97 days post injury, 64 days since last attempt to run
My physical therapy benefits ran out last Thursday. On my last appointment, I told my PT that I spoke to the doctor regarding dry needling. He advised me to find another PT, one who will be more aggressive with therapy. I told my therapist this and that my doctor had mentioned ultrasound treatment. She said, "Oh, I could have been doing ultrasound this entire time." I was stunned. I couldn't believe the words that just came out of her mouth. I'm dealing with this injury that has kept me from running for months with little improvement, and she wasn't doing everything she could to help me heal? She said that there was little evidence supporting the use of ultrasound. I really don't care if there is evidence or not. I had been spending 45 minutes of my physical therapy appointments doing strengthening exercises that I could have done at home, while she could have been treating me with ultrasound and massage. It was hard to contain myself. She said that she would do ultrasound on me on my last visit so that I could at least tell my doctor she tried it. Seriously???? I couldn't believe what I was hearing. One ultrasound treatment isn't going to make a difference. I felt royally screwed.
I was set free from physical therapy, off into a world of uncertainty and discouragement. Thanks to many trips to various websites and blogs, I decided to design with my own physical therapy exercises, in addition to the few given to me by my PT. There is evidence supporting the use of eccentric exercises in promoting tendon healing, so that became my focus.
I decided to give myself a couple more weeks of my new and old exercises before seeking out a new therapist. I would be taking a chance with my insurance at a new therapist. In order to be covered, my doctor would have to send me with a different diagnosis code. Risky. I am also giving myself another month before I call the doctor to return for dry needling.
The pain has slowly returned as the cortisone shot wore off. The pain returned to the same intensity as before the shot was given. This was discouraging. I pushed ahead despite the return of the pain. I went through all of my physical therapy exercises, new and old, on Saturday. After the exercises, the pain had subsided to an extent. That was encouraging. However, When I woke on Sunday I was in even more pain. That was VERY discouraging. I was also going to NYC to watch the marathon that day. Knowing I was going to be walking quite a bit, I grew nervous as to what was going to happen with my tendon.
I woke Monday morning and walked to the bathroom. I almost had to rewind the scene because I couldn't believe what I was experiencing. My pain had significantly decreased. A lightbulb went off in my head. Maybe this was truly an example of "no pain, no gain". This is contradictory to everything my PT talked to me about. She persuaded me to not do any exercises if there was pain. As the day went on, the pain level remained stable. I was still in shock. On my drive home, I couldn't help but think about the NYC marathon and wanting to run it. I know I can qualify with a half marathon time when I am in good shape. But the qualifying times must be run by the end of January, 2012. I thought about a comeback plan. Could I be in shape by the end of January to run a qualifying time, and if so, what half marathon could I run?
The answer was Miami. Miami's marathon and half marathon are the last weekend in January. If I started a return to running program on 11/28/11 (12 weeks after last attempt to run), could I be in shape? I frantically referred to Dr. Pribut's return to running program. It is an extremely slow program, but it is in my best interest to return slow. The first couple of weeks involve only walking. I could start this week, so by Nov 28 I could start with 5 min jogging. I'm afraid to think too positively after my experience with this injury, but could I be seeing a glimmer of light at the end of the tunnel?
The plan: eccentric strengthening every other day for one week, then addition of quad and glute strengthening for week two. Alternate strengthening with bike or elliptical PLUS 10 or more minutes swimming without kicking (buoy between legs).
Dr. Pribut's Return to Running Program: (I might have to make some adjustments after the first few weeks if I am to be in shape for Miami)
Week 1: 1-2 mile walks on alternating days
Week 2: 2-3 mile walks on alternating days (I will walk on strengthening days, with alternating days on elliptical or bike and swimming)
Week 3: 5-10 minutes easy jogs every day, with walk breaks every 3-5 minutes. Walk 2-3 miles on alternating days.
Week 4: 12 minute jogs every other day. Walk 2-3 miles on alternate days or 30 minutes elliptical.
Week 5: 12 minute jogs 4 days a week, with elliptical or bike on 2 other days, 30-40 minutes.
Week 6: 14 minute jogs + 20 minute walks 4 days a week. Elliptical or bike on 2 other days.
Week 7: 16-18 minute jogs + 30 minute walks 4 days per week. Elliptical or bike on 2 other days.
Week 8: 20-25 minute jogs + 30 minute walks 4 days per week. Elliptical or bike on 2 other days.
Like I said, If I want to run Miami I will have to make adjustments if possible. But for now, this is where I will start.
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