Tuesday, September 06, 2011

Sports Hernia

Dr Yee at SMG is a knowledgeable guy. Today I went to get the scoop on my not-yet-healed abdominal wall strain.

As I recall it, here is what the doctor said:

  • What it's NOT is any kind of hip problem or hernia. It really is an abdominal wall strain.
  • He said it is commonly called a "sports hernia," pointing out that it isn't really a hernia, but a strain at a point where abdominal wall muscles connect. It happens to jocks.
  • It's likely that the problem was caused when I ran 18 miles one morning and then a 4-mile race that evening without warming up again. Muscles tend to tighten after being stressed, and I probably pulled them later when I raced.
  • Since it hurts just as my right foot hits the ground, I suggested that the stress comes from my innards pushing out against the abdominal wall. He thought it it's more likely that the foot-strike is the moment of maximum muscle tension between the muscles of the abdomen and those of the leg.
  • It's encouraging that two weeks off from running has made an improvement - that tells us what to do: Keep right on NOT running.
  • However, I should expect that muscle tone will fall off somewhat after a few weeks without running.
  • He recommended "water jogging" as an alternative cardio exercise. However, we don't have access to a pool.
  • When I asked what would happen if I just went ahead and ran on the pain, he said that the injury would just get worse, and discouraged that pretty strongly.
  • I mentioned a marathon coming up in less than two weeks, and he made two suggestions:

    • Do a short run before driving to the marathon, and consider just not going to the marathon if there is still pain.
    • If I do go, be mentally prepared to QUIT the marathon if there is significant pain. We're talking my first-ever DNF in 55 marathons.
Hmmm. I'm not too comfortable with the short-test-run notion. If it hurt a lot, then I suppose I would not go. But if it didn't hurt much, which is what happened yesterday, then I would go and try to run the marathon, but that test run might undo a few days of healing time. I'll do the "situp test" (try a situp, see if it hurts) and I'll go if that seems OK.

As to the DNF: I do have eight marathons scheduled for the rest of the year, and right now I couldn't run one. I'm hoping, of course, that another 12 days of healing will fix the "sports hernia" problem. If not, in the worst case, it would become quite painful at some point in the race, and I would stop. More likely, though, based on past experience with this injury, it would start hurting at some point, and keep on hurting but not a lot. Then I suppose I'd keep going, even if that put some later marathons at risk.

Right now, though, I would like to get in some good cardio training. Walking is OK, but it doesn't push me hard enough and I think it is somewhat stressful on the abdominal muscles too, especially fast walking. I'm afraid to try the bike, or do stair climbing, because past experience shows that those can cause other "cross-training" injuries. I'd like to try an elliptical trainer, but we don't have one and don't have any kind of club membership. However, Anytime Fitness has elliptical trainers, and I just got my one-time 14-day free pass. I will try the elliptical tomorrow. There might be other machines of interest there too.

Regular breakfast:

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