How My Chronic Pain Started
The roller blades were not to blame. It’s true they played a key role in my injury, but it was hardly their fault. They’d been buried in our garage for nearly three decades.
“I think I did something really bad to my leg.”
In October of 2018, I was on vacation in Borrego Springs, California, where my husband John and I had lived for a short time in our twenties. Back then, one of our favorite things to do was strap on our roller blades at night and fly down the middle of long desert roads lit by the moon, so when we were packing for our return trip we dug out our blades.
Even though I was wobblier and more cautious than I once was, being back on roller blades under a full moon was glorious, especially since we had our daughter Jessie (then eighteen) in tow. We had stopped to turn back to our rental house and as I pivoted something snapped in the back of my thigh and I went down in a clattering heap.
“Ohhhh Jessie,” I said. “I think I did something really bad to my leg.”
The really bad thing turned out to be a proximal hamstring rupture, in which my hamstring tore eighty percent off my ischial tuberosity. The emergency room doctor, after taking an x-ray which showed no break, assured me it was just a bad strain. After returning home I gimped around for a week before referring myself to a physical therapist, who misdiagnosed my pain as ischial bursitis.
“This type of bursitis is common in some sports,” the physical therapist said during our first session. “Are you an athlete?”
“I’m active, but I’m definitely not an athlete,” I told her.
She treated me with the Graston technique, a procedure used to break up scar tissue that involved dragging a foot-long metal rod repeatedly over the injured spot. It hurt so much it took my breath away. After six weeks of torture with no improvement, I referred myself to an orthopedist who ordered the MRI that showed the tear.
“Are you an athlete?” he asked after giving me the diagnosis.
“I’m active, but I’d hardly call myself an athlete.”
“Do you water ski?”
“Not since I was twelve.”
“Interesting,” he said. “This isn’t a common tear. Usually it happens to athletes who compete in sports where you fall with your legs straight out in front of you, like surfing or water skiing.”
When I did additional research on the injury, I learned that bull riding, rugby, and football are other sports in which proximal hamstring tears can occur. Since I’d never participated in any of these activities, the cause of my injury was chalked up to something odd that happened for no apparent reason.
Because only 8% to 12% of hamstring injuries are proximal tears, there is little data on their treatment and outcome, but what I was able to find in the medical literature stressed the importance of immediate repair. My time from tear to repair was more than three months.
My first surgery, in which my hamstring was screwed back into my hip, was in January of 2019. While I was waiting to be wheeled into surgery, a nurse (not the one assigned to me) popped her head into my pre-op room and said she’d never heard of my kind of injury. “Are you an athlete?” she asked.
The second surgery, in July of 2019, was to figure out why I still couldn’t sit without pain. The surgery landed me back on crutches with another six months of physical therapy but provided no relief.
Being out of alignment for all of 2019 and 2020 created new problems. A disc in my back became herniated and another slipped out of place, and at some point I tore my meniscus. Between my hip, my back, and my knee, at least one body part hurts all the time. Sometimes they all hurt at once.
Having done extensive research on chronic pain during my career as a medical writer, I was already well aware of its complications: depression, anxiety, falls, sleep disorders, substance abuse, lifelong disability, and other fallout. What I wasn’t prepared for is how lonely it is to be in constant pain. I have an amazing support network of family and friends who do everything they can to keep my spirits up, and John is endlessly—sometimes annoyingly—optimistic that I will get my mobility back. But they’ll never know what it feels like, and I worry they think I’m making it up.
“You do believe me, right?” I often ask John.
“Of course,” he says. But what’s happening to me is unknowable, even to the person who knows me best.
Months after my second surgery, when my local orthopedist had run out of ideas about why my sitting pain still hadn’t resolved, I sought a second opinion from a doctor who had a good track record of fixing weird cases like mine.
“This isn’t a common injury,” he said after we introduced ourselves. “Are you an athlete?”
He ordered a contrast MRI of my hip which showed inflammation at the surgery site. While I was hopeful he could help, his office staff was maddeningly unresponsive so I moved on to the promised land of physicians: Stanford Medical Center. The first orthopedist I saw had a perfect Captain Hook mustache but nothing to offer in terms of treatment. He punted me to another Stanford doc specializing in tendon repair, who suggested a platelet-rich plasma (PRP) injection. If he’d bothered to read my medical records, he’d have seen that I already had PRP with no success. It was clear that neither doctor wanted to take my case. They didn’t even ask if I was an athlete.
I found a sports medicine and rehabilitation doctor an hour away with whom I clicked immediately. After listening to my story and asking if I was an athlete, she gave me a nerve conduction test involving needles and electric currents that made me twitch and thrash like a carp on a riverbank. Next came nerve injections, which were so painful I nearly passed out. We’ve now ruled out nerve damage as the cause of the pain and are currently considering “ex” therapies (expensive and experimental) involving stem cells which will cost thousands of dollars with no guarantees.
By the time I was healed enough from my second surgery to re-start physical therapy, I was emotionally exhausted. As I was gathering my stuff for my first session, I grumbled, “Back to PT. Lucky me.”
“That’s the spirit,” John said.
I was waiting for my therapist at the check-in desk when a man came side-stepping by. Side-stepping is commonly prescribed for people in the early stages of lower-body rehab, and the therapists at my PT clinic use all available floor space to get their patients stepping. Sometimes there will be several people side-stepping across the floor in a sort of plodding rush hour.
The man, who was close to my age, had likely suffered a traumatic brain injury or stroke because he was unsteady on his feet and his words were slurred. He had a big smile on his face as he side-stepped past me.
“Nice day, isn’t it?” he said in a garbled voice. “Got to soak up the last of this summer sun.”
I gave him a grumpy smile.
On his way back past me, he said, “We could use some rain though. And fall is my favorite season.”
On his next pass he asked, “What’s your favorite season?”
“I like fall too,” I said.
On his next pass he said, “I think my PT is going to make me side-step until fall.”
I laughed and told him I knew the feeling.
When my therapist finally retrieved me from the front desk, I walked by the side-stepping man and thanked him for cheering me up. Our interaction left me feeling equal parts ashamed and inspired. Here was a person who had miles of rehab ahead. Or maybe he had already come miles from where he’d started and was just happy to be where he was. I wish I’d asked his name.
Chronic Pain Warrior
My world has become very small since chronic pain became my reality. I’m fifty-three and feel eighty-three. My mom, who has arthritis in both knees and a hip, sometimes needs to slow down for me when we walk. I can no longer bike, do yoga, or ride in a car without pillows and pain meds. I can’t sit in normal chairs and do all my work at a stand-up desk. I’ll never take my mobility for granted again.
The next time someone asks if I’m an athlete, I’m going to say yes. Like other Chronic Pain Warriors with freezers full of ice packs, shelves full of anti-inflammatories, and folders full of medical records, I’m running a marathon with a finish line that’s just out of reach. So I guess I’ll run faster.
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