It has been 6 months since I got a green light from my doctor to start running.

Where I am today, Osteitis Pubis wise?

I started with light jogs back in September. I Started with 1min run- 1 min walk, 2 min run – 1 min walk, up to 10min run – 1 min walk, and eventually after a month, continuous 30 minute runs.

I ran my first race (5K) on October 18^th. My 25:28 time showed that I lost a lot of fitness.

After that race, I started increasing mileage. The image below shows my monthly mileage from September including first week of February.

September – December time frame, I felt all kinds of different itches and tickles in the lower abdominal and pubic bone area. Not the same as when I was injured, but I felt that something was happening. Like I have sport hernia or something similar. During regular visits to Dr. Sean, he explained to me that it was normal, and it would disappear with time. He was right, around Christmas time, I stopped paying attention to those pains, and eventually, they were gone. I could completely focus on running.

In January, my running group started a new training cycle. That meant running 5 times a week, with some quality workouts. In January I ran 230km (140 miles). No signs of Osteitis Pubis!.

In February I ran another race (8K). Chip time was 37:02, which is 1:30 slower than my PB, but still a decent time. I was back.

This is first week of March, my mileage should be around 55K (35 miles). No pain.

One very important thing is that during this time, I have been doing a lot of core and other physio exercises that I got from Dr. Sean. I do them 2-3 times a week and I think that is a key thing in me not being re-injured. I run much stronger and taller. No sore calves any more, I feel that I include glutes, hips and core muscles more in my running than before.

And something I did not do before, I spend 5-10 minutes after each workout to stretch.

As a conclusion, I have recovered. It took 10 months, this injury needs time to heal. Patience is very important, and physio exercises. But there is light at the end of the tunnel!

I am much smarter runner now.

Here is a chronology of my injury.

November 2014 – First symptoms that I ignored. Pain in lower abdominal when run.

Here is a list of symptoms that I had: 
– Pain in groin region, of both legs, core, adductors, between the legs 
– Rolling over in bed very painful, 
– Pain is present when walking, running, and when squeezing thighs together 
– Pain increases after sleeping, when I first get out of bed 
– Dull pain on top of the pubic bone 
– Cannot do a sit-up or lift both legs together 

December 2014 – Last run on December 7^th.

December 2014 – Visit to the family doctor and sport medicine doctor

December 2014 – Bone Scan test on December 18^th showed that I have advanced Osteitis Pubis

January – April 2015 – A lot physio, yoga, chiropractor, no running. Still OP symptoms present.

May 2015 – Started light running on my own, but it made things worse

June 2015 – Another Bone Scan test showed that I am getting better but not healed yet. Dr. Lee ordered no running before September.

July – August 2015 – Yoga, Physio, Dr. Sean physio exercises.

September 2015 – Tested running again, almost no pain. Dr. Lee told me that I was healed and that I can go back to running. Dr. Sean made me a plan to get back easy.

January 2016 – Ran 230km this month, no pain.

Here is link to my running log, with more details about my comeback workout program and my everyday running:

My Running Log

So, that is my Osteitis Pubis story. Now I have to be smart, listen my body, keep doing physio, stretching after workouts. And enjoy running.

I just came back from Dr. Lee, my Sport Medicine doctor. He gave me a green light to go back to jogging and after 2-3 months to some serious running. He said that the bone is healed, and his work is done. He advised that I can go back to running, but not to run 2 sequential days for the first couple months.

So that is great news, but where do I go from here?

For the last 5-6 weeks I have been working with Dr. Sean Delanghe, a local chiropactor and a running coach. He is helping me with my lower back problem, but also he is going to write a program for me to get back to running. The plan is to start with some light jogging, like 10 x 1min run, 1min jog, every other day. Depending how my body responds, we will keep adding or cutting run time. Program will include some physiotherapy to address the back issue. I definitely need some plan that will keep me from pushing too hard that I tend to do.

Sean is a great guy and great coach. More importantly, he understands both, runner’s mind and runner’s body. If there is something good that came out from this injury, it is a chance for me to work with him. More info about Sean and his running club here: http://coachinghealthandperformance.blogspot.ca/

I am so looking forward to building some mileage, so I can finally rejoin my friends from Runners By Choice running group. I miss those Sunday’s long runs and chatting with my fellow runners.

Life is good!

Today is 9 months since my last run. 9 months without running, but I think that I am ready to come back. I did a couple test runs last week, 3-4km each. No pain during any of those runs, just some itching to the left and right of the pubic bone during cooldown walk. After the runs, a day later, I felt some burning in the perineum area, but nothing around the pubic symphysis. The burning pain is triggered by longer sitting (as usual), looks like it has nothing to do with running and is not related to Osteitis Pubis. It is probably result of a pinched nerve in my lower back (L4-L5-S1) as the MRI I did 2 months ago showed.

I am going to see Dr. Lee on September 23rd. Meanwhile, I am starting to run every second day, 1 minute run – 1 minute walk, 10-12 times. It really feels great to be pain free!

Waiting for an injury to get healed is a very boring and frustrating process. I found that I spend a lot of time browsing the internet, looking for other people’s experiences. The problem with Osteitis Pubis is that there is not much information available.

But the other day I found a blog from a guy from Australia. His story is almost identical to mine. New runner, pushed too hard, too much too soon, ran 100km a week for a year or so. Eventually his body broke down and he got diagnosed with Osteitis Pubis. His recovery process looks similar to mine too. He was close to my age when he got injured.

Here is a link to his blog, there are a couple posts related to the injury. I will post them here, but I will provide the link too. He explains what he did wrong and how he changed the way he trains. The best part is that he ran a marathon 18 months after the injury with 17 minutes PB.

http://www.coolrunning.com.au/forums/index.php?app=blog&module=display&section=blog&blogid=520

And here is Andrew’s main 2 posts:
Osteitis Pubis – Does This Spell The End Of Your Running Days……no Way !
Posted by Android , 06 July 2011 – · 822 views

12 months ago I thought my running days had come to a very abrupt and permanent end when I was diagnosed with a condition called Osteitis Pubis (OP).

Osteitis Pubis is an inflammation of the pubic symphysis, which is the joint at the front of the pelvis between the two ends of the pubic bone causing both acute and chronic groin pain. The condition is prevalent among footballers but is also known to affect runners and given that there is no specific treatment for the condition it can seriously hinder the careers of sports people affected by it.

Many of the stories you read from people who have been affected by this do not have a very happy ending so I held off on telling my story until such time as I was 100% sure I had completely recovered and could share with you all a rare “there is light at the end of a painful tunnel” story.

How and why I got it:
In 2009 I was averaging 100km plus per week in run training and was doing at least 2 races a month…..and nothing else (the “nothing else” part is the big lesson I learnt from the experience). About one week out from the Sydney marathon in late September 2009 I started to feel sharp pain in my lower abdomen and, needless to say, I ignored it and ran anyway. 7 weeks and 4 more races later the pain was becoming unbearable and my race times were dropping off dramatically. The worst pain was right at the start and after the finish of a race so I convinced myself that it was nothing to worry about if it didn’t force me to pull out of a race.

What next ?:
After a visit to my physio around mid November 2009 I was told to stop running immediately and I was given the depressing news that I had developed Osteitis Pubis which meant a very long rehabilitation, the possibility of surgery and the chance that I may not be able to run again. Given my stubborn ignorance of the pain, the condition was pretty well advanced by this stage. One thing you don’t think about is that the person treating you not only has to be highly skilled in curing the physical injury but also has to be a good sports psychologist who can keep you focused on committing to the rehabilitation program. My physio, Sean Cooney, put together a very detailed program for me starting with very light core, hip flexor and glute exercises which gradually increased in intensity as my strength grew and the pain subsided. He also gave me a list of activities that I could do which wouldn’t aggravate the injury such as bike riding, swimming and my “pet hate”, visiting a…….gym !

The path to Salvation:
Rule number one, you can’t sit back and expect the physio to do all the work, it’s up to you to follow the program and do the exercises EXACTLY as they explain/demonstrate.
Rule number two, learn to variate your training to focus on different muscle groups. As much as I hated going to gyms I caved in BUT chose one that was all about one to one personal training, not a “take your money and look after yourself” styled gym. My PT also communicated with my physio to make sure he understood the do’s and don’ts with my injury.
Rule number three, if you enjoy running, you’ll LOVE riding. Buy a good bike and watch the experienced riders struggle as you blast them on the hill climbs. Good runners make great hill climbers and I experienced no pain at all in the pubic region while riding.

What happened next ?:
After 6 months the pain had subsided significantly so in June 2010 I was given permission to “test the waters” and do a short 10km race to see how the pubic symphysis felt. Only 1:40 slower than my 10km pb and no serious aggravation was a great sign that things were progressing well but we agreed there was no point in rushing back yet and settled back into the rehabilitation program for the next 2 months. Before I knew it was September and the race that first gave me signs of the injury, the Blackmores Sydney running Festival, loomed on the horizon. It was time to test the waters again so I entered the 9(ish)km bridge run and BOOM !! 32 minutes later and 64th outright I was back in business !! With only very small niggling discomfort from the pubic symphysis it was time to seriously ramp up the training but I tried a new approach of high intensity VO2 max gym sessions, riding/running brick sessions and much less km’s in the running shoes (about 20 to 30km max). I also took the opportunity to get some running analysis done to study my technique and make some changes to be more efficient and less injury prone (what better time to learn how to run all over again !).
Since then I have done at least one race per month, between 21.1kms and 30kms, with the Sydney Marathon Clinic club, the Sydney Morning Herald Half Marathon and last Sunday I had my big marathon comeback race at the Gold Coast. Since October last year I have not experienced any aggravation at all from the injury…..GONE !

So what did I learn from this experience ?
1) Big weekly km’s do not always make you a faster runner, just a tired and injury prone one !
2) Strong legs alone don’t make you a good runner. Strong legs and a stronger core makes you a better runner.
3) Variating my training program has increased my general fitness and has made training more enjoyable.
4) To run a marathon you don’t need to train like it’s a marathon.
5) Don’t assume that gyms are solely for people who want to pretend to be fit.

Then and Now:
Half Marathon pre injury pb: 1:24:01 (August 2009)
Half Marathon post injury pb: 1:20:05 (May 2011)

Full Marathon pre injury pb: 3:12:37 (September 2009)
Full Marathon post injury pb: 2:54:51 (July 2011)

Hopefully my story inspires people to stick at it and not give up when they think that an injury has destroyed any chance of achieving their goals.

You can come back stronger, fitter and faster !

Second Post:

My Running Life – The Road From Obsession To Ruin And Back To Riches !
Posted by Android , 06 July 2011 · 667 views

Having completed my fifth marathon and my first since injuring myself back in late 2009 inspired me to look back on the road travelled to get to where I am today.

A borderline obsessive approach to running in 2008/2009 pushed me to the point of physical destruction and left me with a repetitive strain injury know as Osteitis Pubis (explained in detail in one of my other blogs). The injury completely wrote off any chance of serious running until late 2010. Once I knew I was on the road to recovery there was a great deal of soul searching and advice seeking to find a better way of doing what I love !

First of all, the days of 100kms running per week (and nothing else) were cast aside. In its place, a more balanced and varied training program was adopted but I needed help to do this. My physio, Sean Cooney, was the foundation of this new approach and introduced my to two new obsessions, riding and using personal trainers/coaches.

Riding was an easy progression when you have a brother (Trevor Smith) who is probably more devoted to riding that I am to running. Trevor used his wealth of knowledge to leapfrog me from being a relative beginner to a hill climbing Contador killer in no time at all. In fact the transition from runner to rider was so effective that I often wondered whether I’d bother going back to running again. Fortumately I now have a fascination with both sports !

The other huge turning point for me was Seans suggestion that a visit to a gym could do no harm with my rehabiliation. Exercising under a roof, I thought, you’ve got to be kidding !!!. I did however recall an amazing destiny driven encounter I had while running the 2009 Blackmores Sydney Marathon.  Something I enjoy doing while running a marathon is maintaining a “conversation pace” to keep your composure and heart rate under control. You just have to be very careful not to chat with people who don’t adopt the same strategy ! I struck up a chat with a Vision trainer called Jarrod Smith and for the next 20kms we developed a friendship that can only happen while running a marathon. To cut a long story short I contacted Jarrod after the race and next thing I know I’m training in a manner that I never thought was humanly possible. When Jarrod says, “I’ll get you to your Vo2 max and THEN start working you hard” you’d better believe him!

With these two new disciplines added to the training program I had the benefit of endurance conditioning with the riding and all round body strengthening with the V02 max sessions. Most importantly the chances of injury were significantly reduced and allowed me train with the same intensity.

A number of other changes contributed significantly to my personal “ruin to riches” story:

– Rather than entering every single race on the calender, I was far more selective in the races I chose to compete in and I also did my first full season competing in the Sydney Marathon Clinic clubs races which is a combination of monthly half marathons and longer races throughout the summer “off season”.

– Nutrition, between AND during races took on far greater importance. Many of the energy gels did not agree with my stomach but after plenty of experimentation (another great thing about doing the SMC series) I found that the SIS brand of gels suited me perfectly as the flavours were not overly sweet and, being a diluted isotonic gel, they were not as concentrated and were far easier to digest with or without water.

– My physio, personal trainer, massage therapist and many fellow runners were staggered by my lack of fluid intake. I have now gone from drinking less than a litre of water per day to comfortably consuming over 3 litres per day, with noticable results. I also realised that the 5 seconds you saved not slowing at a drink station during a race often resulted in losing over 30 seconds per km at the back end of a race. Slowing down at drink stations was a far better option that falling to pieces late in a race !

So, a typical training week prior to the injury would have been:

Monday: Run
Tuesday: Run harder
Wednesday: Run hardest
Thursday: Run tired
Friday: Try to run
Saturday: Run all day
Sunday: Run in pain

After a complete change to my training a typical week now looked like:

Monday: Rest day
Tuesday: AM Vo2 max gym session
PM Gentle run
Wednesday: PM Gentle run
Thursday: AM Vo2 max gym session
PM Gentle run
Friday: AM Core gym session
Saturday: Long ride/short run
Sunday: Longish gentle run

How much did this change my performance ?

My personal best times over all distances have improved significantly but the defining moment was at this years Gold Coast Marathon. The faster you go, the harder it is to drop your times by the same margin but that could not have been further from the truth in my case:

2008 Sydney Marathon 3:33:46
2009 Canberra Marathon 3:21:45 Margin gain 12:16
2009 Gold Coast Marathon 3:12:45 Margin gain 8:45
2009 Sydney Marathon 3:12:37 Margin gain 0:08
2010 Out of action !
2011 Gold Coast Marathon 2:54:51 Margin gain 17:46