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Ischial Tear
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I am reaching out to tap in to the collective knowledge in the Womens Forum.

The past several years I have been doing expedition length adventure racing. I have had a variety of running injuries and most come and go. I have an ischial tear. I tripped trail running and caught myself before I fell. Apparently, not the best idea. I got a PRP (platelet rich plasma) injection at the end of September and am on week 8 of no running or biking. It still hurts just as much and I am super frustrated.

I have very religiously followed doctor's advice post injection, but I think the reality is that it is a very difficult area to isolate. Walking, driving, lifting anything, tug at the injury. Admittedly, I have been doing a lot of unavoidable driving lately and just realized that was not helping. I have upped my game and started wearing compression shorts all the time.

My first question; Has anyone else had this injury and have suggestions/advice on how to get better?

I am 54 years old and love to race. My life circumstances have changed a bit; I just became the primary caretaker for my 79 year old Mom with Alzheimer's. Mom is great and I love having her close to me now and not 3 hours away. This obviously impacts training and racing, but I am okay with that.

The other recent change is that my husband has decided that he wants to hike (no trail running lol) and mountain biking with me. We were doing this prior to my injury. It is awesome because I get to do my favorite activity with my favorite person. I don't necessarily feel that need to travel across the country and do a 6 day race.

My primary focus going forward is to be healthy and active.

Does anyone know a good resource or coach that could develop a daily stretching and core fitness regime?
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Re: Ischial Tear [DirtGirl] [ In reply to ]
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I had this issue about six years ago...it took a long tine to heal. partial tear where the muscle attaches to the ischium from trying to sprint on cold muscles.. Sitting in the car was torture. it would start to feel a little better and as soon as I would start to run it would re-aggravate after a mile or two.

What I think got me over the hump to healing was ultrasound from physical therapist. Also alternating hot and cold a few times daily seemed to work well.
Also, if you are a cyclist consider changing to ISM type saddle.

Good luck and be patient with yourself.
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Re: Ischial Tear [TricentralPA] [ In reply to ]
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I would also add that I did exercises with ankle weights that helped a bunch...again the p.t. set me up with the protocol...it was too long ago to remember the specific routine.
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Re: Ischial Tear [DirtGirl] [ In reply to ]
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I can't help but I am so sorry you're dealing with this and that it's not getting better.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Ischial Tear [TricentralPA] [ In reply to ]
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Thank you for the replies! Everything I have read says this is a pesky injury and can take a long time to heal. Blech.
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Re: Ischial Tear [DirtGirl] [ In reply to ]
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Totally biased, but I agree with the PT comment - and given the location and nature of the injury - it may be worthwhile to see a pelvic health specialist (we aren't just for incontinence!).

Have you tried walking in a pool or gravity reducing treadmill? May not be better, but it could be. If you were to try, I would try to get into water that is well above your hips, preferably chest area so that your hands can comfortably by in the water when you are walking and helping push you through.

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl
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Re: Ischial Tear [tridana] [ In reply to ]
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I just got the results from my MRI and I have a 60% tear of 2 of the 3 hamstring muscles from the sitbone.

I have a PT appointment on January 10th and and an appointment on the 30th with a surgeon. My ortho said the primary purpose of the PT is pain relief, the tendon won’t get better. The surgery and recovery are pretty brutal. It will take a year for full recovery and I may always have pain there.

My ortho said I can walk on the treadmill and do some core body workouts as long as there is no sharp pain. So I have taken full advantage of that! I am going into PT with an open mind. I feel a little bit better because I have a path forward.
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Re: Ischial Tear [DirtGirl] [ In reply to ]
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I had a guy with similar results and he was able to get out hiking and rock hunting again! So glad you have some answers and a path forward. Being on a path, even a long one, can be encouraging!!

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl
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Re: Ischial Tear [DirtGirl] [ In reply to ]
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I'm glad you updated us. I don't know anything about this, but I wonder if they could do a stem cell therapy of some sort that would grow new tendon cells. Have you posted on the main forum? It's great you can walk on the treadmill a bit.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Ischial Tear [tridana] [ In reply to ]
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ooooo, really glad you bring up pelvic floor. the suggestion being that OP was more likely to have a high hampstring tear (all 3?) if she had weak pelvic floor and too anterior pelvic rotation? And that improved pelvic posture will aid in her recovery etc etc.

I am stealing this TedTalk link from your FB feed :)
https://www.youtube.com/...dded&app=desktop

Anne Barnes
ABBikefit, Ltd
FIST/SICI/FIST DOWN DEEP
X/Y Coordinator
abbikefit@gmail.com
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Re: Ischial Tear [ABarnes] [ In reply to ]
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YES! please steal and share far and wide!

Regarding the OP or any of us with hip, low back, pelvis injury/pain...at least 1/3 of athletic women who have NOT had children report urinary incontinence during activity. The general prescription from the inter webs, general orthopedic PT's, etc is to do a pelvic floor contraction (kegel) - this is often not the best advice as often the pelvic floor is too tight rather than too weak. With an injury like the OP - there is always a chance at injury to the deep rotators, pelvic floor muscles, etc due to their home in the pelvic girdle.

Again, of course, I am biased, but I really think that many of these injuries can benefit from a perspective of a pelvic health PT and if the person is open to the idea a full internal assessment to ensure that nothing is being overlooked. (BTW - this applies to the men who may be lurking too!).

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl
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Re: Ischial Tear [DirtGirl] [ In reply to ]
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An important question to ask is, "what are the consequences if I don't get surgery?"

Surgery creates scar tissue, which has it's own set of consequences.

No coasting in running and no crying in baseball
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Re: Ischial Tear [tridana] [ In reply to ]
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I did have a supracervical hysterectomy 10 years ago. I’m not sure if that is a contributing factor.
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Re: Ischial Tear [Tri3] [ In reply to ]
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The ortho wasn’t pushing surgery. She was very clear that it was not a magic wand. I just don’t to be limited by this in the future. I am doing PT to see how much improvement in strength and movement I can achieve. Right now I can’t pick up anything slightly heavy without a sharp pull.
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Re: Ischial Tear [ABarnes] [ In reply to ]
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ABarnes wrote:
ooooo, really glad you bring up pelvic floor. the suggestion being that OP was more likely to have a high hampstring tear (all 3?) if she had weak pelvic floor and too anterior pelvic rotation? And that improved pelvic posture will aid in her recovery etc etc.

I am stealing this TedTalk link from your FB feed :)
https://www.youtube.com/...dded&app=desktop


Awesome TED Talk; many thanks for sharing! I have committed hundreds of hours and thousands of dollars in the last few years of my professional life to this subject. I like the subtitle, "poos, wees, and sex" which underscores that both genders share this problem. It's unfortunately when we have catastrophic failure that something gets done. Then it's a year or more in recovery. When I had a hamstring tear 15 years ago, it was 2+ years before I could run without a reminder of my injury and ***I believe*** it is a contributor to ongoing saddle sores on the left side only when I have a heavy (3+ hours) cycle training rides. It will be interesting to see what happens this year as I begin my biggest training push in several years. I have added Pilates (postural core training referred to in the TED Talk above) to my practice and I will post how my core changes. My posture has already improved considerably.

DFL > DNF > DNS
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