Diagnosis Of My Hip and Leg

It has been a crazy couple of weeks -- almost three weeks, actually. It all started July 3rd.

As most of you know, this prep phase had been magical. I noted several times throughout the process that I felt that I was on cruise control, and that things were going just about as good as I could have asked. That is not to say that it was "easy." No prep phase is every easy. However, relative to past preps (and I have done a lot of them over the years), this one was a breeze.

I still had to deal with covid and gyms closing down just like everyone else. Unlike everyone else, though, I had resources and options that not everyone had. I did not miss even one training session during this entire process, even though I did have to drive to Miami to train at 2 or 3am every night. I kind of enjoyed the solitude and isolation, to be honest with you and I noted this several time throughout the process. The alternative was to sit on my couch eating cheetos and drinking mountain dew like most everyone else. I also think that staying locked into prep allowed me to keep my sanity during a time where there was really nothing else to do but worry about everything that was going on, anyway. It was a bit of a blessing.

Fast forward to July 3rd and this was roughly 4 weeks out of the show that I needed to do to qualify to compete in the masters division at North Americans. My condition was great, I was deep into prep and was feeling the effects but loving the process as I always have, over the years. I would prep 12 months out of the year if I could get away with it. I LOVE prep vs. the off season.

Here is the breakdown of what has happened since July 3rd, in detail. I have waited to post this so that I had concrete information and a concrete diagnosis because I didn't want to post with speculative information and then be wrong and have to update my situation with current information, as this all played out.

I went to the ER Friday night, July 3rd, after having a bad spasm in my hip and the pain made it impossible to train legs that night. When I say spasm, I mean it locked up like a baseball and was one of the more painful things I have felt since having chronic lower back pain years ago. It wasn't really the pain that sent me to the ER but this odd feeling that something was REALLY wrong and that I might actually have a blood clot. Blood clots are some scary shit and I couldn't get it out of my mind that this might be what was going on because the pain and swelling in my hip had started to move into the top of my quad. 

Now, I have to be careful how I phrase this because of policies and rules regarding discussing things like this in my coach logs. I will say this, and if you don't know what I am talking about, I will not explain it and you will simply have to deal with not knowing. Those of you who know will know and others might not fully understand it:

2 weeks prior to July 3rd I had done something to my ventrogluteal area that is common in this sport. It was a typical, frequent and planned thing that happened a couple times a week in this location. In my 35 years of training and bodybuilding "things" I have never had even one issue from this -- not even ONE. This time was different and my hip was so stiff that I couldn't even do my hip stretches prior to training legs like I always do so that my lower back is protected and less likely to be injured. However, I figured that if I was careful and tried to stretch my hips, they would probably open up/loosen up and everything would be fine. I tried to stretch my left hip and it hurt horribly bad. I knew right away that stretching my hip was not a good idea and I trained legs without stretching and all was fine. I had a great leg workout and everything seemed normal... until the next day when the hip swelled up and was swollen with thick skin. This only lasted a day or so, and it began to dissipate. I didn't think much of it other than I had a tight hip and kind of "tweaked" it and I shouldn't stretch it if the tightness and stiffness was going to continue.

Over the next week it progressively got better and I feel it was about 90% healed when I sat down on a bench to do a triceps exercise and felt a pop in my left hip. It immediately swelled and locked up from a spasm. I was dragging my leg behind me for about 20 minutes while trying to continue to train arms when all of a sudden it just unlocked and was fine -- just like that. It was bizarre, but I was just happy that it let go and felt fine after what was very painful and difficult to even walk while it was locked up.

The next day it was sore as hell and I could barely go up and down stairs. I was limping on it but figured that this would be like it was a week ago and it would be fine in another day or two. It got progressively worse. This is when the pain slowly moved from my hip to the top of my quad the following morning. I found this bizarre but even more bizarre because as the day progressed, it was slowly moving down my quad and by the time it got to mid-quad, I knew something was wrong because it was moving and because it was so painful. This is when I went to the ER because I was scared that it might be a blood clot (and it was 9pm so no urgent care facilities were open and they likely would have sent me to the ER, anyway). 

I spent almost 9 hours in the ER as they ran test after test including EKG, CT scan, X rays, blood work, etc. They put me on 2 very strong antibiotics via IV and then finally sent me home to do a 7-day oral run of Bactrim (horrible shit) and cephelexin. 

These antibiotics made me feel nauseous almost 24/7 and very lethargic -- to the point of really not wanting to train but simply forcing myself to do it because I was getting so close to the shows and figured I needed to push through so that when the infection cleared, I would still be able to compete. I say "infection" because the diagnosis at that time was an infection and that is why they put me on strong antibiotics.

I went home feeling that I would be ok as long as I continued the antibiotics for a week and then everything would be fine. I was wrong.

The pain did not even start to subside until well after the antibiotic run was finished. The swelling had not subsided, either, and at this point my left quad measured 1.5 inches larger than my very detailed right quad. I had one quad ready to stand on stage and the other looked to be 6 months deep into the off season. 

Because the pain had not subsided, I decided I better do a follow up to be sure that the infection was gone or find out what the hell was going on and if there were other problems I was unaware of. 

This brings me to this last week:

I see an orthopedic specialist and he reviews my blood work from the ER and says he doesn't even think there was an infection, at all. He orders 2 MRIs (the only tests the ER did not run) and says that these will be definitive in diagnosing the problem. He stated clearly that he didn't think there was an infection and that the MRIs would show that I had a partial rupture in my piriformis, gluteus medius or maximus. He also ordered more blood work just to rule out a lingering infection. After he explained the symptoms of a partially ruptured piriformis, gluteus medius or maximus, I was pretty sure that he was right and that this is what was going to be found. It explained the swollen hip and quad, and it explained the spasms, and pain and the movement of the pain and swelling, into my quad and moving down my quad.

I had the MRIs done on Saturday and went home with the disc of images. 

My orthopedic doctor won't read my MRIs until Wednesday, but I have a client whose father has read MRIs for decades and he offered to read mine for me. I took him up on this because I felt that I could get information from this doctor to contrast against what my doctor's diagnosis was. Basically, I was getting a free second opinion out of the deal.

Gluteus Medius and Maximus

He read them and concluded quite easily from the MRIs that the piriformis seemed fine, but that I had partial tears (that he said are pretty bad) in both the gluteus medius and maximus. Because these two muscles overlap, this caused both muscles to tear at the same time when I heard the pop when I sat down. This always explained the horrible pain when the greater trochanter was palpated or when I would simply brush against it with a dumbbell or my gym bag. It also explained the fluid "leaking" and swelling into my quad near the IT band as that is where the gluteus maximus insertion point is. 

To add insult to injury, the MRI also showed a 500cm^3 hematoma in the top outside portion of my quad. If you know anything about hematomas, this is a big hematoma. This specific area where the hematoma was, also spasmed and locked up, as well. Yay me.

Gluteus medius

The plan now is to see my orthopedic doctor on Wednesday and see if he reads the MRIs the same, but I anticipate that this is exactly what will happen. What the method of recovery is, I am unsure. Because they are partial ruptures, it is not as likely that they will want to do endoscopic surgery to reattach, but I won't know for sure until I see what he says. My research tells me that usually they will only repair and reattach if the ruptures are complete ruptures but, again, I am speculating at this point. I have no idea how much time it will take to recover. It could be another 3 weeks or it could be a couple of months, I just don't know, yet.

The bottom line is this:
I am not going to qualify in Tampa as planned. Yes, I COULD go there in the condition I am in and qualify. However, my mindset is that I am not going to stand on stage at a big show with one leg looking off season and the other one ready to go. I also would have not trained legs but one time in 5 weeks at that point, as well, and my legs are already 2 inches smaller than they were prior to my back injuries years ago. I simply cannot stand on stage looking like this when I can't even fully flex my left quad and the skin is thick as hell. I won't do it.

If the recovery is relatively quick, I could continue to not train legs for another few weeks and do a different qualifier. I still have 7 weeks until North Americans and that might be enough time to still train legs relatively hard a few times if the recovery is not going to take very long. Then, there's this issue, though, to contend with:

Pennsylvania just increased restrictions for crowd gatherings due to covid numbers going back up. They are not allowing groups of more than 25 people to gather indoors. Even if they go back to the restrictions of only 2 weeks ago, gatherings were only allowed for up to 250 people. There will likely be 3 or 4 times that any COMPETITORS in the show, let alone the audience. It is incredibly unlikely that North Americans will even take place, anyway, at this point. This show or the masters nationals were my motivation for prepping this year. Without those two shows, there is little motivation for me to train at a smaller show where I show up with 4 other guys and battle it out for a 50-and-over masters title with 2 of the other guys being fat and one being skinny. There could be one badass in there to kick all of our asses, but my point is that I wanted to stand with the best masters over-50 competitors in the country and see where I landed. It appears that is not going to happen no matter if my hip and leg heal in time or not. 

I still may decide that I don't want to ditch such a great prep phase and at least stand on stage at the largest show I can find when my hip and leg are recovered. I can maintain condition as I was just about ready to go when this all happened. I just need to find out what the recovery time for this injury is and see if it is doable or not.  I will find all of this out on Wednesday and then I need to quickly decide what my decision is going to be from there.

In short, I have not "pulled out" of anything just yet, even though my options do seem very limited and I am admittedly quite devastated by what has transpired after everything has gone so well. It would be nice to still be able to push on and get on stage even if it isn't at the "big dance" at North Americans. I'm in limbo until I meet with my doctor on Wednesday.

 

 

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