Having 'normal' running injuries with PMR

[Skinnyjonny]

I apologise for the following question but those that know my motivation and progress in PMR remission will understand my query. I've asked my physiotherapist(s), running colleagues and PTI at work and all suggest asking my good friends at HealthUnlocked. Is there any research or evidence to suggest that having PMR has a greater effect on receiving 'normal sporting' injuries (e.g. tight Achilles, calf muscle strain) and does PMR effect recovery of these injuries?

[polkadotcom]

I'm not sure that PMR itself causes soft tissue damage, but steroids most certainly do. Since PMR causes inflammation in the muscles themselves (the stiffness and pain on moving) I would say there is a fair chance that any injury would be exacerbated by it. Tendonitis and muscle damage caused by anything will, with most patients, take longer to heal than if you were 'normal'.

I have permanent Achilles tendonitis and the tendons in my neck and shoulders are also affected. I do stretching exercises which helps, but have discovered recently that heat is a problem. Why, I don't know, but there might be something there for some research?

[Skinnyjonny in reply to polkadotcom]

Thank you polkadotcom - I thought this was the case but haven't got any evidence for PMR sufferers. I'm now on 4mg Pred (down from 20mg in May last year) and putting in a couple of 30 mins trail runs (barefoot) and a 5km Parkrun every Saturday plus swimming sessions. For over 40 years I've followed a rigorous fitness programme which involves a daily stretch routine for my work (PE Teacher and Fire Officer) and hobbies (mountaineering, climbing and running). I've now modified my daily stretch routine to assist PMR recovery using a Fit Ball and Stretch Bands. For the past few months I've received weekly physiotherapy and hydrotherapy which has really helped. I pulled my Achilles during a training trail run and obviously eased back on fitness, applied hot ginger rubs and cold peppermint sprays as well as regular ice packs. I just wondered whether their was any evidence and will continue to research subject. Thank you again for your feedback

[Whittlesey in reply to Skinnyjonny]

Hello Skinnyjonny, Congratulations on all that you do and how you are dealing with PMR. I have GCA, not sure of PMR, possibly I have it not sure. Have a cartoid artery dissection which is painful in my neck and shoulder, not sure if PMR is there, also.

Read your post and it is very encouraging what you are doing.

I used to be pretty capable, athletically. I live in NYC and before "this" I could 20 blocks to work or for an appointment, work a full day (take the train or bus home, one of these 20 block walks was enough) and work a 5 day week. with many "long block" walks.

Began to have some hip problems, now diagnosed with degenerative joint disease, left hip and Meralgia paresthetica (MP) same area, very painful. Walking limited now. I do stretching and exercises. In 2012 was diagnosed with GCA. lost of problems with prednisone, but somewhat ok with 4 mgs daily. Want to be off of it, but want my eyesight, also.

What you are doing is amazing, so courageous and a really good model.

I have been diagnosed with Cushingnoid symptoms, so I am really careful, and don't take on the 20 block walks, but I do walk. I get fatigued and am careful.

I am wondering, what exercises do you do? stretching ? Do you swim?

Again, I am very impressed with what you are doing. Believe it is good and so necessary.

Thank you for your post. please continue.

wishing you health and continued mountain climbing ! Hoping to be climbing mountains in New Jersey (NYC has no mountains, just flat sidewalks), hopefully in the near future !

thank you, all my best, Whittlesey , NY U.S.

[Whittlesey in reply to Whittlesey]

Just a quick note: on the ginger rubs. I have found that with the pain in my left thigh, if I cut a piece of ginger, and use a pain patch over it, and put it on the top of my thigh, within about 20 minutes, the pain is very reduced. Thanks for the information on the ginger rubs. Will look for them.

all my best,and continued success. Whittlesey

[Skinnyjonny in reply to Whittlesey]

I use 'Natural Hero' products - Hot Ginger Muscle Rub and Peppermint Freeze & Ease Sports Spray. The hot rub really gets into the muscles and the spray eases aching muscles ... plus they both smell lovely.

[Whittlesey in reply to Skinnyjonny]

Will look for them. They sound really good. Thanks, smell sounds good, also. all my best, Whittlesey

[Skinnyjonny in reply to Whittlesey]

Hi Whittlesey - great reply. By the way I'm over in New York running in full fire kit at the Tunnel to Towers run in late September in memory of a fallen firefighter during 9/11. Come down and cheer us all on as I understand there are international firefighters running the 5 km.

My daily routine starts with Pred and 45 mins rest followed by shoulder, chest and upper body muscle stretches using resistance bands whilst sitting on my fit ball for core stability. This also involves flexibility stretches to ease my shoulders. I also do sit-ups and some light 5 kg dumbbells for muscle mass. Nothing like I used to do but really helps with body maintenance.

Daily exercises involve either a swim between 40-100 lengths (1 to 2.5 km) or 30-45 mins trail run in barefoot trainers - wonderful to feel the wind in my hair! I have physiotherapy on shoulder muscles mid week and hydrotherapy on a Friday.

Throughout the last 18 months I've tried to work with the condition and kept a smile on my face I hope you keep well and it would be great to see you in New York in September.

[Whittlesey in reply to Skinnyjonny]

Hi Johnny, will try to make the Run in NY in September. Glad you're running in it. Will watch for it.And usually in those runs, they include international people, should be no issue. Need a hip replacement and may be in the hospital, if I'm not, will try to be there. Sounds amazingly good. Congratulations, truly. I'm so glad you are doing this with this illness. Very good role model and inspirational. Your exercise routine is fantastic. Will try some. I know with my hip, some I can't do. And you take pred in the am, rest and begin to exercise and then swim and run? Wow. I think if I can do some of that, will be doing well. Really good news. As we pull out of this, I was wondering how much I can do. ? Thank you for helping to answer. I am very impressed. In support on keeping up the good work ! Thank you. all my best, Whittlesey, NYC

[Whittlesey in reply to polkadotcom]

Really good answer and thanks polkadot.com. Good to know. Would say one thing -- for people with GCA which has gone to other arteries -- -- I was doing some pretty extensive neck stretches and exercises -- and began to have tremendous pain in the left side of my neck.

A CAT Scan revealed that my cartoid artery was dissecting. This causes pain. I don't know if the stretching exacerbated it. I will ask. I don't do those kind of stretching exercises anymore. was pretty worried about a cartoid artery "dissecting" -- coming apart -- boy !

I asked my internist how or if this will heal. He said yes it will heal, new cells will grow and create a new "outer" covering for this artery. which is good. He said the dissected parts will remain there and form a pseudoaneyurism which might cause problems. I have CAT scans of them every three months to make sure they have not moved upwards. I also have this situation with two arteries in my back, and with the pseudoaneuyrisms (spelling?).

For those with GCA, would say, be careful with the neck stretching. my god.

I do a couple of neck stretches, and that's it.

thanks polkadot for your information, as we try to get through this.

all my best, Whittlesey

[polkadotcom]

You are welcome, Jonny! Altogether I'm 15 years plus into this malarkey and at the moment not very mobile, so the thought of all the exercise you do brought tears to my eyes. Dancing was my hobby until this hit. but the very last time I was able to dance was in 2002 when we did a jive demo. I haven't been able to set foot on a dance floor since then.

I have been helped by all the ballet stretches and basic exercises at times, particularly for my neck and shoulders - but my legs don't want to know any more!

[Skinnyjonny in reply to polkadotcom]

Thanks for your advice and support. I enjoy reading your posts which have been very helpful to many people. Keep up the good work xx

[Whittlesey]

Hi Skinnyjonny and Polkadot, I have also wondered about this. I am about to schedule hip replacement surgery and will go through physical therapy after that. I may have some problems with my left thigh (MP) which may stay with me. But my mobility should be much better.

I am wondering about this. How much can I exercise? Need to have thigh muscle begin to work again. Don't want to "injure" it in the process. I have nerve damage diagnosed in my left arm (they believe it is due to the high doses of predisone, last year). So apparently the pred can damage nerves and muscles.

I am wondering about the muscle supplements like biotin and whey. Can they help to overcome the damage from the prednisone (and I have take methatextrate, which can negatively affect the arteries and muscles). The whey possibly can cause inflammation, so that might not work. But biotin ? and there are others. Will they help, possibly in small amounts ?

[piglette]

I have friends with PMR who do Pilates and also Tai Chi which they say helps. Stretching seems to be good. I swim and do about half a kilometre a visit, but I have found I have had to slow down and not pretend I am on an Olympic trial!! I feel much better after swimming particularly in the shoulders which can still be very painful. I am on 17.5mg of pred at the moment having had a go already to get to 15mg from20mg.

[Skinnyjonny]

Very poignant and emotional day for me as last year I'd prepared to run my 5th London Marathon (23rd marathon) and couldn't lift my arms or even get out of bed! Now I'm running 45 mins again and aim for the Great North Run and Tunnel to Towers (New York) in September. What a day! A massive "Thank you" to HealthUnlocked and all members for helping we get some normality back into my life. I'll continue to raise awareness and understanding for PMR-GCA and wearing our tee shirt at Parkruns every Saturday morning. Keep up the great work - Invenium Vium aut Facium

[Whittlesey in reply to Skinnyjonny]

Nice post, Skinnyjonny. So glad you have such done such amazing work and are an inspiration. While you were preparing -- you couldn't raise your arms -- tremendously inspirational ! Thank you, for your work and awareness raising of these little known conditions. will be taking the paper on these conditions to my doctors and giving them to two hospitals in NY. Currently, as an unemployed paralegal, I work on nursing home reform and write for ABLE Newspaper (for the disabled), will include the paper on GCA and PMR with Able newspapers I distribute to doctors and medical professionals. I have one year of Latin and am not sure what your closing is, but let me say in one adopted language, tres, tres bien !

[Celtic PMRGCAuk volunteer]

piglette, your friends are so right. I started Tai Chi mainly to help with my balance problems after finally being diagnosed with PMR following a lengthy time in bed and without answers. At first I couldn't lift my arms to any great height and I also had to sit down occasionally but the more sessions I went too, the more improvement I noticed - it was such a thrill when I found I could once again lift my arms straight up above my head!

In the later stages of PMR and on the lower doses I also joined an 8-week course on Nordic walking - great! The two sticks gave great support, and I also learned from the instructor that it helped those diagnosed with osteoporosis - so a great weight-bearing activity for our bones.

[Celtic PMRGCAuk volunteer]

skinnyjonny - you're a real inspiration. It must be so difficult to watch from the side lines when you are so used to taking part, but at least it must be comforting to look back on the last year or so and see just how far you've come. Keep it up!

[PMRpro Ambassador]

I was given medrol and a quinolone antibiotic - which caused inflammation in the achilles tendon (known side effect, no one put 1 and 2 together to get 3!). However, it started with stiff calf muscles before settling in the heel. The orthopods here told me I had to be VERY careful - just tripping on a kerb edge would be enough to snap the tendon and that is a major operation to sort out and they didn't fancy doing it! They said 9-12 months - 9 months it was!

The year before I went flying while skiing (snow was too soft and I was hoping to get to the bottom of the shortest run and go home. Failed by 50m! However - I tore the medial collateral ligament and the cruciate. The MCL must have torn completely - no pain at all. It healed fine after 4 weeks immobilisation in a brace. We ignored the cruciate and my knee is stable without.

I did ask both times if the pred would have had anything to do with it. The achilles - yes, both the pred and quinolone abx can do it but both together is far higher likelihood. The knee - they didn't think so and it certainly healed very quickly. Even the doctors were surprised that the knee was stable after 4 weeks and totally OK after 6. But I did wear the brace day and night as I'd been told to - and we wondered how often THAT happens!

[Carris]

Hi Skinnyjonny, yes this PMR does take us fitness buffs for a ride...i am a retired pe teacher who has always been reasonably fit..Always done my pushups, curl ups, weights, 5k runs each week. Plus participate in softball and pickle ball, thus far have not had significant injuries, but know that poly is with me every day. I am on 3 mg of prednisone, came off of it two months ago but had to go back to a low dosage. I know my body is not the same as before, but i keep telling it we go on anyway....Good luck and it is great to hear about your workout schedule...Carris from north carolina

[Hidden]

As PMR is looking more likely to be part of the Vasculitis family, it is more likely that blood supply to the muscles is impaired. Therefore it would then mean that PMR would impair the healing process.

I snapped a tendon and it took an operation and nearly one year to walk again.

We need to remember that currently there is no known cause or cure, but research is taking place.

[Whittlesey]

Yes, Skinnyjonny, I also would like to know the answers to these questions. I am hoping to get back to work, which includes a fair amount of walking, running for buses, walking blocks, etc. Sometimes, using assists, now, when I get home the pain in my legs and right arm and shoulder (nerve damage diagnosed) is pretty bad. use neurontin and sometimes take one gm of pred for the pain. Will this get better. and if I hike or do a run, (which I used to love to do) will I end up in a bad way? Really good questions. thanks for asking them.

And I wish so much -- everything -- as you move forwards through this disease. Hope to see you in the city !

all my best, Whittlesey NYC U.S.

[Skinnyjonny in reply to Whittlesey]

Great to hear from you again Whittlesey. I'm really looking forward to the Tunnel-2-Towers race in New York in September. Just managed my first overnighter in the UK Lake District with a UK Parkrun, a couple of hill walks and the best bit ... a classic rock climb Napes Ridge on Great Gable! "Not only Running free but now Climbing free with a smile"