Six weeks off...

I have not run for two weeks now, and I learned this week that it's going to be quite a while longer.

Last Friday, I went back to Dr. Babiy.  The purpose of the visit was to look at the x-rays on my ankle and determine the next steps, as well as to get my electromyogram (EMG) on my butt.  The x-ray came back negative for a fracture.  However, it did show some signs of "cortical thickening," which I guess means that the outer layer of my tibia bone had grown thicker than usual.  She said this was probably the result of my running--as the muscles pull on the bone, they cause stress on it and make the cortex thicker.  She said this was probably not a huge deal, but told me to get an MRI just in case.

The EMG is a test used to record the electrical activity of muscles.  It can be used to detect muscle abnormalities, such as when there is a pinched nerve.  The purpose of the test was to see if I had problems with the sciatic nerve, since I had reported a "pins and needles" sensation to her.

The test was sort of like the rubber mallet reflex test that doctors do, only more high-tech, and much more painful.  The doctor places these electrodes up and down my leg.  She would administer a little shock here and there to basically see how much my leg reacted.  By my foot, where the sciatic nerve is at its smallest, I would feel what amounted to a little electrical pinprick.  But as she moved up my leg, the shocks felt more and more intense, and my reflexive reaction got bigger and bigger.  When she got to my butt, it felt like I got hit with a stun gun, and my leg let out a huge uncontrollable kick.  It was kind of funny and painful at the same time.  The EMG showed that there was nothing wrong with my sciatic nerve, so it turns out that my butt issue is just a muscle problem, like a pulled hamstring or something. 

Later, at physical therapy, my PT Marina (funny, both Dr. Babiy's and my PT's first names are Marina) confirmed that the problem area was not, as I had believed, my piriformis muscle.  She did this by isolating my piriformis muscle: I lay on the table on my left, bent my right leg and raised my right leg up, while her hand applied downward pressure.  This maneuver apparently isolates the piriformis muscle, which ends up flexing out of the butt.  She poked around at that muscle, and I didn't feel anything abnormal.  The area where I felt tenderness was further outside--my glute.  So I guess Dr. Metzl was right, I just have a weak butt. 

So I've been working some exercises to strengthen it, although some of them don't really seem to be butt exercises at all.  One of them is a "pushup" where I lie on the floor and push my chest up while keeping my legs and hips on the floor, kind of like an Upward Facing Dog in yoga.  My favorite part of physical therapy is when she attaches the electrodes to my butt.  The electrodes make a tingling sensation, nothing like the EMG shocks.  She sets the machine for ten minutes, and I usually end up taking a quick nap while it makes my butt feel all warm and fuzzy.  Here's the machine:

The next day, Saturday, I went to get my MRI on my ankle.  I have to say, as great a doctor as Dr. Babiy is, the places she sends me to get imaging done are the worst.  For my x-rays, I went to a place on 17th Street, where I had to sit in the waiting room for an hour and a half!  This was during my lunch break so I thought I was going to get fired.  For my MRI, Dr. Babiy sent me to Union Square Diagnostic Imaging.  I appreciated how this place had evening and weekend appointments.  They were able to fit me in the day after I called them, for a Saturday evening appointment at 7:30 (yes, I was planning to spend Saturday night getting a magnetic image of my ankle).  Around 2:00 they called me and told me they were running ahead of schedule, and asked if I could come in at 5:30.  I gladly obliged.

Well, I got to the waiting room, and ended up waiting for an hour and forty-five minutes.  I was like, ripsh-t.  I mean, like, they f-cking tell me to get to my appointment two hours early only to wait in the f-cking waiting room for two f-cking hours to watch f-cking Animal Planet on the f-cking TV?!?!  I went like apesh-t at the poor receptionist there, who was the one who told me to come early.  Not one of my proudest moments.

The MRI itself went off without much incident.  Despite the completely unnecessary noise (like an ambulance siren combined with a tractor truck's backup beeps), I managed to fall asleep during the half hour long process.

Wednesday, I had another physical therapy appointment.  And although I did not have a separate appointment that day with Dr. Babiy, she agreed to see me after my PT to discuss my MRI results with me.  It's things like this that make Dr. Babiy such a remarkable sports medicine doc.  I can't imagine another doctor taking time out of their busy day to have an unscheduled meeting with me.  So here's another plug for her.

Well, the MRI results were not good.  I have a partial tear in my tibial tendon.  On top of that, a bone bruise cannot be ruled out.  Though she's not able to say for sure at this point, Dr. Babiy said that these types of injuries usually require about six weeks off from running.  I've already taken two, so four more to go...  Dr. Babiy also referred me to a foot and ankle specialist, Dr. Jessica Gallina, who will further evaluate and treat the condition.  She mentioned the possibility of wearing a boot.

What little information is available online about posterior tibial tendon tears does not give me great confidence.  It is also somewhat confusing.  This injury does not appear to be a common one in runners.  Instead, it usually occurs in sports that require a lot of lateral movement, such as basketball or tennis.  It could also result from a sprained ankle.  I vaguely remember twisting my ankle at some point after the NYC marathon.  But there's a possibility that I'm imagining it, or it could have been my other ankle, and I certainly don't remember it being particularly major.  My appointment with Dr. Gallina is on Monday, so I guess at this point, there's no real point to stressing over it.  It's worth mentioning that while all this is certainly bumming me out, I am glad I sought out Dr. Babiy for a second opinion after Dr. Metzl told me there was nothing wrong with my ankle.  I'll let you know what happens after my Monday exam.

Last week I went to yoga five times.  Yesterday, I realized that I need to get back to doing cardio, lest I continue to balloon up.  I went swimming for the first time in months.  Hopefully, by the end of six weeks, I'll at least be able to develop my stroke.

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I made a couple of chicken dinners over the past week.  The first one was a five-spice braised chicken and daikon that I made in my pressure cooker.  I just threw the chicken and daikon in the pot, along with some scallions, ginger, garlic, soy sauce, rice wine, Manischewitz, five spice powder, star anise, and sugar.  In the picture below, the daikon looks a little like scallops.  I recently discovered that I can make brown rice in my rice cooker, so I'm making an effort to eat more brown rice instead of white rice.  And I've been on a collard greens kick of late, so that made a nice pairing.

The next night, I made pan-barbecued chicken.  For the barbecue sauce, I used ketchup, soy sauce, sesame oil, grated ginger, sugar and Worcestershire sauce.  My cast-iron skillet did a great job at giving the chicken a tasty caramelized crust.  I served it with a vinegar-based nappa cabbage coleslaw (I was excited to use, for the first time in my life, coriander seeds in this), and some not-so-homemade Bush's Baked Beans.  Oh, and some leftover brown rice and collard greens.  Dessert was a delicious Betty Crocker carrot cake with cream cheese frosting.  Mmmmm......