Saturday, September 13, 2014

Fracture rehab, Sept 13

My  physical therapy is progressing. Around a month ago some muscles that I'd had trouble getting to fire -- notably the right glute-- "woke up" and I fairly suddenly became able to do 1-leg glute bridges.  The PT started me on hamstring curls, dynamic lunges, and some other exercises designed to more aggressively work the hip abductors, hamstrings, and glutes-  including "monster walks"-- walking  with a tight rubber strap wrapped around my legs stepping 45 degrees out and forward to the right, then to the left, etc;  and side steps wrapped the same way.  The most effective of the exercises seems to be the dynamic lunges, which leave me sore the next day.

Two weeks ago I had another set of X-rays and the orthopedic surgeon told me he can no longer see the acetabular fracture in the X-rays.  The PT started me on the treadmill with a  0.5 mile slow run;  yesterday I did a 1 mile slow run.  It felt OK.  The injured right side has soreness in the glute primarily.  I remain focussed on improving flexibility with hamstring and quadriceps stretches 2 or 3 times daily, as well as TFL "stretches" using a tennis ball to roll tender spots.  The latter has helped to reduce pain and tightness on the anterior of the hip joint.

Ive been getting out and walking 2 miles per day most days.

I've also been continuing my eccentric heel drop exercises to restore calf strength and deal with soreness in the achilles-  the good leg got beat up from doing all the work while I was on crutches and the bad leg was just weak from lack of use.  These exercises are done typically with 3 sets of 15 on each leg, with both straight leg and bent leg.  The  progression thus far has been:

Week ending July 28:   heel drops, no weight, 1x daily
July 31-> 2x daily
Aug. 9->  2x daily with 25 lbs
Aug. 21-> 2x daily with 33 lbs
Aug. 30, 2x daily with 41 lbs
Sept 11, 2 x daily with 58 lbs
Sept 13, increased reps from 15 to 25

I started working at the office last week.  The folks at my workplace had a little "welcome home" party for me and being there with these people, some of whom have been friends for 25 years, really lifted my spirits.  The only issue I've had working in the office is that sitting is uncomfortable -- meetings are a bit painful unless I stand.  Its good to be recovering a bit of normalcy in my routine.

Sunday, August 10, 2014

Hip rehab status, plans looking towards 2015

I've been in physical therapy for two weeks now.  Since beginning weight bearing on July 22, following 7 weeks on crutches due to my pelvic (acetabulum) fracture, I've faced these challenges:

1.  Right calf and arch weakness from non-weight bearing;
2. Left Achilles irritated from having my left leg do all the work for 7 weeks;
3. Walking with a limp due to difficulty straightening out my right leg and hip  due a very tight hip joint;
4. Incredibly weak right hamstring and glutes.

To deal with 1 &2,  I began a program of eccentric heel drops on both sides (http://fredippides.blogspot.com/p/since-oct-31-i-have-been-doing-twice.html) particularly to strengthen the calf and arch of the foot on the right;  and at the same time to rehab the achilles on the left, and strength the achilles on the right to prepare for a return to running later this year.   The right calf muscles were really weak at the start:   I couldn't do a full set when I  started out.  Beginning with a set every other day, by the end of the first week the calf was extremely sore.  The second week I started one set each day;  the third week I began two a day sets.  This week I have begun adding weight-  25lbs in a backpack.  Its progressing nicely.

The more serious issue is 3&4- walking with a limp due to tight hip joint and weak/atrophied glutes and hamstrings.

My PT has had me doing the following exercise and stretches:

1.  Two-leg Glute Bridges, 3 x 10,  for the glutes, hamstrings and lower back:  (http://backandneck.about.com/od/exerciseandsport/ht/Lower-Back-Exercise-Strengthening-Your-Back-With-The-Abdominal-Bridge.htm)

2.  Standing hip clams with a rubber strap.  Started with 3 x10;  progressed to 3 x20;   2x daily.

3.  Standing hip extension exercise with rubber strap:   3 x 10,  2x daily.

4. Supine Straight Leg Raises (3 x10, 2x daily).

5.  Hamstring stretches-  lying on my back, using a strip of webbing to pull my straight leg up, 3 x 30 sec,  2x daily.

6.  Quad stretches lying on my stomach (prone), with strip of webbing looped around my foot to pull it up against my butt.  3 x 30 sec 2-3x daily

7.  Calf stretches on ramp, 3 x 30 sec 2x daily.

7.  This week:  Started 1-leg Glute bridges.

The most difficult of the exercises above has been the glute bridges.  It is somewhat akin to trying to wiggle my ears:   my right glutes don't seem to want to "fire".  The right glute is noticeably smaller than the left;  I suspect the issue has to do with the surgical wound required to access the acetabulum to perform the ORIF surgery.

My PT has therefore directed me to do glute squeezes:  Both glutes together, then one-sided. lying down --to keep the buttocks safely shielded from view for the benefit of all concerned -:).  This seems to have been working as I am finally getting the right glute to "fire" and the muscle is sore.  A good sign that I am finally getting access to the muscle to strengthen it.

I am no longer walking with a limp!

I will continue these exercises  and assuming things continue to progress I will start walking in a month.  My program will focus on walking through the fall and hopefully I'l  be able to start running by Juanuary in preparation for the 2015 ultra season.

Saturday, August 9, 2014

Volunteering at the 2014 AC100: A great consolation prize for my DNS

Idlehour A/S, Mile 84 of the AC100.  Photo credit to Scott Applebaum

Last weekend I had an absolutely  fabulous time as a volunteer with the Ultra Medical Team at the 2014 AC100.  Although I'd have preferred to be racing, and hated the fact that circumstances forced me to DNS, it was a heck of a "consolation prize" to be able to contribute to the race, to hang out with running friends,  and I made many new friends at the race.

I had been training to race again this year but on May 31, during a training run, I took a freak fall and fractured my pelvis  (http://fredippides.blogspot.com/2014/06/training-run-gone-bad-self-rescue-with.html).  I was fortunate in that I was able to hike out and get to the ER;  the next day I underwent surgery ("ORIF") to have by acetabulum (hip socket) screwed back together.  Three weeks ago I was given clearance to bear weight, so volunteering at the race was ON.  I used my crutches anyways since I'd been counseled to not over-do the weight bearing:  As I could walk about 15 minutes on the leg before it started hurting,  I was very careful not to overdo it.

My primary responsibility at the race was to arrange the logistics and set up of two new medical stations at the Cloudburst Summit (Mile 37) and Idlehour (mile 84) aid stations.  In addition I was detailed to Idlehour for the evening-  this being near the scene of my accident-  how ironic is that?

On 9am on race morning I rendezvoused with Nick Nudell, the Medical Director, at Vincent gap  to see how the med stations go together and to pick up the gear to set up Cloudburst Summit's medical tent.  Heading out to meet the medical team at Cloudburst, the Venture Scouts had the tent set up for us in no time.  My medical team-mates included Mike, an ICU nurse, and Melissa, a ultra running fire-fighter/EMT, and my good friend Brad Harris, MD.  Brad and I shared some of the best miles of my running career at last year's AC100, when we tore out of Three-Points together to Hillyer at a blistering pace, making the leg to Hillyer in 1:06, tying for second fastest split of the day, en route to  silver buckle finishes for the both of us.
With my pal Brad Harris at Cloudburst Summit

The weather was so unusual on race day.  Cloudburst was positively chilly and we donned windbreakers and jackets, such a contrast to the furnace that Cooper Canyon and Cloudburst usually shape up to be on race day.  It felt more like being in the Rockies prior to an afternoon shower.

After Cloudburst Summit A/S closed we broke down the station and packed it up in Mike's truck to ferry it around the front range to drive up the Toll Road to Idlehour Aid Station.  Joining up with a fresh crew of first aiders (Ty and Dorothy) Mike and I arrived around 8pm and got the medical tent set up in the waning daylight and settled in for the evening shift.  The Idlehour station was amazing:  What a great, fun, and well-prepared crew:
Idlehour A/S crew.  Photo credit to Scott Applebaum
I had a blast helping the runners as they came through through the night amid the intermittent rain squalls.  I saw my friends Jason Emberger, Vincent Juarez, Tim Hendricks and many others.  It was terrific to see Ruperto come hauling through in the lead, in a front row seat up at Idlehour!   My friend Larry Rich came in in the early morning paced by John Chin -- it was so great to be a part of their race:

The vast majority of the runners showed great respect for the race volunteers.  All in all, a wonderful time and a great way to take the sting out of my DNS this year.

I find myself reflecting on the fact that the majority of the aid station volunteers I met at the race were not ultra runners let alone AC100 vets.   The acrimony that occurred on the AC100 Facebook page this week  really stood out, conveying a bit of a sense of entitlement by us runners.   (For the record, I too would like to see some changes like a waiting list, so that I could have handed off my spot when I pulled from the race in early June).  By contrast I saw all weekend a quietly selfless attitude of service among the many  volunteers that I met out there giving their entire weekends to support us ultra runners in what really must be acknowledged to be an  immensely selfish quest to run the race.  Most of these volunteers have never run AC100 nor can ever hope to do so.  How Ken and Hal have assembled such a group of good hearted, selfless and committed volunteers, just amazes me.   These people seem to me, after this wonderful weekend, to be the true heart and soul of the race.

For this insight I have my accident to thank and I am grateful for the new perspective.    In the future if I am shut out of the sign up process I hope I will find the grace to show up again as a volunteer to continue to be part of this wonderful institution.  It was (almost) as fun as racing.

Friday, August 1, 2014

Good luck AC100 runners!

 Tommorrow at 5am the gun will go off in Wrightwood starting the 2014 Angeles Crest 100 mile Endurance Run.    I wish all the runners good luck and if you should chance to read this I hope you run to the best of your potential this weekend!

 I have a race number waiting for me up in Wrightwood but I won't be claiming it, having fractured my pelvis in a freak accident while on a training run back on May 31 (http://fredippides.blogspot.com/2014/06/training-run-gone-bad-self-rescue-with.html).

Instead, this year I will be helping out the Ultra Medical Team with logistics and set up.  I'll be the guy out there handing out water wearing a silver buckle (!) and walking with crutches.  (While I am cleared for weight bearing, I don't want to overdo it;  long periods standing or walking tend to irritate my hip so I'll be playing it safe).    I'll be setting up at Idlehour, my favorite wilderness sports injury site.  How is that for irony?

   A year ago today my crew was gearing up to help me with my AC100 race,  and I was wigging out up in Wrightwood.  But it all came together and God graced me with one of the best days of my life: http://fredippides.blogspot.com/2013/08/angeles-crest-100-race-report-.

It is amazing how fast a year goes by, and yet its sobering how much can happen.  Today, my good friend Richard Peck is on my mind.  He was so excited to come up and crew me last year.  Just last February he was diagnosed with cancer and he passed on July 1.

All this reminds me how ephemeral life can be.  There is an ecstatic aspect of life, as exemplified for me by my experience last year of running 100 miles across the San Gabriel Mountains in a day.  I look back on some of the best miles I ran in that race, like the blistering stretch out of Three Points with my pal Brad Harris, the last 25 run with my pal, pacer Joe Tholt, and the experiences sharing that ecstatic race with my wife and kids and crew -- it was so fantastic!   I am mindful that one day one can wake up and find such opportunities severely circumscribed -- so grab onto it while you can!  Enjoy it with your friends and loved ones!

A friend asked me earlier this year if I might pace him at a different 100. I waffled due to various commitments and then the opportunity was taken away by my injury.  I'm sobered by this and  hope that next time I will have a right perspective and seize such an opportunity without hesitation.

I am getting preachy so its time to stop writing.

Good luck runners!  I hope I see you out there!

Tuesday, July 29, 2014

Let the PT begin....

Having been given the clearance to put weight on the fractured right leg last week,  I was cleared to begin physical therapy to restore range of motion and general conditioning to restore muscles weakened by 7 weeks of inactivity.

I immediately set out to make a PT appointment but backlog made it impossible to secure an appointment until yesterday.

This one week delay was probably a good thing.  Initially, simply walking on my right leg tired the weakened calf muscles, quadriceps, and the bottom of the right foot.  Despite all the isometrics exercises that I had done,  it turns out that there is simply no substitute for weight bearing to maintain leg strength.  So, for example, whereas before the accident I was routinely doing sets of 25-30  heel drops on one leg with 85pounds on my back;  last week I could not raise my body weight once on the right leg, my right calf having become so weak.

In any even,  after assessment the therapist gave me a home program of:


  1. Hamstring stretches, lying prone, using a length of webbing with a loop tied in the end to capture my foot (as opposed to doing bent-over toe touches, which irritate my right hip).  3 x 20 sec
  2. Calf stretches on ramp or leaning against wall, 3 x 20 sec
  3. Quad lifts, quad locked, lying on my back, 3 x 10 rep
  4. Hamstring/glut bridges starting on my back with knees bent, 3 x 10.  These I find to be REALLY difficult much to my surprise.
  5. Standing hip clamshells with elastic loop around legs 3 x 10
  6. Standing hip flex, w/ elastic loop around legs, 3 x 10
All of the above, twice daily followed by icing.

Also, last week I started eccentric heel drops, no weight;  3 x 15 straight leg, 3 x 15 bent leg, every other day.  This week I am increasing the frequency to daily.  On the right side I cannot do 15 reps with straight leg so I cut the reps to 10.  I will increase to twice daily as soon as the right leg can do  compete sets in control.




Monday, July 21, 2014

No more crutches!


Today I got my 6 week check up:  X-rays look good says the doc.  He gave me the OK to put full weight on the fractured leg-  No more crutches!

It felt extremely strange walking on the bad  leg;  the calf and quad are very weak and my arch  and heel are sore and tender after 7 weeks without weight since the surgery.  But I walked around the block with my wife and daughter!

Friday, July 18, 2014

Richard Peck, Rest in Peace




 My friend Richard was buried yesterday.  He had been diagnosed with an aggressive cancer back at the end of February.  He passed on July 1st.  


I met Richard back in 2011 when he took his son Nick and his other Webelos to check out Troop 4.  Richard struck me as no-nonsense, and a little gruff as he sized me up; we hit it off and he jumped right in and was right there working knots with the boys.  A few months later Nick and Richard joined our troop. 

Richard was absolutely devoted to Nick.   He and Nick went camping at the beach and he taught the boys first aid;  we went camping in the local mountains, and he helped the boys make the most shocking pagan war flag, it was awesome.   Richard often told me how excited he was about Nicks growing confidence and independence and sense of self empowerment.   Richard  helped out everywhere and the boys and the adults loved him.  He was salt of the earth.   He taught cooking  and pulled my introverted son into it;  they shared a love for Penzey’s spices.    Richard gave us his chile verde recipe. 

At Bandido a couple years ago Richard helped me out with a climbing program.  He was off belaying other boys while I taught  Nick how to rappel.  Richard was so proud of Nick for taking that on.  He wrote me later that  he “could see a sense of pride.... No false bravado from him....Bravery is accepting that you are afraid, and pushing forward in spite of that. One of the best emotions in life is laughing through tears...:. Or grinning while physically shaking .... Good stuff !!”  We went out on our own and climbed and rappelled at Horseflats; Richard belayed me while I tackled the crack at Romeo Void over and over until I got it.   I was pretty scared on the crux of that little climb but Richard had me on belay until I got it.  Richard loved all this so much he got his climbing instructor card.  He took Nick out on  his final instructor’s exam -  where Nick got to show off some ‘special’ techniques on a 70 foot rappel!  Richard was beyond proud of  Nick for how he handled this;  he told me that most of the adults had bowed out (it was very high “pucker factor”).   The last time we climbed was after the Angeles Crest 100 last year (where Richard crewed me, along with my wife, brother, and a couple of other close  friends)  when Nick and Richard and I went up to practice anchors and rappel rescue at Horseflats.   We looked forward to climbing and exploring more up there.  We wanted to scope out the scary 80- foot Toprope wall, but we never got the chance.   



I trusted Richard  and that trust extended  from the rock into some hairy stuff in the real world.   He was real.    We tried to be on our  best behavior around the scouts and I for one had to work hard to keep my language clean.   But I loved the fact that when we were together  without the boys his language could sometimes blister paint -- I felt like I could breath around him.  Richard became my close friend and confidant.  When I got  upset at people places or things, he would just listen, wouldn’t judge, but would tell me that he wasn’t going to put any bullets in my chamber.


About these adventures, Richard once wrote to me, “We all have a ‘golden window’ in life sometimes, to do things we haven't done before, and may not be able to do again in the future. This is one of those opportunities for me…”  I read those words now and they seem prophetic and leave me speechless.   His time was too short and I miss him.