Ugh. It was all going so smoothly, but here I am facing some hefty bumps in the road. My bone density has barely moved, and I've given myself another stress reaction. What happened?!? Here's the scoop:
My health was returning, so I jumped, ran and lifted heavy weights. No problems! It had been 4 months since I stopped training when I had the initial stress reaction, my hormone levels are back to normal and my hips were feeling fine. No evidence of any bone injury. I had come to believe that my bone density must be coming back nicely, but I wanted to check it out and make sure before ramping up my training more, so I scheduled a DEXA bone scan.
The result: low bone density!
My reaction: "What?!?!? I only gained 9.7% in my spine?!? And I lost 4.0% in my femur!?!? I thought I was on the right track!"
The problem: There are lots of them. First, my expectations weren't set properly. I was under the assumption that I could gain tens of percents in my bone density within a year. My fault. I should have known, by asking my doctors or doing some Googling, that bone density improves really really slowly...to the tune of 10% per year if you're doing well. Second, there is a margin of error of +/- 5% for these tests. Third, the two datapoints, 7 months apart, don't tell the whole story. I was very disappointed at first, but after giving it some thought, talking to my doctors, and looking at the evidence, this is actually a pretty good result. Yes, even the loss of 4% isn't so bad. My first DEXA was done in May 2016, but that probably wasn't my low point. I was injured and had low testosterone, both of which were further hurting my bone density. Further evidence comes from a bone resorption test that I did (it shows how much bone you're breaking down) in late June that showed I was breaking it down pretty quickly. I had another bone resorption test in November that showed a dramatic decrease in the amount of bone I was breaking down. Therefore, the story is likely that my bone density continued downward till a low around July, but then necessarily must have rebounded in order to arrive back at the "nearly unchanged" numbers we see in January 2017. This would suggest that I've actually been progressing since mid-summer, and that I need to just keep doing what I'm doing. Great. So my priorities are: 1.) I'm still susceptible, so don't get a stress fracture 2.) keep hormone levels normal, which is of utmost importance for healthy bones and 3.) keep lifting heavy weights to encourage bone growth
Fastforward three days. I go for a 9 mile run with a few short pickups. It's nothing out of the ordinary as I've been doing pickups recently and have run up to 10.5 miles at a time without issue. Two hours after the run, though, my hip starts aching ever so slightly. It's the same feeling as when I first had the stress reaction. My first thought..."this must just be in my head. I got the disappointing bone density result and bone stress injuries are fresh in my mind. Plus, I've been doing runs like this, and throwing heavy weights around, and jumping and I haven't had any problems, so why would this run-of-the-mill 9 mile run affect me? Are you becoming a hypochondriac? Matt!? Are you!?" Then I ran on Thursday morning, an easy 6 miles. The ever-so-slight achiness returned...hmmm...then I lifted heavy that same day and the achiness moved into the range of undeniability. It felt like soreness deep in my hip area, but only on my right side, the same exact feeling I had back in May 2016. I immediately contacted my doctor to set up an MRI, which I did the very next day. Well I got the result on Tuesday and WHAM! I've got a stress reaction. It's in the same exact spot as before and looks to be approximately the same intensity.
What does this mean? For the short term, it means I won't be running anytime soon, I won't be doing any heavy lifting, and I can't do any hard bike workouts. Chances are slim to none that I will be doing Puerto Rico 70.3 . I'm lucky to still be walking without crutches. I can, for now, still bike easy and swim, but if that aggravates it, then I won't be able to do those either. For the longer term, maybe this is God's way of telling me to put this mission aside. "Here, I'm giving you something more important to worry about, a daughter!"
My new priorities: 1.) get ready for the arrival of our little one 2.) heal my stress reaction 3.) maintain hormone levels 4.) restore bone density to levels where I can run without reinjuring myself
I write about this topic so that others will be aware of the health debacle that can occur if you overtrain. So many articles write about overtraining and how it's not good for you, but they don't get into the nitty gritty. What actually happens to your biology? Why does performance suffer? Why do you become more injury prone? Why do you feel tired and why don't you want to have sex?! It's much deeper than "I'm tired from training," and I feel I have a duty to spread that word. I'll be doing a speech on this topic in 2 weeks at a Sports Medicine conference in Greenville, SC, I'm working with a researcher named Dr. David Hooper on a study assessing overtraining in endurance athletes, and I offer consultations to those who are in a hole and need help. To be clear, my point isn't to diminish enthusiasm about training for endurance sports, but just that we need to be smart about it! There is a balance that can be found in each person's life situation that will allow them to fully enjoy triathlon and become better athletes, all while remaining healthy. I encourage you to find your balance!