Monday, October 31, 2011

A little time off...

I've taken a little time off from running the last few days.

It's not a bad idea -- my right leg hasn't been 100% for, oh, all year or so -- trying to balance that out with some stretching and strengthening, as well as some cycling in recent weeks. It's been sore in the groin area on and off since last year, and occasionally the hamstring, and while the pain hasn't been bad, it's a definite stiffness and weakness that holds me back a bit on longer runs, especially when my left leg feels fantastic. It actually wasn't too much of a deal in Leadville, it hurt more after Denver Marathon a year ago. I think the stretching and alternating with cycling have been good things, and I need to pay attention to it. Let me know if you have other ideas, but I think the actual source is the piriformis, so I've been working more on that.

I've also given it 100% rest the last few days, which was unplanned. That's because I slipped on some ice at the gas station on Saturday morning. Stepping on a solid sheet of ice (from water dripping above, the rest of the parking lot was clear), I slipped completely backward, cartoon-style. Didn't hurt anything on my body at all...

But I smacked the back of my head on solid concrete. Worse than anything else was the slapping sound of my head hitting the ground, which I heard with detachment, like somebody dropping a bowling ball or something down from 6 feet. That was the sound of my head hitting the ground???

I didn't black out or bleed, but I conservatively modified any plans of heading to the mountains, exerting myself, or drinking alcohol, until any headaches stopped. No other brain symptoms (I had one concussion a few years ago and felt noticeably foggy), thankfully, just soreness, mostly in my neck. Unfortunately, my neck was more sore the next day, and I could even feel it while swallowing, so when eating lunch, i got something stuck in my throat (also from eating too fast, probably) and then threw up.


Feeling OK now, a bit of a headache this afternoon but I think it was from my neck. Should be running soon, and like any injury or minor scare, it quickly made me remember -- again -- how important being healthy is. Especially in the brain!

And watch out for that ice!


  1. Ouch. Sorry to hear about the konk. Sounds like a minor concussion to me.

    Interesting on the leg imbalance. Groin area, eh? I seem to be battling a similar thing but I have concluded psoas over piriformis. I'd suggest we'd compare notes but I imagine that Brownie would get way too much delight out of that.

  2. Yeah, I saw you had a recurrence after the 100, and it's generally the same stuff we talked about last year. I've dug around in the psoas, as that's where most of the pain is (in that area), but reading about piriformis syndrome and sciatica in general, I started wondering if that were the root cause. If I think about it, and dig into that area, it is a bit sore there as well -- just wasn't a major concern.

    Anyway, stretching like pigeon pose is supposed to be good for both. I'm hoping an occasional focused massage, and a bit more stretch of the piriformis glutes, and some strengthening this winter, will help.

    I don't know about you, but sometimes my legs feel "tired" after long runs, but if I really think about it, my left (good) leg actually still feels pretty good. I've decided ignoring it completely isn't the best solution: there's pain (e.g. scraped knee from falling) that you can just "get over," but nerve pain absolutely leads to muscle weakness.

  3. Any stretches you recommend beyond the pigeon then?

  4. I was on other websites, but here's a good summary:

    Ugh, I hate even thinking about stretches!
    The sitting stretch is good for meetings, school, etc. -- I push down on my knee and lean forward a bit, and can really feel it in the lower back as well.
    Adductor stretches, too, at home.
    Lastly, biking makes it feel better: that's more of the type of schedule I had a few years ago.

    The minor realization I had was the foam roller/tennis ball massage -- that's when I could actually feel that, indeed, the piriformis was tight. Try that out to see if that's causing your pain or not.

    Any other ideas you've had?

    Ironically (thankfully?), speedwork is actually not affected much at all. It doesn't make anything impossible, just seems like it slows me down over time.

  5. Mike!! I'm concerned about your ice-slipping-head-hitting incident. Are you still experiencing next pain? Hitting your head on the concrete like that is considered a high MOI (mechanism of injury). If any of my patients has a high MOI AND are experiencing any sort of neck pain I immediately take c-spine precautions and slap a c-collar around their neck, strap them to my backboard, and secure their head with head blocks. Then I take them to the ER where they usually get cleared by the ER doc and can take c-spine precautions off. BUT the possibility that you fractured your cervical vertebrae is possible...

  6. Thanks Ean -- it has gotten better every day, and as far as I can tell, it was all soft-tissue whiplash injury. I could feel/massage everything that was sore, and it's getting better. I was concerned that I threw up from a concussion, but I hadn't been dizzy or anything -- then I read more about whiplash, and it made sense with how my neck was feeling (swallowing was more difficult, a bit of hoarseness). It's mostly better now, though.

    I otherwise don't have any other pain in my shoulders, etc. -- does it seem like my spine is probably OK, is there anything reasonable I could possibly make worse if I ignore it?*
    (*My asking medical advice online, without seeing me -- is a GREAT IDEA! =)

  7. medical advice...hmmmm.

    Well, as I tell all my patients who ask me doctor-like advice...I am not a doctor so I highly recommend you get evaluated by a physician.

    BUT, from one friend to another...It's highly likely that if I had taken you into the Emergency Department the doc would have done a 2 minute assessment of feeling your spine and asking you a few questions, then cleared you of c-spine precautions. You would, most likely, have been told that if you continue to experience pain in your neck, numbness or tingling in your extremities, or it gets worse at all to get yourself evaluated by a doc immediately.

    There...does that help ;-)

  8. My bet ? DJ would tell you that ER SOP would be to get imaging. I'm slightly concerned about this one. I'd also bet that the throwing up would be considered pretty significant.


  10. Yeah, but the...well, the...did they consider...

    Damn, you got me with science! Bulletproof!

    Thanks, seriously. The issue here, I think -- and I should have titled it better because I think it's interesting -- was that I got something stuck in my throat due to difficulty swallowing; tried drinking some water, which also got stuck; and then had a reaction. I wasn't otherwise nauseous or dizzy, so I was thinking that the whole thing was a complication of whiplash and sore neck muscles, plus swallowing something too fast, rather than a brain-related thing.

    Of course, the 2x-relative risk in the study doesn't segregate those.
    Lastly, I think I had one concussion a few years ago, which had more noticeable cognitive effects, and had none of that (nor blacking out) this time. Conservatively, I did come back and decide *not* to go up to Cameron Pass.

    And, now I have a few days of hindsight, where everything has been OK -- perhaps it would have been better to get things checked out right away. But: we had guests! ;)

    Thanks, though, you (and Ean) are probably right in what should be done immediately out of precaution -- and probably what I would say to anyone else -- and certainly what I would do if it were a child, for example.

  11. Bonus details for those that read the comments:

    Fortunately (I guess) we were sitting on the patio at Woody's Woodfired Pizza. I had barely eaten some salad before heading to the edge of the railing and getting rid of it. After that, I headed to the bathroom for ~15 minutes or so, until I felt better (including one false start, where I barely made it back into the bathroom in time).

    When I got back and settled in, apologized for being gross, I asked if anybody really noticed. Erik said, "Not really, except the guy at the end of the patio (now) that has his dogs tied up there made sort of a weird face!"

    If anything good came out of this, it was, apparently, a dog's breakfast.

  12. Your explanation makes sense, but ... then again ... you hit your head ;-)