Relapse, recovery, and cabin fever: The saga of my 'pain in the ass'
There are worse times of the year to be stuck inside dealing with a pesky overuse injury. Instead of cold, snowy, and gray, it could be warm, green, and sunny outside—an ideal time for being active outdoors.
That is the one good thing about my SI/piriformis/glute/nerve issue: It reared its ugly head during the coldest, darkest months of the year, when the sidewalks are often covered by snow and ice. I would not have been able to run much during the past month even if I could have. Despite the searing pain that has plagued my back, butt, hip, and leg, making it nearly impossible to walk and sit, it could be worse: I could be homebound on perfect spring, summer, or autumn days, gazing longingly out the window as healthy runners, walkers, and cyclists pass by.
How's that for looking on the bright side?
This is getting old. My SI/piriformis/glute/nerve issue has been, as my boss empathized recently, "a pain in the ass" literally and figuratively for a long time. It has put my life on hold since the beginning of December. (Not that there is much to put on hold, but whatever.) Though I did take a weeklong trip to SoCal last month, I struggled. Days before leaving, as I gingerly tossed and turned in bed for another night, trying to find a comfortable position, I thought about canceling the trip, seriously considered eating the cost of my nonrefundable basic economy tickets and not going. But I'm too cheap and masochistic, and Advil thankfully made the flights to and from SoCal bearable. Besides that, visits to the grocery store have been my only escape.
Though I've been a social hermit for the past two months, missing birthday parties and declining social engagements, my self-imposed confinement has been necessary. I've been in too much pain to do anything but stay at home.
I've had this problem before. A nagging discomfort on the outside of my left thigh became hellishly painful and debilitating in March 2016. One morning while I was in San Diego for my annual conference, it took me 15 minutes to get out of bed without triggering the intense, shooting pain that paralyzed my lower left side. It was three thirty and all I wanted to do was visit the bathroom, but I decided to stay up and work, avoid lying down and repeating the whole painful ordeal in an hour or two. Pacing and a very hot shower helped a lot, and it did not bother me much during the day while I walked and worked, but something was not right.
Though the outset was not as painful this time—the pain I experienced that morning in San Diego was the second worst I have felt in my life—it has affected me much more and longer. I could sit in 2016, but this time sitting has often been impossible. Sleeping on my back with my legs elevated by a mountain of pillows helped me sleep nearly two years ago, but no position is comfortable this time; I have often dreaded bedtime and regarded my bed as a torture device. I was able to walk and bike last time, but tightness and nerve pain kept me from doing either until recently. The worst pain did not last long in 2016, but weeks last month are a blur of pain management. Even watching basketball has been painful. I cringe when players hit the floor hard, when the sound of human hitting hardwood echoes through the arena. Dude, I think, that loose ball is not worth it.
I thought I licked it in 2016, thought it was a thing of the past, thought my diligent stretching and correcting every morning would forever prevent a relapse. Nope.
What is wrong with me? That is what I am trying to figure out with the help of a physical therapist—again. Physical therapy and a stretching program cured me in 2016. (Or at least they ameliorated the underlying issues long enough to make me think I was cured.) What was the diagnosis back then? Super tight muscles protecting a tilted pelvis. (My physical therapist theorized that the left side of my pelvis was tilted so far back that the muscles in my butt, back, hip, and leg froze, crushing nerves in the process, to keep my pelvis from tilting farther. Crazy, huh?) What I have now feels like the same thing, and my PT confirmed that my pelvis was tilted again. (It was because I corrected it.) I'm responding to the same stretches I did in 2016, only at a much more gradual rate—likely a testament to how much worse it is this time.
Why did it happen again? What are the underlying issues? Those are the questions I need to answer, because I do not want to deal with this again. A number of aggravating factors is likely the culprit. The main one is sitting since I sit all day for work. Sitting has been called the new cancer because of the many problems it causes those who sit for prolonged periods on a daily basis. Neck and shoulder strains, back problems, hip problems, weak bones . . . the list can probably go on and on. That's why there are so many Varidesk commercials: Sitting becomes so painful that it becomes impossible—and a productivity killer. Poor posture is a related factor. I use my laptop for work, which means my head is always tilted down to look at the screen. I therefore have a bad habit of slouching.
Those factors alone may have caused pain, but I've added running and inadequate stretching. Despite all the preventive stretches I've learned over the years, many after similar bouts of pain, I was not doing some stretches correctly. I also was not targeting certain areas at all. (Hips, how did I neglect you for so long?)
I have made a number of changes to how I do things, and more will need to follow if I want to avoid another round of this misery. Sitting all day is out; I now split my time between my desk and lying on my stomach (as I am right now while writing this post by hand). When I sit, I make sure I sit with my back against the backrest—which is easier said than done after years of slouching and continued use of a laptop. On that note, buying a desktop computer is a good idea. Though I do get up and move often throughout the workday, it is apparently not enough. I may need to start taking short walks at lunch.
Running is likely a thing of the past, and I'm not even sad to admit it. Perhaps my approach to running has been reckless and masochistic: always building time and distance in a quest to run farther and longer (though I never ran very far or for very long relative to other runners). What else could explain the steady rate of overuse injuries? (Compounding factors such as sitting and inadequate stretching, of course.) Deliberating whether or not I should stop running is a separate post in itself, but I suspect I already know the answer and shouldn't waste my time.
The good news is I am getting better, slowly and surely. The pain has dissipated to a dull, abnormal ache that is manageable and less frequent, and new stretches have unlocked a lot of mobility. I think I'm at 60–70 percent. It's a good thing for many reasons—especially because spring is less than two months away. I can feel cabin fever setting in.