PRP (Platelet-Rich Plasma) Injection and Recovery: Week 1
As I've mentioned in a couple of earlier blog and social media posts (like this one), I suffered a partial tear of the tendon that connects the hamstring muscles of my left leg to the sit bone (proper name: ischial tuberosity), likely during the Germantown Half Marathon on March 12 (at approximately 10.27 miles into the race, but who's keeping track, right?). I was having a PR day and felt amazing...until something went "pop" and all hell broke loose.
On Monday, June 26, I received an injection (or four) of a platelet-rich plasma concentration: the area of the tendon connection site (at the bone); a little further down the tendon, since that's where I'd been feeling the most discomfort; and, since he was at it, my doctor offered to hit up the tendons of the greater trochanter - those that connect the gluteal muscles to the hip joint - since I've had problems with this area since I was in high school. I left with four of those cute little circle band-aids and about an hour to spare before the anesthetic would begin to wear off.
The physician who provided this treatment was recommended to me by not only my orthopedic physician, but also four local running/cycling friends who'd received treatment from him in the past. He has an excellent reputation with several orthopedic groups because he's done his homework: he uses ultrasound to guide the injections into the areas that are most involved; he utilizes an anesthetic (ropivacaine) that has shown to inhibit the effects of the concentration the very least (so that you're getting all the benefits of the platelets and growth hormone without horrendous pain); and he understands that athletes want to get back to their sport so he is very honest, yet compassionate, about the appropriate steps to take following the procedure.
I'd already prepared myself for the worst experience possible, so the injection process itself was quite tolerable. I was positioned on my right side, so that he could have access to the injured side, on an exam table (and I couldn't see any needles!); there were certainly a few moments when I clutched the table but, thankfully, those moments didn't last long and it was somewhat relieving to know that he was hitting all the right spots!
Including the blood draw (to prepare the concentration for injection), the entire thing took no more than an hour; the injection part only lasted about fifteen minutes. During my initial consultation, I'd received information on the post-injection recovery process/timeline, but he went over all of that with me again, allowed time for me to ask questions ("When can I get back on my bike?" - GAH!) and scheduled a follow-up appointment in a few weeks.
Days 0-3, post-injection, are referred to as the "acute stage;" other than activities of daily living, and moderate walking around at work, etc., complete rest is required. This was not difficult, since I was quite sore during this time period. The first night was the worst, and getting comfortable to sleep was pretty difficult, but every day after I noticed consistent progress and felt much better by the end of day 3.
Beginning on day 4, Friday of last week, I started doing some upper body and core exercises, as recommended by my physician's plan; some gentle stretching is also advised at this point (to encourage blood flow more than flexibility), so I decided to go to a Yoga Lite (it's not just for old people, y'all) class on Saturday morning and begin the Jasyoga #jasyogajuly challenge.
There were a couple of times when I needed to modify poses but, for the most part, I had no trouble and my body felt better after the movement; thankfully, I had no soreness later that day or the following day, but I took it easy on Sunday.
By Monday, seven days post-injection, I was feeling semi-optimistic; while I was still experiencing periodic soreness (maybe due to prolonged periods of sitting?) in my hip/glute area, my left side felt really good while walking and doing general range of motion activities. I walked a couple of miles with Miles on Monday afternoon and, since I'd been cleared to get out on my bike "after 7-10 days," I was looking forward to a ride on Tuesday, the Fourth of July.
My plan was to go in to work early on Tuesday and then try to leave early and get in a nice afternoon ride; unfortunately, the forecast started looking pretty grim and I did NOT want to miss my opportunity. I decided to get up early, get out on the roads as soon as I had some daylight, and test it out.
I rode for an hour yesterday, just over 14 miles, and felt great; I stayed on a (mostly) flat route, as instructed, and made sure to pull back anytime I approached an incline or felt like I was exerting a little more effort than I should. It was so great to be back out there!
After yesterday's ride, I'm taking a rest day today; I'll be curious to see if I have any increased soreness/tenderness after that bit of activity and then I'll plan accordingly. While running is absolutely not allowed (too much load on the tendon) for at least four weeks after the procedure, I'm in no hurry to push things along; I feel like I've been granted a do-over for healing and recovery from this injury and I want to take advantage of it!
I hope you all had a great Fourth of July holiday; I'll keep documenting my progress as I, hopefully, work my way back to running and the Richmond Half Marathon in November!