Monthly Archives: October 2011

Postponed

Somewhere, down there, someone is riding a bike. I am not. For a while.

Yesterday I had my first post-cortisone physical therapy session. I did the usual 15 minutes on the table hooked up to the electro-shock machine and then was stretched. Sounds like torture, right? The electro-shock pads are placed around my hip near the surgery scars and then I select a level of stimulation I can tolerate. It contracts the muscles in a sequence for 15 minutes. After that I am stretched by the therapist in various ways. I usually do a sequence of spinning on a bike, weight machines, and exercises, however on Monday all I did was the stretching. And it is going to be like that for a month. No bike. At all. Not even the 5 minutes a day of light spinning I was doing. No strength training, no leg lifts, no squats, nothing. Because of the tendinitis I’ve been experiencing, I am relegated to the bottom of the recovery timeline and I don’t like it.

I have no idea what my timeline for training is going to be. I was hoping to begin riding outdoors at the end of this month. Now, I don’t know. I have a follow up appointment on November 12th with my doctor and hopefully I will get a better idea of what to expect then. As of now I’m in a holding pattern. I need to rest, follow my protocols for stretching at home, and go to physical therapy once a week. I will do as I am directed by the professionals and make do. Maybe I’ll watch Cancellara’s run of dominance in the 2010 spring classics. Maybe I’ll stock up on Honey Stinger Waffles.

I’ll definitely be photographing some ‘cross races, including DCCX this Sunday. I plan to have enough pics at the end of cross season to put together a book. I’m pretty excited about this, it’s my first attempt at a photo book that wasn’t a portfolio and I couldn’t imagine a better topic.

Unrelated to cycling or my hip surgery, I photographed the F-35B Joint Strike Fighter today. While it was out to sea. Which meant I flew out on a MV-22 Osprey to get there. It was pretty awesome.

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Shots, Shots, Shots!

Ok, this stinks. Despite having a brief respite from pain, it came back. With a vengeance. I’ve had setbacks with physical therapy and my return to biking outside has been postponed. All I have is the fading memory of what it felt like to be relatively pain-free for 3 glorious, yet too-quick, days.

I developed tendinitis in my hip flexor while recovering and rehabilitating from surgery. According to my doctor, the hip flexor gets irritated from him messing around in my hip capsule. So it’s a little sensitive when you are coming off crutches and attempting to return to normal. He said if I was a couch potato before, it wouldn’t get irritated because I’d probably still be a couch potato after the surgery. No stress on it and there’s no problem. For someone like me, a photographer that runs all over Capitol Hill and a competitive cyclist, things are a little different. I’m on my feet all day long. I have to crouch, kneel, squat, bend and scrum to get pictures. I have to do what I have to do to get the shots I need. It’s the nature of the business and I love it. Except when I’m in pain.

Over the past week and a half the pain and tendinitis have gotten worse. It’s hard to describe, but imagine a constant dull pain that has moments of intense burning and soreness. And it hurts no matter where you move or how you position yourself. I’ve had a few sleepless nights. I had an appointment with Dr. Ochiai on Tuesday and explained what was going on. We figured the next course of action is a cortisone shot directly into the tendon. Oh fun. Dr. Ochiai commented, “hip flexor tendinitis is the bane of my existence.” I said, “yeah, mine, too.”

I am not fond of getting shots. Especially ones that require it to be placed in a spot so precise that the doctor has to use a live X-ray to find it. I’m also not fond of constant pain that doesn’t seem to get any better, which is why I had the surgery in the first place. Getting this shot is a small price to pay, in my book.

Madeline and I arrived at my doctor’s office and two other people were there to get x-ray guided shots, too. I let them go ahead of me, not so much out of kindness, but so they couldn’t hear me screaming like a 5-year-old. When it was my turn I changed into my skivvies and a gown and went into the room where Dr. Ochiai, a med student and the x-ray tech were waiting. Dr. Ochiai checked my hip flexor and called his med student over. “Feel that? It’s spasming right now.” Great, doc, glad I could treat you to a spasm. A quick x-ray confirmed where the inflamed tendon was located. He sprayed a coolant on my leg to help numb the area and began the injection. I felt the injection go in and it felt like it kept going and going. I winced a couple times and Dr. Ochiai apologized. “It’s ok, trust me,” I said. Yeah, it’s uncomfortable but I totally understand it has to be done. Before I knew it, it was over and I was on my way. As I left, I noticed my leg was numb. Really numb. The cortisone wouldn’t kick in for a couple days so I wasn’t sure what was going on. After my leg buckled coming out of coffee shop on the way to work I decided to call my doctor’s office. It ended up being a local anesthetic that had leaked a little on a nerve. If it didn’t wear off after a couple hours it was an issue, but sure enough, it wore off by the afternoon.

Monday I go back to physical therapy and will continue with that just one day a week instead of two. I will be working on stretches and my range of motion until the hip flexor calms down. Then hopefully I can get back on track. Right now my hip aches but the hip flexor isn’t burning like it had been, so I’m hoping the cortisone has kicked in. I’m very anxious to get back on my bike and back to training for next season.

I mentioned in my last post I would detail what I want to do for next season. I’ll save that for another post and leave you entertained by this:

Hip Flexors and ‘Cross

Late last week I had a bit of relief from pain in my hip.  There were long stretches where I was actually pain-free.  Friday was great, Saturday was even better.  I spun on the trainer for 10 minutes on Sunday and was feeling a little tight after I stretched.  As the day progressed I felt a little bit of something in a familiar spot: my hip flexor.  Monday I walked around quite a bit and the pain started up again.  Today my physical therapist confirmed that the tendonitis was still there.  I did some my core exercises, light spinning and some strength exercises that don’t directly involve the hip flexor.  The best that I can do for the tendonitis is rest, I’m told.  The thing I just can’t do right now is rest.  I live in a 4th floor walk up.  I walk all over the Capitol Building for work.  I have to crouch, squat, kneel, and flex my hip to get pictures.   Having a stretch of pain-free living was great and shows that I’m improving.  I feel like I’m at a spot where I can turn the corner.  I will do everything I can to get better.  These setbacks happen, I’m told.  I’m anxious to get better and to get back on the bike.

In other news (and since I like to have photos on here) Sunday morning I headed out to Winchester to photograph the Winchester Apple Cross race.  I had to work in the afternoon so I could only photograph the morning races so I snapped away at the Cat 4, Juniors, Women’s 4 and the Men’s 3/4 35+.  I have a few friends and teammates in the races so it’s great to cheer on people and document them a bit.  Cross makes for great pictures, no doubt.  Here’s a few of my favorites from Sunday:


The Belgian Wall


More pictures can be seen at my Photoshelter site here.

In my next post I’ll talk about my cycling plans for next year.

What’s going on

Two years ago today I quit smoking cigarettes.  I was a pack-a-day smoker for 17 years and quitting was one of the hardest things I’ve ever done.   In November of 2009 I bought a bike, a Scott CR1.  I hadn’t owned a bike, or ridden one, in nearly 20 years.  Right away I fell in love with it.  My first ride was maybe 8 miles and hard as Hell.  But fun.  The next day I went farther.  And faster.  And so it began.

Down by Gravely Point on one of my first rides

I started riding with a friend that had been cycling for a long time and soon I began riding faster than him.  I bought a cycling computer and started keeping track of how fast I was going and for how long.  I rode every day as the weather permitted.

I wanted to combine my work as a photographer with my new passion.  I started hanging out and riding with a racing team, Squadra Coppi, in the hopes of putting together a long-term project that I could pitch to publications.  What I found was a group of that was inspiring, fun to be around, and overall just great people.  Oh, and they are FAST.  I wanted to race.  So I started training harder and I started racing.   Eventually I published my project in Washingtonian Magazine and joined Squadra Coppi.  (You can see the project here).

Racing is hard.  Don’t let anybody tell you that riding a bicycle at race pace for an extended period of time is no big deal.  If it was easy, everyone would do it, right?   It’s work.  It is physically demanding and it hurts.  But it’s amazing.  I love it.  There is nothing like a bike race.  Correction: there is nothing like RACING in a bike race.  Descending at 45 mph is as close to flying as you can get without growing wings.  Climbing a steep grade out of the saddle with someone right behind you puts your heartbeat a little higher in your throat.  You cannot feel like this any other way.

After I published my project, I landed a new job which took me away from the bike for a little bit.  I would go out occasionally, but not like I did.  The road season was ending and I didn’t have much interest in cyclocross. I was done racing for the year.  A month or two later I started noticing a pain in the upper part of my left leg.  I self-diagnosed it as a strain from carrying too camera gear so I changed the way I carried the equipment and I thought the pain would go away.  It eased a little bit, but didn’t really go away.  Looking back, I think it’s interesting how I just got conditioned to a certain level of pain.  By comparison to what I would later feel, that level of pain was fairly low but I just let it go.

In February of 2011 I had more time to ride so I took advantage of it and went on a few rides with my teammates again.  One saturday morning, about 5 miles into a spirited ride, my leg just gave out on me.  It was more than poor fitness, something was wrong.  I made an appointment with my doctor to try to get to the bottom of it.  After some anti-inflammatories, it didn’t get any better.  Another visit.  Severe tendonitis.  A steroid shot.  More drugs.  An X-ray.  Physical therapy.  Nothing was working and I wasn’t getting any answers.  Finally I asked for an MRI.  I just wanted to know what the heck was going on in my hip.  In the first part of July, right before a trip with my daughter and mother, the radiologists said I had signs of some tearing in my hip.  I scheduled an appointment with an orthopedic specialist for after the trip.

The specialist told me that I had tears in my labrum caused by a condition called FAI.  Femoral Acetabular Impingement.  It’s where there is too much bone on the ball of the femur that goes into the socket, and in my case, too much bone on the acetabulum (the edge of the socket).  The joint was impinging, limiting my range of motion in my hip and tearing the labrum.  The ortho doc told me immediately that there was a arthroscopic surgery for it and that he didn’t do it.  He gave me a list of 5 doctors that did.  One was in California, one in Colorado,  two were in New York. The guy at the top of the list was right here in Arlington, Virginia.  I scheduled an appointment immediately.

My hip before surgery.

I met with Dr. Derek Ochiai at Nirschl Sports Medicine and he checked out my MRI and took an X-Ray to get a better look at the bones in my hip.  He knew right away that I had FAI and the X-ray revealed that I had both a cam impingement and a pincer impingement.  He ordered a contrast MRI to get an idea of what the labrum looked like and what I could expect following the surgery.  Let me tell you, getting a contrast MRI was not fun.  Getting a giant needle jammed into your hip socket in a spot so precise they have to use a live x-ray machine to find the spot is a bit scary.  And then they inject the dye and swell your hip so it distends.  Not comfortable.

July 29th I went to Virginia Hospital Center for surgery.  The staff was amazing.  My girlfriend was even more amazing. I went in at 9 am, went under sometime around 11:30 am and woke up after 4 pm.  I left the hospital around 7:30 pm.  Dr. Ochiai anchored the labrum and reshaped my hip.

My hip after surgery. See how the ball is shaped? Now it's normal.

You can easily see how different the femur and acetabulum look.  For me, the surgery was the easy part.  I just laid there and was asleep the whole time.  I didn’t have to do anything.  The hard part began right after the surgery.  My recovery.

I spent three weeks on crutches.  I couldn’t put more than 20% weight on my left leg.  Easy, right?  Not really.  It’s hard to get around on crutches.  I live in a 4th floor walk up apartment.  (Yeah, yeah, I know, it’s my own damn fault, but I love our place).  I was on pain killers and anti-inflammatories and anti-nausea mediation.  I was out of it.  And despite the surgery and things getting better, I was still in pain.  But things were getting better.

I started physical therapy and that’s when the real work for me started.  It’s been hard.  And it hurts. But it’s working.  My therapists Aleesa and Kim at Nirschl are terrific.  I’ve had some setbacks.  I ACTUALLY developed tendonitis in my hip flexor and have been slowed by that.   But, 8 weeks out from the surgery there are moments where I feel normal.

So, you may ask, what is going on?  Why am I writing and blogging all this?  I plan to use this blog to discuss my recovery, my return to training, my plans for next season, and any other insights I can come up with.  I’ll share my cycling pics and talk about bike racing in general.  If you have any questions, drop me a line at jay at jaywestcott dot com and follow me on twitter @jwestcottphoto