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Speed workout


Question
Hi Nick.  I had an avulsion  ischial fracture last year during a marathon. Took time off and had physical therapy.  I'm doing great now, was able to do 4 marathons this year.  However, I am struggling with my speed workouts.  Whenever I do a speed workout, I hurt for several days in the same location as the fracture. Sitting is even painful as when I initially injured it.  I don't know if it's mechanics or fatigue.  Getting frustrated as I'm pretty much plateaued in my speed due to pain which I've had all year.  I don't want to "baby" it if I don't need to but I definitely don't want to fracture it again.  Is this something that I'll just have to live with or should I get it checked out?  Thanks for your assistance.
Lori

Answer
Get it checked out!

Great question Lori and great job on being so diligent working out.  This is definitely not something you have to live with and don't believe anyone who says it is.  Pain is our friend. It tells us something is wrong. Do not resolve to take a pain killer to dull it.  (Read Pain, Pain, Pain for more info on pain.)

I suggest seeing a different physical therapy doctor than last time.  Another set of eyes is always beneficial.  Further, while you're there ask if you should get an MRI on it.  An MRI would hopefully show if your avulsing it again.  When you sprint there is a greater pull on from the muscle/tendon on the bone.  You possibly just need to work up to this speed more slowly, but since you've run 4 marathons this year it seems like it should be able to take it.  Another possibility is that you're overtraining, but again, if you've done marathons without other adverse effects then you should be alright.  Mechanics is definitely a possibility.  Try to find a physical therapy doctor who specializes in running.  Please let me know if there's any other way that I can help.  

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