Showing posts with label injury. Show all posts
Showing posts with label injury. Show all posts

Sunday, March 11, 2012

Bashed Knee? No Thank You!

A determined soul will do more with a rusty monkey wrench than a loafer will accomplish with all the tools in a machine shop. **Robert Hughes**



       I am definitely a rusty monkey wrench today! It has been one of those weeks were everything hits at once making me fell like the world is out to get in my way.

       Whatever sinus thing has been going on for 2 months is now being treated with big time antibiotics which kill my stomach, my RA has decided to flare up and took one shoulder out of commission for a while, I have had to give up coffee because suddenly it is making my heart race and pound very uncomfortably, and to top it all off, I tripped and fell on my long run and knocked my knee just enough to cause it to stiffen up and hurt. UGH!

       Of all those things, the only one really scaring me is the knee. I didn’t really hit it that hard since I was on soft ground and rolled with the fall fairly well. At the time, it smarted a bit, as did my palms, but once I got up and shook it off all seemed well. I finished my run, and only in the last couple of miles did it start twinging. At that point it didn’t feel any better to walk so I just plodded along, taking care to keep my form very strict, and got home. After stretching and showering I sat down at the computer for a few minutes and then stood up, OUCH! It hadn’t taken long for the knee to stiffen up badly! Walking was painful and going down stairs was worse. Applying ice directly to a joint is excruciatingly painful for me so I settled for rest.

       By Saturday morning it was feeling better, but still tender, so I did not run with my group and instead stayed behind updating computer records. Today it is about 90% better, just an occasional twinge, but no serious pain and not much worse than the rest of my joints which are all complaining about the RA activity. If all goes well, I will head to the gym tomorrow to get on the treadmill so I can stop the minute I feel a twinge. If I have to take the week off from running, it is a good week to miss since it is already a fall back week. I do have a half marathon a week from today, but I don’t need to push it and I think my knee will be fine by then if I behave myself this week. Unlike repetitive use injuries, a mildly banged knee heals quickly with proper care.

       Bottom line here, I’m not looking for sympathy, but to show once again that it is totally normal to have interruptions and hiccups during the training cycle. I’m sure there are people out there that have perfect training records, and probably many more that have the potential for carefree training, but never get off the couch, I’m simply not one of those people. We have to work with what we have and if what I have is an accident prone, 40+ year old body with RA and bad sinuses, then that is what I have to work with. Frankly, I think it is even more important for me to stay strong and maintain every ounce I can muster because the more we have on our plate, the more strength we need to hold it up.

       Oh yes, and the shoulder that was about 90% impaired Saturday morning was down to only about 10% impaired by the end of the run. I know there are plenty of RA sufferers who don’t understand how I can run when I’m in pain from RA, but a run always makes the RA back off. I may still be tired, but my joints are less stiff and sore and I’d rather be tired from a run than RA!

       PS, had a great Interview with Chris from http://www.runrunlive.com/ it is a great website and podcast so please check it out and I will post the link when my interview airs!

Monday, January 24, 2011

Treadmills and Freezing Temperatures

“The road to success runs uphill.” **Willie Davis**


       I am enjoying being back to running, but is hasn’t been a perfectly smooth road. Ups and downs are part of every runner’s routine, and I’m certainly no exception. What makes runners different is our ability to stick to our running plan even when we feel like skipping a run or just quitting and going home. It can be a serious challenge to squeeze a run into an action packed day with everyone placing endless demands on your time.

       The hardest part about coming back from an injury is facing the fact that getting back to 100% is a slow process. There are so many components to a good run and each item that is missing adds exponentially to the difficulty of finishing the way you want. While out with an injury, it seems like, “If I could just run, everything would be fantastic.” So when you finally hit the road for your first run, the lack of speed, heavy legs, and screaming muscles are very frustrating! The injury is healed and feels good, but everything else that has been out of use complains loudly making you feel like you will never be a runner again, or question whether you were ever a runner to begin with. Being back to running does NOT mean being back where you left off.

       This past week I finally ran a 25 mile week, but 20 of them were on the treadmill. My goal is to maintain this as my average for the next several months, moving more and more runs to the great outdoors (weather permitting). I will not dive into structured race training, but focus on strength training to build up my hips and core. It is weird for me not to fill my calendar with races, planning my life around structured runs and preset distances, but I can live with the adjustment.

       Running so much on the treadmill has been interesting. I have heard many people over the years complain about running on the roads after spending a lot of time on the treadmill. We are told to set it at an incline to replicate the effort of being on the road, or to set it on a decline to replicate the pounding. In the end everyone agrees that running on the treadmill is easier than running on the road. It may be lack of wind resistance, or the fact that you are not propelling yourself forward, but I find the biggest difference to be mental. When you are on a treadmill you pick a speed, dial it up, and run. It takes will power to not reach up and dial it down when you get tired, but if you can distract yourself with a TV, MP3 player, or chatting with the friend on the next treadmill, you can cease to think consciously about your pace and just keep up with the belt. On the road it is a very different matter. As my mind drifts, I relax and slow down, sailing along at an ever slowing pace until something catches my attention and makes me realize I have dropped my speed and heart rate into a lower zone. Tempo runs in particular are easier on a treadmill. No need to think, just program in the plan and go.

       I also think treadmills produce a different muscle balance. We use so many muscles when running, to keep balanced, move forward and get the next foot out for the next step, but the treadmill leaves some of this out. On a treadmill you don’t work as hard to balance because it is such a smooth consistent surface, devoid of surprises like pine cones, dog poop, or driveway entrances. With the belt moving under you, there is no engagement of the muscles to push your body weight forward. The one advantage is that the process of getting the next leg up and out in front of you is the same. Since treadmill running is easier, you can run “faster” and engage more fast twitch muscles for the same heart rate.

       One other issue with treadmills, I frequently get vertigo and have to grab the hand rails to keep from falling off. On the road or trail, I have been known to close my eyes for a few seconds at a time, but if I do that on a treadmill my head swims and I crash into the hand rail (which is more than a little embarrassing in a crowded gym). I also feel very disoriented and off balance when I get off a treadmill so I have to stand still on it long enough to get my bearings (also mildly embarrassing).

       All and all, I would say treadmills have their place, but I’d rather be on the road, even when it is uphill. (Except today since it is 1 degree Fahrenheit as I type.)

Saturday, November 27, 2010

The Long and Boring Road: Injury Recovery is the Pits!

"The function of the press in society is to inform, but its role in society is to make money."

A. J. Liebling



       Let me start by saying, everything is calm and normal here in South Korea. It appears the US news media is having a field day with doom and gloom over the exchange of live fire, but nothing has changed for us here since the initial alert last week.

       Running wise, I have had very little to blog about. The orthopedic surgeon said my foot is not yet healed so he wants me to give it 6-8 more weeks and see him again before I try running. He also told me to knock off hiking as there is too great a chance of re-injury if I step on a rock wrong or stumble on a rut. That was hard to hear as the last tolerable days of weather slip past me on our way into a dark and cold winter.

       My one bright note is that I have a group of beginners that I am working with. This past week 2 moms and a gaggle of kids joined me on the outdoor track to learn how to run and love it. I’m teaching them about form and how to run slowly and smoothly to develop good habits that can keep them running for a lifetime. It was a great experience and everyone left with a smile on their face. I can’t wait for their first spring 5K! With a little luck, I will get to run it with them.

Monday, September 20, 2010

Working Hard At Taking It Easy.

“Everything comes to him who hustles while he waits.” Thomas Alva Edison



       Following my MRI and visit with the orthopedic surgeon, the final diagnosis is better than I had feared. It is not a ligament rupture; it is a plain stress fracture of the Navicular and possibly also the cuboid, two of the chunky bones on the top of your foot at the ankle. It appears the main culprit was running down hills, something I will have to be very careful with in the future. I was surprised that I had cracked the chunky bone rather than the long thin metatarsals, but there are big ligaments that attach to the chunky ones and pull hard enough to fracture them when pulled over and over and over and over.

       So for the next 6 weeks (hopefully not extended to 8) I am sporting this lovely fashion statement.



       Now that I have the Boot, I am realizing what good company I am in. Hardly a day goes by that I don’t see someone else hobbling around the base in a matching appliance, and I am on a really small base. The hills here are steep and brutal luring many runners to injury.

       In Virginia, the only hills I had were those on the Noland Trail. One trip around the loop had a gain of over 2,000 ft. over the 5+ miles. I ran that trail 3 times in a row right before I left, (a total of a mile each of ascent and decent), so I thought I was ready for hills, but it consisted of dozens of small hills instead of long continuous ones, and it was a dirt trail which is way less stressful on your body than asphalt or concrete. In addition, I was exhausted with jetlag and stressed from the move, I added hills to every run while maintaining my mileage and pace, I was running on sidewalks instead of the road most of the time, and running both up and DOWN hills. And, of course, I’m an over 40 woman. By adding hills to every workout and not backing off on mileage or intensity, I totally exceeded the 10% rule!

       I was asked on my regular running forum, how I thought barefoot running plays into injuries like this my answer was: In the early stages of barefoot running, being actually barefoot (not in a minimal or "barefoot" shoe) protects you from TMTS (too much, too soon), but once your feet are conditioned for the miles, it is just as easy to overdo it in bare feet as in shoes. I think if I had tried to add speed work to every work out, the bottoms of me feet would have let me know before I got hurt, but hills did not add a challenge for the soles of my feet so I didn't have that warning. Plus I have learned to run on very old rough roads and the roads here on Osan Air Base are pristine. I could probably run a full marathon on them without my feet being tender or blistered. Being barefoot neither protected me from, nor caused my stress fractures. I simply exceeded my limits.

       I was also not listening to my body. I've always been opposed to running streaks because people will run no matter how horrible they feel, not wanting to break their streak. I see now that mileage goals are no better. My goal of 1,000 miles for the year is what blinded me to what I was doing to myself. I didn't want to fall behind on my mileage when I had already lost some ground in the previous week due to the move. Physically, I could easily have cut back on miles and still been gaining conditioning because of the hills, but I was so determined to keep my numbers pumped up that I ignored my better sense and kept going.

       I have never thought much about stress fractures, they were something that happened to other people who weren’t paying attention and pushing too hard. I’ve never broken a bone and always been strong so it simply was not something I was looking for and I had no warning. I did not feel tired on that run, I did not feel like my form was off. I had no soreness anywhere. Nothing physically told me I as over doing it. When I felt the pop in my foot, it felt like a spring "sprung," it really wasn't painful at all, just very strange. At that moment I stopped running and my foot began to feel a bit tender, but on a scale of 1-10 it was only a 2. After a minute or so of walking, I tried running again and it didn't feel any worse so I just slowly finished the last couple of minutes back to my hotel. The next day my foot was sore, but after another couple of days it was no longer tender to walk on and I could jog in circles around my house without pain so I went for a short run. Everything was fine for about 15 minutes and then it suddenly became VERY sore. It actually hurt worse to walk than to run so I turned around and ran back to my car. After that the level of soreness did not waiver. I could not walk, let alone run, so I knew I had really done something this time and went to see a doctor.

       I have been questioned about whether or not my rheumatoid arthritis was a factor in the fracture, but I am confident that if RA was to blame for my stress fracture it would have happened while I was marathon training, in the marathon, or for sure at the 24-Hour Relay. I cannot blame it on anything but my own lack of judgment. I have used some cortical steroids to treat RA, but rarely and not in high doses or for long periods of time. My bones do not show thinning and I have put them to the test before. This is not an RA related injury and in my life the benefits of running still vastly outweigh the risk of injury.

       What I'm hoping to really push is the fact that hills are much more stressful than running on flats so if someone moves from a flat to a hilly area, or goes on vacation from their flat city to the mountains, this is something they really need to watch out for. I knew hills were more stressful, but I hadn't really connected the dots on HOW much more strain they were putting on my body. If I had treated them with the 10% rule and considered 10% as no more than 10% of the running time up or down a hill and no more than 10% of my weekly time totals, instead of just thinking of them as not that much of the total distance, I would probably not be in a boot. I had never heard of anyone getting a stress fracture from running hills and thought I was taking it easy enough by doing some of my running in flat areas. Sometimes these things sneak up on us, but now everyone that has read this blog will hopefully tuck away this grain of information so that if they are ever faced with more hills than usual, it will pop up and remind them that somewhere they read about someone getting a stress fracture from running hills.

       The other lesson I want to stress here is: When something in your foot pops, STOP and do not proceed until you have seen a doctor that has experience diagnosing stress fractures. The general practitioner I saw at first was great, but he didn't know how to manipulate the foot to determine a stress fracture so I was walking around on a broken foot for 2 more weeks (yep, a total of a month walking around on a stress fracture, OUCH!)

       The good news is, I'm cleared for cardio in the gym as long as I can do it with the boot and AND it doesn’t hurt. Since it did hurt my foot to do spin class before, I have been holding back and not going to class, just sticking to the stationary bikes in the cardio room at the gym, but I did sneak in between classes and give it a whirl. I could stand to pedal with the boot on, but I think I need to at least give my foot a couple of weeks of peace before I push it that hard so I will wait a bit to resume spin class. Additionally, I have added to my supplements. I am not usually one to pop pills for nutrition, but some things we just can’t get enough of. I was already taking loads of Vit D, but I have now added calcium and magnesium to make sure I'm getting plenty to build new bone. I see the orthopedic surgeon again later next month and I will sign up for physical therapy to get started on a good and healthy track. The boot isn't so bad, it makes it much easier to walk (it has a rocker on the bottom like all the new power walking shoes, LOL) and keeps my foot from hurting. I am maintaining my goal of at least 5 hour of cardio a week plus some weights and I have actually lost weight, (although my pants are a bit more snug so I know I am losing muscle, not the fat I would like to lose). It is rather disconcerting to see that my right calf is already significantly smaller than my left, but I am definitely not the first person to have to rebuild a muscle after casting so I know it will be back to normal eventually.

       It is killing me to look out from my window and see hills that I know are full of hiking trails (Koreans are very into fitness) and not be able to run them while the weather is beautiful. Of course, I have already found a “Return to Running after Injury” training plan and cannot wait to get to it! Patience, patience, patience! Just 4 ½ more weeks…

Friday, October 23, 2009

Acceptance

"Everything changed the day I understood that if I was to become a runner, I would have to run with the body I had." John Bingham, The Courage to Start

I read this quote in the blog of my friend Amy and it really struck me. I need to take it to heart and stop beating myself up every time I step on the scale. Amy will be part of my group at the Outer Banks in a couple of weeks running the full marathon, her very first! She inspires me. Amy learned to swim recently so she could compete in a triathlon and hasn’t let anything stop her. This is what I love about running, all the people overcoming their fears and getting out there even though they aren’t top athletes, even though they aren’t going to win, but just to be part of something and show they can do it.

We are all up against our own bodies. Maybe we carry a few extra pounds that slow us down, maybe we have nagging injuries, illnesses, or busy lives, but we get out there and run. Images like Paula Radcliffe sitting in the curb, head in hands, remind us this is not unique to amateurs, but we keep running. When we can’t run, we obsess about it.

I blew it last week. I’ve been doing too much speed work, desperate for the sub 54 10K that will give me the confidence to try to break 2 hours in the half marathon at OBX. “Desperate” is the problem. As I hurdled down the street, doing an 800 meter interval, I leaped off the curb and landed with a sickening pain in my calf. It was such a graceful leap. I was enjoying every moment of being airborne, planning to land with the precision of a ballet dancer in toe shoes, instead I nearly crumpled to the ground. 1 ½ weeks to the 10K, 2 ½ weeks to the half marathon, and I’m limping down the street trying to figure out who to call to pick me up. After a few minutes on the curb I started walking, bending my knees and finding a way to walk without pain. Once I got the walking down, and realized I still had over a mile to go, I tried a slow jog. I was able to very slowly plod home (turned out that jogging hurt less than walking) and won’t try running again until Saturday. If I can’t run Saturday, I won’t run at all for a week. It will be a long stressful week, but better a week than a month or a year.

So, I’m on a forced running vacation, but it won’t be forever.