It started slowing down last year, and it seems that since the turn of the new year, this blog has all but died. The reason for the silence is pretty simple: due to an injury, I haven’t been able to ride my bike much at all since February. With no ability to ride, hike, or really even walk that much, I’ve felt a lot less inspired to write.
It all started with some hamstring pain a few years back that would come and go, nagging me without really being debilitating as long as I managed things. Thinking back, it started to creep up on me in 2012, and the 200K brevet that I did in late January was pretty much the proverbial straw that broke the camel’s back, making an occasional nag more of a constant annoyance to the point where I could no longer ignore it or continue to cycle. It hurt to sit, it hurt to walk–it basically just hurt all the time.
After being told I had a simple hamstring strain and protesting until I was sent for a second opinion, an MRI revealed some “proximal hamstring tendinopathy.” Basically, the hamstring tendon up near where it attaches to my left sit bone was thickened and scarred. Unlike tendonitis, this is not an inflammatory, but a degenerative condition. Esentially, the tendon has given up and has stopped healing itself.
From what I’ve seen online, this injury seems more common to ultra-distance runners, though cyclists are obviously not immune. I’ve read reports from runners who said they have been dealing with this for a year or two with little success.
Yeah, not good.
Trying to get the tendon to heal has turned out to be a real bear, and a serious exercise in patience. For the past seven weeks, I’ve been doing about an hour of hamstring (eccentric strengthening) and core exercises every day. The idea is to progressively load the tendon to get it to start healing properly again, realigning all those fibrotic and messy collagen fibers that are there now. I’ll probably have to do this at least another 5-6 weeks, and then some recommend that you keep doing them a year after most symptoms have gone away. Tendons heal slowly, and like to re-injure themselves. I’m also doing something a bit experimental–wearing a nitroglycerin patch over the affected area, which some studies have suggested can provide a boost in tendon healing.
While I am better than I was two or three months ago, it still hurts to sit, meaning I have to get up every ten or twenty minutes when working. Long-airline flights are unbearable. I bought a cushion to sit on, but that offers only a little benefit. I’ve been able to get out on my bike for 45 min in the last week or so, and it’s been OK, but I’m really trying not to push it and re-aggravate things.
Though I’m trying to be patient with all the hamstring strengthening exercises, I am going to talk to orthopedics next week about other options if this doesn’t start to clear up soon (I’m on my fourth month of conservative therapy and it still hurts to sit!) . Surgery is an option, though the recovery is frustratingly long. There’s also the possibility of platelet-rich plasma injections to try to boost the healing process.
So the lesson for you bikers and runners out there: pay attention to niggling pains, even if they seem manageable for a time. Track down set-up, training, or other bio-mechanical factors that are causing the pain. You can probably get away with a lot more if you are young and/or don’t do stupid long rides. I definitely wish I had been more proactive about this.
Needless to say, it has totally sucked to be off the bike for close to four months now. When you are used to getting a good 12+ hours a week of saddle time, not getting out makes you feel like a bit of a caged animal. At the same time, it does occur to me that in many parts of the country, people regularly go without riding much for four-month stretches.
It’s called winter!
Living in a place with winter is probably a pretty good thing for avoiding overuse injuries like this as it gives you time to heal up and really recover. So I am trying to pretend that this is just “a very long winter” for me, even though it’s been sunny and 70 degrees outside.
On the bright side, not being able to ride has given me lots of time to read, and I’ve re-kindled a teenage interest in Tolkien and fantasy. Finish the next Game of Thrones book, George!
Those were some great books, but I’d still rather be out on the trails!