20 miles to deliberately cause pain!

Later today I have an appointment at a sports injury clinic in London. The Dr that I am seeing specialises in groin pain, and the clinic’s approach is one of looking into the complex reasons that can cause groin problems, rather than going down a ‘quick fix’ surgical route. I’m not under any pressure to get back to my sport within a few weeks like a footballer may be, so I’m happy for long term rehabilitation if it means avoiding surgery. That’s the outcome I’d like anyway. I’ve no idea if they are a contributing factor to my problems, but this weekend I’ve also changed my work shoes. I’ve swapped my pointy fashion shoes for school boy shoes. My uncle told me a few weeks ago I needed some more cushioning under my heels. My current shoes, pictured below (you get some odd looks on a packed train when you start taking photo's of your shoes, I can reliably inform you!), were looking a bit tired anyway, and you can see the destruction of the heel. My foot was always tilting and wobbling in them, which can’t have been any good, regardless of if they contributed to my current woes.

The heels have taken a real hammering haven’t they? Interestingly I didn’t used to heel strike so hard with my left foot, not until I had orthotics in my shoes anyway. I’ll be quizzing the Dr about any contribution the orthotics could have made as well.

These are the new shoes. I haven’t had a pair like this since I was ten years old. They are Clarks (i.e. sensible!) shoes. No heel on them, just a long rubber sole with a lot of in-built cushioning in them. As I say, they may not have caused any problems but changing them makes me feel a little better, and certainly won’t do me any harm.

I ran 3 miles at lunchtime last Wednesday, running with one of the guys from work, one day when I was in the London office. It was just a slow pace run along with Thames. Just enough to remind me that this problem with my groin hadn't gone away, not that I thought it had.

On Saturday my friend Mike asked me to show him the route of an event he is doing in a couple of weeks; well half of it at least. I figured this would put me in a good mess to see the doctor with this week, since the route was 20 miles and included 5000ft of ascent. The route was in the Peak District and took in Castleton, Hollins Cross, Edale, Kinder, Back Tor, Lose Hill, Win Hill and Ladybower. For the first 8 miles I was ok. By 10 miles I was in some discomfort, by 12 miles I was having real problems, and by 15 miles I was walking 100%. I had to walk the last 5 miles, and even that was broken up with a break because even walking caused too much pain by then. Mike noted that I was running with my right foot turned outwards, something I hadn’t noted myself. I know this happens when my pelvis is twisted though. Again, I think this is more evidence stacking up for a biomechanics problems, rather than a trauma causing this. The pain as always seems centred on my lower Rectus Abdominis, but as I run further radiates out into my wider abdomen, upper right inner-thigh, right gluts and lower back. All in all those last 8 miles were very unpleasant, but served the purpose of returning me to a pretty sorry state the following day. Can’t do a sit up, sneezing causes a sharp pain in the area, turning over in bed hurts etc. I was in fact quite content to be hurting so much. Plenty for the doctor to work with today.

For those with some physiology knowledge last week’s MRI radiographer report states “a focal signal increase in relation to the right tubercle, and this does infer there is a small micro tear at the abductor tendon origin here”. I don’t know much about tears in this area. Do they heal themselves? If so, does it really take more than 5 months? What caused it?

Other than the additional loss of muscle mass I showed in MRI photo (last week’s post), the radiographer report doesn’t highlight any other areas of significance, which is good. I’ll let the Dr look at the report and images later, and do his own assessment. I’m not sure how much can be achieved in the appointment today. He indicated if necessary he could do a full biomechanical analysis at SPARC (Sport Performance, Assessment and Rehabilitation Centre) in London. Today, I hope this is the start of a road to recovery. I’m not expecting anything to happen overnight. I realise this is going to take some time to fix. I’ve got no major events until next year, though of course I’d like to do some day-long or weekend events later this year if at all possible.

I’ll let you know how the assessment goes in a day or so.