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I stopped doing any aerobic activity (stationary bike, recumbent bike, elliptical) since my last doctor’s visit. I just want to follow the doctor’s advice and give my body time to heal. I got the same advice from Dr. Wang, a traditional Chinese medicine doctor, who I visit for acupuncture sessions.

I am still doing core/pelvic/hips strengthening exercises and a lot of stretching, mainly through yoga. I noticed that I can do lunges without pain now, although I am not doing them, I feel like it is pushing too much.

I am waiting patiently July 20^th, when I have an appointment with a pelvic floor physiotherapist (www.abodyinmotion.ca), who is supposed to be really good. Pelvic floor area is where I really have most of the pain, that I start feeling after longer sitting.

Registration for new session in my running club was last Thursday. I went to see my coach Michele. I met a couple other running buddies. I really miss running and all the excitement with that.

This week is 6 months since my last run. I went to see Dr. Robert Lee. He sent me for a Bone Scan test again and asked for test to be compared to my test from December. The results came in. Here is what the radiologist doctor wrote:

Exam Date: June 8, 2015

“The delayed planer and SPECT images do demonstrate a persistent mild increased activity at the symphysis pubis but this does appear less intense on the SPECT images compared to the prior December 17, 2104 study. The prior slight extension in the adjacent medial superior right pubis ramus is no longer seen. No other significant new focal abnormalities are present.”

I improved, but Osteitis Pubis is still hanging around. On a scale from 1 to 10, if I was 10 in December, I feel like I am 4 today. Dr. Lee advised that I take another 3 months off running. Meanwhile, he sent me to see a Pelvic Floor physiotherapist, because, all my dull pain moved from the Pubic Symphasis to pelvic floor and lower abdominal muscles. Just to clarify, I feel this pain only when I aggravate it by longer sitting. Otherwise I am pain free.

So, I see this as good news and a bad news. Bad news is that I have to be patient. Good news is that I am making progress and eventually I will be healed. Meanwhile, I will do yoga, core exercises, swimming, recumbent bike. I am still not sure if I should use a regular bike, I will decide that after seeing the pelvic floor physiotherapist. I have scheduled an appointment for July 20^th at “A Body in Motion” clinic in Waterloo as recommended by Dr. Lee. Looks like a very busy place, I will have to wait over a month.

I am definitely getting better. I think that the worst is mostly behind me. The only issue I have now is dull pain in lower abdominal when I sit for a long time (1 hour or longer) or when I run.

I started doing 45 minute interval workouts on a stationary bike, 2-3 times a week. No issues there. But the test run from 3 days ago showed that it will still take time before I start running regularly. I ran again today, a bit longer intervals (1-3 minutes). No pain during the run until last 3-4 intervals when I felt that dull pain in lower abs, 2-3″ above the PS. Now, 8 hours after the run, I feel some itching around the PS, I hope this will disappear by tomorrow. But in general, it is better than a week ago.

Last week I visited a traditional Chinese acupuncture place. I have not noticed a difference after the treatment. I am going again today and probably next week. I want to give it a chance.

I am actively looking to buy a road bike. I want to use biking as an alternative to running this summer.

I attended a conference on Monday and Tuesday this week. No exercises in those 2 days but I spent most of the time sitting. As a result, that dull pain in lower abdominal came back. It was still there on Wednesday and Thursday, but Friday was better, Saturday even better, and today, on Sunday, it is on the border. I do not have pain, but it feels like it might come back any moment.

I went to see Meaghan on Tuesday. She added a couple more exercises to the list, as you can see below. Last time I ran was Tuesday night. I will hold off running for another week, to see if it will make a difference. Meanwhile, I did a yoga classs, a couple recumbent bike sessions and some gardening. None of them caused any additional pain or discomfort.

Here is an update about what happened since my last post.

I keep seeing my physiotherapist once a week and every time I get a new set of exercises. Photo # 1 are exercises from April 7^th, and photo # 2 are exercises from April 14^th. I am very diligent doing the exercises regularly. I do all 4 of  them 2-3 times a day. As a result I see a nice progress. Burning pain in the lower abdominal area is very low compared to 3 weeks ago and I rarely feel it. I can do a sit-up and lift my legs together with much less pain and stiffness than before. Last week I was on a vacation in Cuba. While there I ran twice my old routine, 30 second run, 90 second walk, 10 times. I still feel pain in lower abdominal during the running part.

During those runs, I focused on improving my form. I am trying to run taller, to shorten my stride and increase cadence, and I am engaging deep core muscles (TA, PF, MF). The goal is to eliminate the original cause of the injury which is poor running form and weak core, glutes and hip flexors. All this work on my form is in coordination with Meaghan, the physiotherapist.

I ran another test run today. I still feel dull pain in lower abdominal during run intervals. Walking part is fine. But this running pain feels like it is less pain than 2-3 weeks ago. No pain or itching after the run. I wonder if warm weather and a lot of swimming helped me to recover faster.

I went to watch a marathon race here in my town this morning. I really miss running and competing.

I have been working with my new physiotherapist Meaghan for the last 3 weeks. The first week I was working on TA activation, PF activation and diaphragm activation. Next 2 weeks I was doing this:

• TA and diaphragm activation together
• PF and diaphragm activation together
• Multifidus, activation

I saw her again 2 days ago. My assignment for this week is the activation of all 4 groups together: TA, PF, MF and diaphragm. It is a bit tricky, but if I am focused enough I can do it. I do 10 repetitions, 3 times a day.

I gave up doing any other core workout for now. I am strictly following Meaghan’s instructions.

Pain wise, I am making progress. No more pain on top of the pubic bone. The main issue now is burning pain in lower abdominal, 2” above the pubic bone.

Pain when get up after longer sitting is almost non-existent. I still feel some pain (much less than before though) when I want to do a sit-up or to lift both legs together.

I will see Meaghan again on Tuesday and Kevin, the chiropractor on Thursday next week.

I changed my strategy a bit. For the last 3 weeks I have been focusing more on doing core workouts than stretching. 40 minutes core, 10 minute stretching. Before I was doing the opposite, I went quickly through the exercises and focused more on Yoga and stretching. I do 6 exercises. 4 of those I got from Sean and I added 2 more. Leg raises (see the picture below) and plank, 30 seconds + 45 seconds + 60 seconds + 30 seconds with 20 seconds rest between. I ride recumbent bike for 5-10 minutes before workout. I am surprised how much I improved during this time. The pain when I get up in the morning is almost gone, I can walk without lower core pain most of the time. Pain in the lower abdominal is much lower than before. I have this pain when I want to do a sit-up or lift my legs together. I rarely have that isolated sharp pain left from PS. The weather got significantly warmer, I wonder if that contributed to me feeling better.

I saw Meaghan, my new physiotherapist twice in last 10 days. First time we spent 50 minutes together. She went through my running history, reviewed my bone scan test results, asked a bunch of questions about the injury and at the end examined me. She wants me to work on activation of my pelvic floor, transversus abdominal, multifidus and diaphragm, one by one for now. She gave me the following brochures to follow:

Activation in general
Transverse Abdominal (TA)
Pelvic Floor (PF)
Multifidus (MF)

I started doing those exercises in parallel with everyday’s core workouts. They are hard to do in a sense that those muscles are hard to isolate. During the second visit, she asked me to start working on activation of TA – diaphragm and PF – diaphragm at the same time. She also told me to stop doing core workouts, but I still might do them 2-3 times a week.

I saw Kevin (chiropractor) on Thursday. He told me that his work is mostly done and advised that I focus on physiotherapy. I will see him again in a month. He asked me to go for a test run, which I did last Sunday.
The same as before. 30 seconds run, 90 seconds walk, repeat 10 times. First I walked for 15 minutes to warm up. The workout went a bit better then 2 weeks ago. I felt dull pain in lower abdominal during running part. But less than last time. And sharp pain left from pubic bone was not there. That day after the run, my lower core muscles were very sore. I had to ice them. On Monday I was still sore, but on Tuesdey everything was fine. All together, I enjoyed the run. It was better then last time for sure.

Last Sunday was 12 weeks since my last run. 12 weeks later, I am still injured. There is a progress, some symptoms are gone, but I still do not see the light at the end of the tunnel. There is no adductors pain any more, I can do a sit-up, I can lift my legs together, I can squeeze my knees together without pain, there is no abdominal pain when sneeze or cough. But that stiffness above the pubic bone is still there.
On Sunday I went for a test run. 30 seconds run, 90 seconds walk, 10 times. It went terrible. First of all, it was very cold evening and streets were covered by snow and ice. As soon as I started running, I felt dull pain left from the pubic bone. Also unusual pain in the lower abdominal. Like my core muscles are shaking. During walking part all the pain stopped. I finished the workout, 20 minutes, total of 2.4km.

Went to see Kevin on Tuesday. He was surprised to hear about my run. He explained that it could be combination of cold weather (I did not warm up before the run), uneven surface, and loose muscles after 12 weeks of a lot of stretching and no running. I guess he is right but this is getting frustrating.

I decided to change my physiotherapist. Sean is a great guy, but I need someone with more experience. I am going to see Meagan from the same clinic next Tuesday. Meanwhile, I will keep doing Sean’s exercises and yin yoga.

Last night I went with my wife and a couple running friends to see Margaret Webb speaking. She wrote a book, “Older, Stronger, Faster”. It is about running after 50. She stopped smoking when she was 50 and started her journey to be a healthy runner. I bought the book, as soon as my wife is done, I am going to read it. Very interesting lady, more info here: http://margaretwebb.com/