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.

Volunteering with the UMT 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.

Finish line crew.  I'm the guy on crutches.

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.

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!