H.O.P.E. (Hold On - Pain Ends)

The title is very optimistic, but to be honest I am not sure whether I believe it anymore. What strategy is best? To hope for the pain to end or to learn to live with it? I have been practicing the first for a while now, but I have come to understand that I might have to settle for the latter. A combination of both is of course the best: work actively for the pain to end, but at the same time continue to enjoy everything fully despite the pain.

OK, what are we actually talking about? The above can be applied to many kinds of trouble in life; my focus right now is injuries caused by running. I have had an injury in my right buttock for about one and a half years now, and I am slowly losing hope that it will ever go away completely. This injury came in the early fall of 2013,  several months before I started running longer and more intensively. I am not really sure what caused it, because it is not something that happened suddenly during a run, but it progressed slowly. In the start it felt like a pain at the back of my right thigh, and later it has become more and more concentrated around the buttock. In May 2014 I got it examined by MRI scan, and yes there was in fact edema right in the middle where many small muscles are intervened underneath the big buttock muscle (gluteus maximus). Since then I have been regularly receiving physical therapy, and I have also tried several sessions of acupuncture. It is better now than before. I think. Or I have got used to it.

In September 2014, I got a new injury, the IT band syndrome, which turns out to be one of the most common running injuries, especially for women.  I quickly realized that I was running with wrong type of shoes, and got new ones, and I started doing some of the exercises that are recommended to cure this injury. Although I was very optimistic in the beginning that I would very quickly get rid of this, it has stayed with me. The trouble with this injury is that the advice about how to cure it is so diverse and most of the time so contradictory that it is really not easy to know what to do. Exercises to strengthen the gluteus medius muscles (on the upper side of the hips) seem to be recommended by everybody. However, whether or not stretching, foam rolling, or resting helps seems to be highly debated. During late fall, my physical therapy and acupuncture sessions also treated this injury. Again it is much better now than in the beginning. I think. Or I am also used to this injury, and have learned how to keep it under control and to live with it.

With each of the injuries, I had a period where I was quite depressed and worried that this would slow or stop my progress. However, as time went by I have come to terms with the situation. Fortunately neither injury bothers me much during competitions. As long as I warm up properly, and I have had a few days of rest before, everything works fine during a race. After a competition or a hard training session, though, both injuries, especially the buttock, can be really painful for days. To keep my spirit high, it also helps to realize that almost everybody I know, who is an active runner around my age, has some kind of chronic pain that they have to live with. So this is perhaps just a part of the game. I have now decided to stop physical therapy. It is extremely pleasant while it lasts, but unfortunately I don't think it is curing either of the injuries in the long run. I have learned a lot from my physical therapist who has been an active runner and skier all his life, and in that way the physical therapy sessions have been very useful.

Last week I tried something new: deep muscle massage. Now, this turned out to be something completely different! It was extremely painful, and it did in fact give me renewed hope that my injuries can become better. I could feel the effect of the massage for days, so at least it is clear that it started some processes in my legs. The therapist, who was recommended to me by several of my friends in Melkesyre, has a lot of personal experience in running and training, and treats many active athletes. He told me that my leg muscles are in general very tight. What to do about it is clear: more really slow runs! This is exactly what all experienced runners recommend, and what new beginners find very hard to follow. I have not been good in this respect in 2014, and it a clear goal for me this year to do a large portion of my weekly mileage as slow and moderate pace runs. On the positive side, the therapist also asked me whether I do strength training. I was happy to be able to answer that I do at least two full hours of strength training every week in terms of PT sessions, which was very well received. Strength training is in fact very important for runners, but it is largely neglected by many. I have now ahead of me a couple of weeks of intensive deep muscle massage, slow runs, and focus mainly on uphills. No matter how it goes, it feels good to try something new, and to again start believing that I might get rid of the pain at some point.

Hold on, pain ends! Maybe :-)