The Sounds of Silence

“No more running.” – Orthopedic Doctor

“For how long?” – Me

“No. More. Running.” – Orthopedic Doctor

Silence.  Shock.  After that he went on the give me the medical term for what you see below at my L5/S1 disk.  I have no recollection what he said, because I couldn’t get past those three words.

MRI of my lumbar spine
MRI of my lumbar spine

If you’ve read this blog recently, you know that I had been struggling with some hip/glute pain since last fall.  It all came to a head in the Houston Marathon in January.  So after I got back from Houston, I decided to get the hip healed up before I set off on my next training cycle.  But I didn’t know exactly what the problem was, so I decided to head to the sports medicine doctor and find out.  After an X-ray that didn’t show any particular issue, he decided it was very likely ITB syndrome and sent me home with anti-inflammatories and told me to take it easy on running.  The pain subsided after about two weeks, so I started to run again, but as soon as I got to any decent pace, the pain returned.  I decided to get some chiropractic attention too, and with that got a different diagnosis:  gluteus minimus.   With the pain continuing, I decided to stop running altogether and get my aerobic fix by cycling until I could run again.  After a few weeks of this and no difference in the pain, I decided to head back to the orthopedic guy and push for an MRI.  I know I’m not the most patient guy around, but I also hate not knowing what the real cause is.

After fighting to get them to prescribe the MRI (they wanted to do an ultrasound), I finally got it scheduled on March 9.  Three days later I was back to the doctor to see what they found.

“I’ve got good news and bad news.  The good news is that your hip looks great!  No problem there at all.  However, in this MRI we see a small bit of your lower spine and that L5/S1 disk doesn’t look right.  It should be white like this other one, but it’s all dark.  Because we weren’t aiming specifically at your spine, we need to get you back in to get a lumbar spine MRI.  The nerves from that area of your spine head right down into the hip area, so it’s not surprising at all that you’d feel the pain there.  If that disk is damaged it could be impinging the nerve.”

OK, no real worry yet, but I don’t like the sounds of this.  I was lucky to get the spine MRI scheduled for the next day, March 13, so there I was, trying to lie still once again.  It’s a good thing I’m not claustrophobic.

On March 18th, I saw the doctor again.  If you look at the picture above, you can follow along.

“If you look at L3, you can see what the spine and disk should look like. Smooth lines all around, everything lining up with one another, consistent coloration.

If you look at L4, you can see the beginnings of deterioration. Not too bad yet, but heading in the wrong direction.

If you look at L5/S1, you can see where the problem is. The padding in between is almost completely gone, and in a few places you’re already bone on bone.  Even where there is still cartilage, it’s pretty damaged. Also, you can notice that the spine bones on top and bottom are no longer in alignment. The one on the bottom (S1) is actually impinging on the column upward. That area is no longer stable because it’s out of alignment and the cartilage in not holding it in place.  That instability is a real issue.”

I need to see a spine surgeon to what can be done.  He said they may suggest getting the bones fused to help stabilize the area, but it’s not certain.  But then he repeated that I should be prepared to hear no more running.  Ever.

I still haven’t come to terms with this news.  Honestly, I’ve been struggling with it since that day.  I’ve gotten to a point where running is not just something I do, but it’s part of who I am.  And I like that.  I want that.  I’m not ready to give it up, so I’m going to push and push until someone gives me an answer that doesn’t include stopping completely.

The story is not over yet by a long shot.  But after brooding about it for a couple weeks, I had to get it out.  It is as much a part of the running journey as any race result is, so it deserves a post.

Last night, I laughed at a funny note a friend of mine sent me and my wife said, “That’s the first time I’ve seen you smile in weeks.”

Worrying in silence doesn’t help anyone, including me.  It’s time to move on.