the National U19 cricket festival as part of the Warwickshire team to get to the Semi-Final that year. I’ve rarely thought about it again… until last Friday.

According to the consultant, the said L5-S1 (sorry… disc!) has been doing its best to perform its best version of Brexit, we’ll call it Rexit for no other reason than my name starts with an R.

My disc’s Rexit process has taken about 10 and a half times longer than the Conservative government took to leave Europe albeit without regular updates from Laura Kuenssberg.

There’s neither rhyme nor reason as to why it would cause an injury now, that is unless you ignore the fact I’ve run close to 16,000 miles in the last six years. I should perhaps have learned to drive! The key to the L5-S1, and we’ll give it its name here as it relates specifically, is that it acts as a shock absorber, something quite needed when doing impact sport which in my case has involved the said 16,000 miles of impact.

So what next? Is that it? Is it ****!!!! And that’s been affirmed by the consultant albeit in much more professional and polite terms.

It does mean changes however. I absolutely need to find a better balance between impact and non-impact work. I don’t think I’m in any danger of trying a triathlon any time soon but swimming and cycling will be examples of non-impact work. I also need to do more strength work to build abdominal activation, protecting hips and pelvis more than I currently do.

In short, the strategy is less mileage, more non-impact although I rather liked the fairly simple… “if it doesn’t hurt, run, stop if it does.”

I suspect my strategy will be somewhere between all of these thoughts, and for all of my playfulness I will be sensible. The body is a gift from God and not mine to abuse.

What does it mean for 2020? Genuinely, I intend to complete my #20in2020 campaign. Mathematically, if I reduce my mileage by 50% from the usual 60 to 30 miles a week, within 18 weeks I will have saved myself 540 miles, and 20 marathons is 524 miles. You see the method in my madness.

Ironically, for the depth of the scans and the brilliant discoveries that he made, neither consultant nor physio have got to the bottom of the groin and thigh problem. That said, my first run back, on Saturday morning, was pain free. That is not to say it was without discomfort – there is still a niggle but in my new found sense of caution, I’ll keep on returning to the road gently unless it starts to be painful.

So an exciting year awaits… hopefully! Please visit my recent post, A Twenty 20 Vision to remind yourself of where and when I’m running, and also the amazing charities I’ll be supporting.