I'm not sure if I've mentioned this before, but I work in the orthopaedics department at a major hospital. I mainly do basic research in the development of implantable devices, but the clinical half of our lab works directly with patients and is expanding to a number of gait studies. This is really exciting for me, since the majority of my work has been engineering-based, which makes sense since I'm an engineer. But I've always wanted to work on the clinical side - the point where I've debated returning to nursing school or getting a certificate in clinical research so I can shift gears.
Now I was chatting casually with one of our clinical research staff/PTs at the coffee machine last week. She was asking about how my IT band issues were coming along, and I, in turn, brought up the fact that they were great compared to the stress fracture. I dicussed my visit to Sports Medicine the week before, and how I wasn't sure if I was going to return to my traditional running shoes or the Vibrams.
Now my doctor has worked with the clinical labs in our department over the years, thus my coworker was familiar with him and his experience. She started to tell me about the new offsite gait/sports medicine facility they're currently getting set up along with a number of new biomechanics studies that I might be interested in -- and ultimately a new sports medicine PT that arrived last year. This PT apparently has extensive experience in running gait analysis. I perked right up at that. She said she would talk to him for me, see if he could help me get back running again. She also said that they'd be thrilled to have me help them out with the gait studies they'll be starting later this year.
So wait, let me parse this down for you, since I'm ramling:
(1) I get to work with an accomplished PT to determine weaknesses in my biomechanics and ultimately how to fix them to run healthy.
(2) I have been invited to participate in running gait analysis research, which will ultimately be cutting edge research in the sports medicine/orthopaedic field and help answer all of the questions that have arisen in the wake of the minimalist running fad (it's now my word too).
Showing posts with label injury. Show all posts
Showing posts with label injury. Show all posts
PT and Biomechanics Analysis
Tuesday, May 10, 2011 barefoot running, biomechanis, injury, physical therapy, stress fracture
Ill-fated Trial Runs
Sunday, May 1, 2011 injury, stress fracture
Test Run #1: Wednesday, April 27th
After the go ahead on Wednesday, I immediately decided to leap into action and go for a run. He said treadmill, but it was the most beautiful day ever and I couldn't resist the call of the wild (or in this case, the call of the urban park). Going home directly after work, I thought I'd do a nice 1 mile loop down and around Bremen Street Park. Children and families were everywhere. Busier than your average summer weekend even. I guess that's the call of the first spring-like day.
I took it easy, settling into what was about a 9:30 min/mile pace, lightly bouncing off my forefoot in the Bikilas. I decided to stick with the VFFs because ultimately I feel more efficient and comfortable with the new gait. I think this is a viable option as long as I strength the weakness in my feet, ankles and calves. Take it slower. Avoid cement.
When I met up with the park, I jogged solely on the grass. It's very squishy, lush grass, but with some mild risk of turning an ankle in a divet. I didn't do so. I made it about 1 mile without pain, when I paused for a stretch. It felt good. I did some push-ups, then took off again. I made it another 0.25 of a mile before I called it a day. I wasn't about to push my luck. I felt a mild ache in the top of the foot as if perhaps it would turn to pain if I'd kept it up.
I left the run optimistic!
Test Run #2: Friday, April 29th
Given the nearly positive results of my Wednesday run, I thought I'd do a quick out and back along the esplanade two days later. Another gorgeous day - the grass green, the sky clear and sunny, the weather warm with a breeze off the river. Everyone was out taking advantage of the weather from joggers, like myself, to cyclists and families.
In order to avoid the harsh impact on cement, I casually walked through the intersection by Science Park until I could hope onto the grass/trail near the tennis courts. Passing the Charlesbank playground, I turned off through the parking lot to join the running trail along the river. All was going well up until I hit the overpass by the Long Fellow. Approximately 0.5 miles into the run. Mild, ignorable pain in my foot. Pain that eased up when I used a midfoot landing and forward shuffle instead of a bouncing forefoot strike. I stopped by the bridge to stretch the calves, rest the foot a few minutes.
When I started up again, I stuck the dirt beside the paved path, but never made it much further than the boathouse. I stretched some more and turned myself around. The very pain had hit me that I was warned not to run on. I was also feeling it in the left side of my ankle. As if perhaps I'd been compensating somehow in my landing and put extra strain on the ankle. Defeated, I returned to the gym with my head hung low.
Conclusions:
I've since decided to give myself another two weeks of rest before I attempt another run. The foot had clearly not healed entirely and I likely set back my progress with the trial runs. This isn't boding well for the Warrior Dash in June - but at least my aerobic capacity is being held in shape with my regular bike intervals.
After the go ahead on Wednesday, I immediately decided to leap into action and go for a run. He said treadmill, but it was the most beautiful day ever and I couldn't resist the call of the wild (or in this case, the call of the urban park). Going home directly after work, I thought I'd do a nice 1 mile loop down and around Bremen Street Park. Children and families were everywhere. Busier than your average summer weekend even. I guess that's the call of the first spring-like day.
I took it easy, settling into what was about a 9:30 min/mile pace, lightly bouncing off my forefoot in the Bikilas. I decided to stick with the VFFs because ultimately I feel more efficient and comfortable with the new gait. I think this is a viable option as long as I strength the weakness in my feet, ankles and calves. Take it slower. Avoid cement.
When I met up with the park, I jogged solely on the grass. It's very squishy, lush grass, but with some mild risk of turning an ankle in a divet. I didn't do so. I made it about 1 mile without pain, when I paused for a stretch. It felt good. I did some push-ups, then took off again. I made it another 0.25 of a mile before I called it a day. I wasn't about to push my luck. I felt a mild ache in the top of the foot as if perhaps it would turn to pain if I'd kept it up.
I left the run optimistic!
Test Run #2: Friday, April 29th
Given the nearly positive results of my Wednesday run, I thought I'd do a quick out and back along the esplanade two days later. Another gorgeous day - the grass green, the sky clear and sunny, the weather warm with a breeze off the river. Everyone was out taking advantage of the weather from joggers, like myself, to cyclists and families.
In order to avoid the harsh impact on cement, I casually walked through the intersection by Science Park until I could hope onto the grass/trail near the tennis courts. Passing the Charlesbank playground, I turned off through the parking lot to join the running trail along the river. All was going well up until I hit the overpass by the Long Fellow. Approximately 0.5 miles into the run. Mild, ignorable pain in my foot. Pain that eased up when I used a midfoot landing and forward shuffle instead of a bouncing forefoot strike. I stopped by the bridge to stretch the calves, rest the foot a few minutes.
When I started up again, I stuck the dirt beside the paved path, but never made it much further than the boathouse. I stretched some more and turned myself around. The very pain had hit me that I was warned not to run on. I was also feeling it in the left side of my ankle. As if perhaps I'd been compensating somehow in my landing and put extra strain on the ankle. Defeated, I returned to the gym with my head hung low.
Conclusions:
I've since decided to give myself another two weeks of rest before I attempt another run. The foot had clearly not healed entirely and I likely set back my progress with the trial runs. This isn't boding well for the Warrior Dash in June - but at least my aerobic capacity is being held in shape with my regular bike intervals.
What happened with the podiatrist
Wednesday, April 27, 2011 barefoot running, doctor visit, injury, minimalist running, stress fracture, vibram
I had my visit with the orthopaedic podiatrist this morning. It was uneventful and confusing. Now I really liked the doctor. He was friendly, had a sense of humor and amicable to asking all of my questions. He even said I had good questions - score!
Perhaps it was the excellent conversation that left me pleased with the visit in spite of the lack of answers.
When I explain how I went about injuring my foot, I could already see the rueful shake of his head. I later learned that give the "fad" (his word, not mine) of minimalist running, that people were arriving at his doorstep in epic numbers with injuries such as mine. I was, in fact, a statistic. He and some collaborators at Harvard are currently writing a paper on this very observation, to be submitted in the near future to JBJS or JSM.
Now he specifically stated that he neither supports nor discourages minimalist running. However, he did spend quite a bit of time pointing out some rather glaring holes in the few papers published on barefoot running - notably the sample population in the Nature article (all Kenyans who had never worn shoes and grew up running on grass compared to shod American runners who ran on urban surfaces). Or that fact that they measured impact force on the ground as opposed between the heel and shoe. And the obvious lingering question - even if you can steadily show that barefoot runners land with 20% of the force of a shod runner, does this actually lead to lower rates of injury? Even Dr. Lieberman wasn't able to conclusively say that barefoot running resulted in lower risk of injury. The research simply hasn't been done at this stage. Adequate controls and sample populations weren't in place in the published studies.
Beyond the few studies themselves, becomes the most relevant question - one that I asked him: As a heel-striking, shod runner, how can I safely transition to a minimalist, forefoot-landing running style? There is no proven or certified method of doing so at this stage. Current research compares lifetime barefoot runners and lifetime shod runners. As someone who spent the first 30 years of their life wearing shoes, running in shoes with an elevated heel, will I not only be able to transition to a healthy, safe barefoot stride that equals the same efficiency? My body has adapted and is "efficient at running inefficiently" - to quote Danny Abshire. The bottom line: Will this transition reduce my risk of injury? The answer is that no one knows right now. The research hasn't been done.
So after spending 30 minutes talking intently to the orthopaedist about this, we did come to several conclusions.
I have a fairly uncommon foot type where my heels are set inward when I stand with my feet facing straight forward. So if you look at my feet head-on, you can see the insides of my heels. This results in a mild supination of my foot, where my foot settles off to the sides and I land harder on the outside of my foot. This is something that could be corrected with a couple millimeter heel wedge. He said that if I continue to have ITBS problems, to give him a call and we'll look into the heel wedge.
If I stick to a minimalist stride, the ITBS may not be a problem, since it is primarily an overuse injury that is a result of the heel-striking gait and compensations associated with it. Therefore, if I continue to land on my forefoot, I will likely curtail the ITBS.
This sounded great to me. My entire reason to swap to the VFFs and natural running stride was to get rid of the ITBS that was plaguing me with mileage above 6-8 miles. So upon having this route confirmed, I asked, "So how do I safely return to the forefoot striking gait without reinjuring myself?"
That's the million dollar question.
For one thing, the stress fracture repairs itself stronger and healthier than it was originally - so the likelihood of refracturing that exact spot is unlikely. That doesn't mean I won't just fracture at another location. I asked if there was a set program or recommended transition. He laughs in a good natured way "You mean, is there running school or programs that safely transitions runners from shod to barefoot running safely? No. That would be handy. I'm sure you can find some guy claiming to be able to do just that, but its not routed in research or proven safe practices. There is no certified program to transition you. Our PTs wouldn't be able to help with that, and I don't know of any place off hand that offers such a program."
So pretty much, I'm on my own. He did confirm that weak calves were the primary problem. I suggested calf strengthening exercises - something I already do - and slowly easing into running. On grass - not pavement. He didn't really confirm or deny. But I can certainly continue my non-impact weightlifting and cardio.
He did tell me that I can go onto the treadmill tonight for a trial run. I am to run 1/2 to 1 mile. If I feel any pain, I should stop. Pain indicates that the fracture isn't healed. I can "only run when there is no pain." This can take any numbers of days or weeks, depending on my day to day activity levels. Every time I feel pain though, I should consider the fact that I'm taking a little away from the healing process.
I asked if I should wear the VFFs or my Landreths for the treadmill trial. He said that was up to me. But suggested if I was going to go the minimalist route in the future, that I should consider alternating in the beginning. That is a wise idea.
So...that's that. You're probably as confused as I am. But I'm not more confused than I was going in. I've just had the confusion over this transition to minimalist running confirmed by one of the leading doctors in the nation. Sweet.
On a side note, I gave myself a mini-pedicure in anticipation of the visit today. My toes are sparkling with fluorescent pink polish. I get giddy just looking at them.
Perhaps it was the excellent conversation that left me pleased with the visit in spite of the lack of answers.
When I explain how I went about injuring my foot, I could already see the rueful shake of his head. I later learned that give the "fad" (his word, not mine) of minimalist running, that people were arriving at his doorstep in epic numbers with injuries such as mine. I was, in fact, a statistic. He and some collaborators at Harvard are currently writing a paper on this very observation, to be submitted in the near future to JBJS or JSM.
Now he specifically stated that he neither supports nor discourages minimalist running. However, he did spend quite a bit of time pointing out some rather glaring holes in the few papers published on barefoot running - notably the sample population in the Nature article (all Kenyans who had never worn shoes and grew up running on grass compared to shod American runners who ran on urban surfaces). Or that fact that they measured impact force on the ground as opposed between the heel and shoe. And the obvious lingering question - even if you can steadily show that barefoot runners land with 20% of the force of a shod runner, does this actually lead to lower rates of injury? Even Dr. Lieberman wasn't able to conclusively say that barefoot running resulted in lower risk of injury. The research simply hasn't been done at this stage. Adequate controls and sample populations weren't in place in the published studies.
Beyond the few studies themselves, becomes the most relevant question - one that I asked him: As a heel-striking, shod runner, how can I safely transition to a minimalist, forefoot-landing running style? There is no proven or certified method of doing so at this stage. Current research compares lifetime barefoot runners and lifetime shod runners. As someone who spent the first 30 years of their life wearing shoes, running in shoes with an elevated heel, will I not only be able to transition to a healthy, safe barefoot stride that equals the same efficiency? My body has adapted and is "efficient at running inefficiently" - to quote Danny Abshire. The bottom line: Will this transition reduce my risk of injury? The answer is that no one knows right now. The research hasn't been done.
So after spending 30 minutes talking intently to the orthopaedist about this, we did come to several conclusions.
I have a fairly uncommon foot type where my heels are set inward when I stand with my feet facing straight forward. So if you look at my feet head-on, you can see the insides of my heels. This results in a mild supination of my foot, where my foot settles off to the sides and I land harder on the outside of my foot. This is something that could be corrected with a couple millimeter heel wedge. He said that if I continue to have ITBS problems, to give him a call and we'll look into the heel wedge.
If I stick to a minimalist stride, the ITBS may not be a problem, since it is primarily an overuse injury that is a result of the heel-striking gait and compensations associated with it. Therefore, if I continue to land on my forefoot, I will likely curtail the ITBS.
This sounded great to me. My entire reason to swap to the VFFs and natural running stride was to get rid of the ITBS that was plaguing me with mileage above 6-8 miles. So upon having this route confirmed, I asked, "So how do I safely return to the forefoot striking gait without reinjuring myself?"
That's the million dollar question.
For one thing, the stress fracture repairs itself stronger and healthier than it was originally - so the likelihood of refracturing that exact spot is unlikely. That doesn't mean I won't just fracture at another location. I asked if there was a set program or recommended transition. He laughs in a good natured way "You mean, is there running school or programs that safely transitions runners from shod to barefoot running safely? No. That would be handy. I'm sure you can find some guy claiming to be able to do just that, but its not routed in research or proven safe practices. There is no certified program to transition you. Our PTs wouldn't be able to help with that, and I don't know of any place off hand that offers such a program."
So pretty much, I'm on my own. He did confirm that weak calves were the primary problem. I suggested calf strengthening exercises - something I already do - and slowly easing into running. On grass - not pavement. He didn't really confirm or deny. But I can certainly continue my non-impact weightlifting and cardio.
He did tell me that I can go onto the treadmill tonight for a trial run. I am to run 1/2 to 1 mile. If I feel any pain, I should stop. Pain indicates that the fracture isn't healed. I can "only run when there is no pain." This can take any numbers of days or weeks, depending on my day to day activity levels. Every time I feel pain though, I should consider the fact that I'm taking a little away from the healing process.
I asked if I should wear the VFFs or my Landreths for the treadmill trial. He said that was up to me. But suggested if I was going to go the minimalist route in the future, that I should consider alternating in the beginning. That is a wise idea.
So...that's that. You're probably as confused as I am. But I'm not more confused than I was going in. I've just had the confusion over this transition to minimalist running confirmed by one of the leading doctors in the nation. Sweet.
On a side note, I gave myself a mini-pedicure in anticipation of the visit today. My toes are sparkling with fluorescent pink polish. I get giddy just looking at them.
Pre-Appointment Update
Tuesday, April 26, 2011 doctor visit, injury, stress fracture, x-rays
Tomorrow is my appointment with the orthopaedist. Last week (April 18th), I had another set of x-rays taken on my foot. I received a note from my doctor stating that it was continuing to heal well and that I should bring along my x-rays to the appointment. Therefore this morning I swung by radiology to grab copies of the x-rays. I will now share them for your viewing pleasure!
As you can see from the periosteal reaction, the stress fracture is located near the head of my second metatarsal of my left foot. These images are at 4 weeks and 7 weeks post-fracture, once healing had begun.
I don't necessarily see dramatic healing in last week's x-rays, but my day to day pain has subsided. I can perform lunges and last week I participated in yoga without much difficulty. I feel comfortable performing knee-dropping dance moves on Dance Central. I get minor pain (3/10) when I walk up a steep incline or hill, but daily activities are unaffected. I'm feeling confident that I'll have permission to start running ASAP.
I will report back after tomorrow's visit!
As you can see from the periosteal reaction, the stress fracture is located near the head of my second metatarsal of my left foot. These images are at 4 weeks and 7 weeks post-fracture, once healing had begun.
I don't necessarily see dramatic healing in last week's x-rays, but my day to day pain has subsided. I can perform lunges and last week I participated in yoga without much difficulty. I feel comfortable performing knee-dropping dance moves on Dance Central. I get minor pain (3/10) when I walk up a steep incline or hill, but daily activities are unaffected. I'm feeling confident that I'll have permission to start running ASAP.
I will report back after tomorrow's visit!
A lot of nothing.
Wednesday, April 13, 2011 injury, stress fracture
I haven't updated in the past week because nothing has happened.
My appointment with specialist isn't until April 28th. My foot feels generally unchanged. I haven't been wearing the shoe, but I haven't been jogging or walking around in heels either. The most pressure I've put on the foot is to do seated calf raises, and while this will eventually lead to an imbalance, my right foot tends to carry most of the load.
Outside the sphere of running, I've been making strides in with my lifting. Yes, I'm graphing my weight gains on Excel. I think that my muscles are beginning to pick up steam now that I'm back into the routine and I'm seeing faster gains in strength. I'm back to Fall 2009 levels with my upper body, but I'm taking it easy with the legs. The last thing I need is to vault myself into further injury by non-running related means.
I think that mentally I've nearly had it with this injury business. In some ways, I feel like I've lost my identity as a runner. It's been over a year now, since I ran injury-free. Last summer and early autumn seemed like a fluke. It doesn't seem real that I actually ran that half marathon. My vibram/natural running transition of December-Feburary was so low mileage that that didn't even seem to qualify. I have no idea what kind of standard I'm setting to call myself a runner again, but at the moment, since I'm not running, I'm definitely not meeting it.
The weight gain and general loss of cardio-vascular strength is frustrating as well. I feel unmotivated to perform any type of exercise if running isn't somehow involved. Yes, the lifting is fun - but I always did it in conjunction with running. I was doing it to be a better runner. There has never been anything independent about my other exercise. It has all been for the purpose of improving myself as a runner. While continuing to workout while injured, I am certainly trying to maintain some level of fitness so that my return to running won't be hampered by sloth - but I really just don't love the rest of it as much.
I'm also getting bitter when I hear friends talk about their running and achievements. I am completely thrilled for them and motivated by their efforts - but feeling motivated while you're injured is like gunning the engine while you're in park. It's very frustrating after a while. That's where I now stand. Or sit. Or have parked my car.
My appointment with specialist isn't until April 28th. My foot feels generally unchanged. I haven't been wearing the shoe, but I haven't been jogging or walking around in heels either. The most pressure I've put on the foot is to do seated calf raises, and while this will eventually lead to an imbalance, my right foot tends to carry most of the load.
Outside the sphere of running, I've been making strides in with my lifting. Yes, I'm graphing my weight gains on Excel. I think that my muscles are beginning to pick up steam now that I'm back into the routine and I'm seeing faster gains in strength. I'm back to Fall 2009 levels with my upper body, but I'm taking it easy with the legs. The last thing I need is to vault myself into further injury by non-running related means.
I think that mentally I've nearly had it with this injury business. In some ways, I feel like I've lost my identity as a runner. It's been over a year now, since I ran injury-free. Last summer and early autumn seemed like a fluke. It doesn't seem real that I actually ran that half marathon. My vibram/natural running transition of December-Feburary was so low mileage that that didn't even seem to qualify. I have no idea what kind of standard I'm setting to call myself a runner again, but at the moment, since I'm not running, I'm definitely not meeting it.
The weight gain and general loss of cardio-vascular strength is frustrating as well. I feel unmotivated to perform any type of exercise if running isn't somehow involved. Yes, the lifting is fun - but I always did it in conjunction with running. I was doing it to be a better runner. There has never been anything independent about my other exercise. It has all been for the purpose of improving myself as a runner. While continuing to workout while injured, I am certainly trying to maintain some level of fitness so that my return to running won't be hampered by sloth - but I really just don't love the rest of it as much.
I'm also getting bitter when I hear friends talk about their running and achievements. I am completely thrilled for them and motivated by their efforts - but feeling motivated while you're injured is like gunning the engine while you're in park. It's very frustrating after a while. That's where I now stand. Or sit. Or have parked my car.
Confirmation
Monday, April 4, 2011 doctor visit, injury, stress fracture
Nothing has really changed. I got confirmation from the second set of x-rays today that it's a "healing" stress fracture. Which I suppose explains why hurts less now than it did a couple of weeks ago. On a positive note, in my mind at least, this means that I can totally run the 5k in a couple of weeks. If its already healing, then it should be fine by the time of the race. I lightly jogged to the train this morning (mainly because it was arriving and I wasn't at the station) and my foot didn't feel so bad in my Landreths. I guess cushioning and heel-striking tends to lessen the damage on my toe. I'm debating if this means I can run three miles like that. I think that this week I will go for a 1 mile trial run down the park and back. I'll ice it up and if it feels good, then I'll be on for race. Or more like a slow jog, which I know shames people actually racing it. But what can you do? I just love the exhilaration of marathon weekend.
I'm going to try to score the x-rays when I talk to my doctor next time. I really want to see my the bones in my foot.
Anyway, this is what happened:
Image from AAOS website: Here
I'm going to try to score the x-rays when I talk to my doctor next time. I really want to see my the bones in my foot.
Anyway, this is what happened:
Image from AAOS website: Here
X-Rays Results + Round 2
Friday, April 1, 2011 injury, stress fracture
Well, my x-ray results came back on Tuesday, but we played phonetag until Wednesday. The nurse who called me wouldn't tell me what she found, only that it was important that I come back in on Thursday to have a second round of x-rays taken to confirm the results. I headed in on Thursday assuming it would be a quick in and out, only to be called up to the doctor's office to speak with my doctor directly. As in, my physician called down and asked radiology to send me up.
When I arrived she told me that they think I have a stress fracture in the 2nd metatarsal from the first set of x-rays, but that the second round of x-rays will confirm. She wanted to proceed for now as we would for a stress fracture. At this point the bones haven't moved out of place, which is good news. She said that if I didn't hear from her by Friday with the additional x-ray results, that I should give her a call next week.
She also scolded me over the Reef sandals that I was wearing and referred to them as the Worst Possible Thing I could be wearing. She didn't seem to understand that I'm on vacation and it's like 50 degrees out! Honestly, regular walking doesn't hurt much these days. Only playing Dance Central does and specifically the Back Breaker move in Pon De Replay. In any case, she reiterated that I should wear highly cushioned running shoes from now on.
She then gave me The Ugliest Velcro Shoe On Earth (TUVSOE). The guy who fit me with the shoe explained that it simply has a stiff sole to prevent my toes from bending when I take a step. I felt that the cushioned running shoe advice was at odds with the stiff sole shoe purpose. My running shoes are highly flexible. That's the point. I'm confused. Especially since when I step in TUVSOE, my toes still bend up as I push off during a step. It is doing nothing except chafing my ankle and looking like an ugly orthpaedic shoe for someone who isn't nimble enough to tie laces. At least give me a big honking boot that actually prevents movement AND gives the impression that my foot is actually injured, as opposed to looking like an unfashionable old person sandal. I see no universe in which I will wear this thing.
I'll update next week. My received my appointment with the orthopeadic specialist - a foot/ankle guy at MGH. I won't be able to see him until April 27th. I'm on the fence about what I'm going to do about the B.A.A. 5k on Marathon Weekend. It's only 3 miles. I'm wondering if I can manage it if I wear my Landreths and take it in a jog. The alternative is to find someone who is looking for a bib. It seems a waste, especially monetarily, if someone doesn't get to the run the race with it.
When I arrived she told me that they think I have a stress fracture in the 2nd metatarsal from the first set of x-rays, but that the second round of x-rays will confirm. She wanted to proceed for now as we would for a stress fracture. At this point the bones haven't moved out of place, which is good news. She said that if I didn't hear from her by Friday with the additional x-ray results, that I should give her a call next week.
She also scolded me over the Reef sandals that I was wearing and referred to them as the Worst Possible Thing I could be wearing. She didn't seem to understand that I'm on vacation and it's like 50 degrees out! Honestly, regular walking doesn't hurt much these days. Only playing Dance Central does and specifically the Back Breaker move in Pon De Replay. In any case, she reiterated that I should wear highly cushioned running shoes from now on.
She then gave me The Ugliest Velcro Shoe On Earth (TUVSOE). The guy who fit me with the shoe explained that it simply has a stiff sole to prevent my toes from bending when I take a step. I felt that the cushioned running shoe advice was at odds with the stiff sole shoe purpose. My running shoes are highly flexible. That's the point. I'm confused. Especially since when I step in TUVSOE, my toes still bend up as I push off during a step. It is doing nothing except chafing my ankle and looking like an ugly orthpaedic shoe for someone who isn't nimble enough to tie laces. At least give me a big honking boot that actually prevents movement AND gives the impression that my foot is actually injured, as opposed to looking like an unfashionable old person sandal. I see no universe in which I will wear this thing.
I'll update next week. My received my appointment with the orthopeadic specialist - a foot/ankle guy at MGH. I won't be able to see him until April 27th. I'm on the fence about what I'm going to do about the B.A.A. 5k on Marathon Weekend. It's only 3 miles. I'm wondering if I can manage it if I wear my Landreths and take it in a jog. The alternative is to find someone who is looking for a bib. It seems a waste, especially monetarily, if someone doesn't get to the run the race with it.
The Doctor's Appointment
Monday, March 28, 2011 doctor visit, injury, stress fracture
Well, I went in for my yearly physical this morning with my new physician. She's a bit older, but very sweet. I asked if she could look at my foot while I was there, providing a brief history of my running injuries over the past year. I suppose I'm rather long-winded when I describe my running history, but I felt that it was necessary in order to provide proper background to diagnose the issue. Apparently she didn't feel that way.
She rushed me and didn't ask too many questions. Instead, she scolded me for wearing Vibram Five Fingers and made a bold, baffling statement: "Your feet aren't meant to run without lots of cushioning." Something along those lines. She actually referred to the Vibrams as "Extremely dangerous." Seriously. Someone hasn't brushed up on their recent running biomechanics. However, I nodded and smiled because she was referring me to an orthopaedic specialist and wanted me to go to PT once we took some x-rays. Basically, it doesn't matter what her opinion on natural running and Vibrams are once I'm placed into the hands of the specialist. I requested someone from MGH, if possible due to both convenience and the fact that it took over an hour past my appointment start time to see my doctor. I don't think my new health center runs efficiently.
So tomorrow I'm going back for x-rays of the left foot and we'll see if its tendinitis or something more serious.
She rushed me and didn't ask too many questions. Instead, she scolded me for wearing Vibram Five Fingers and made a bold, baffling statement: "Your feet aren't meant to run without lots of cushioning." Something along those lines. She actually referred to the Vibrams as "Extremely dangerous." Seriously. Someone hasn't brushed up on their recent running biomechanics. However, I nodded and smiled because she was referring me to an orthopaedic specialist and wanted me to go to PT once we took some x-rays. Basically, it doesn't matter what her opinion on natural running and Vibrams are once I'm placed into the hands of the specialist. I requested someone from MGH, if possible due to both convenience and the fact that it took over an hour past my appointment start time to see my doctor. I don't think my new health center runs efficiently.
So tomorrow I'm going back for x-rays of the left foot and we'll see if its tendinitis or something more serious.
Sunday, March 20, 2011
foot pain,
injury,
tendinitis
0
In a somewhat predictable turn of events, I mangled my foot some more when I went grocery shopping yesterday. I stepped down wrong on the left foot, it couldn't bear the weight on the weakened tendons, so the foot twisted as it failed to hold me, and ended up causing more pain. I finished my grocery shopping and had the longest walk home ever. Lots of pain.
I napped for 5 hours after combining wine, ibuprofen and numbing my foot with an ice pack. Below is the look of the foot. The photos don't really do the swelling justice, but it's there.
At this rate, I'm glad that I have a doctor's appointment next week. I'll have them take a look at it, and hopefully they'll have some kind of excellent advice beyond trying not to walk on it - which is next to impossible unless my health insurance will fund a taxi to take me to work each day.
I napped for 5 hours after combining wine, ibuprofen and numbing my foot with an ice pack. Below is the look of the foot. The photos don't really do the swelling justice, but it's there.
At this rate, I'm glad that I have a doctor's appointment next week. I'll have them take a look at it, and hopefully they'll have some kind of excellent advice beyond trying not to walk on it - which is next to impossible unless my health insurance will fund a taxi to take me to work each day.
Three days to recover
Thursday, March 10, 2011 injury, running, stress fracture, top of foot pain
Well, I'm three days away from the Ras na hEirran and the diagnosis doesn't look good. I can walk without a limp now and at a moderate pace. I still have to ice at night, morning and take Aleve, but I'm otherwise in relatively little pain.
That is, until I try doing something strictly load bearing on my foot - such as forefoot running, calf raises, lunges, etc. Even the plank/push-up plans for last evening fell short because I had to do them one-legged, which provides additional difficulty to the exercises and disheartened me, ultimately my downfall.
Ab Ripper X is getting easier. I excel at Crossovers, Roll Ups + V-Ups, and Leg Climbers. They are very similar to pilates moves that I used to love. I suspect there is some muscle memory at work here. The Mason Twist is a struggle to complete and my oblique v-ups simply aren't up to his speed.
Did I mention that I miss lifting at the gym? Nothing has changed, except me. I think it'll take a couple of months, but I'm hoping to match my previous lifting numbers by mid-May. Anything I accomplish over the summer should be a big bonus.
Not running is bringing me down, but it's beginning to be a sad old story. I'm wondering about the wisdom in pushing it the way I do. But about 5 minutes into upright bike intervals, I remember why running outside is nirvana-inducing.
On a fun note, we've decided on our Warrior Dash team theme: Ke$ha Warriors! There will be neon, glittering facepaint and crazy hair.
...glitter on our eyes
Stockings ripped all up the side
Looking sick and sexy-fied...
That is, until I try doing something strictly load bearing on my foot - such as forefoot running, calf raises, lunges, etc. Even the plank/push-up plans for last evening fell short because I had to do them one-legged, which provides additional difficulty to the exercises and disheartened me, ultimately my downfall.
Ab Ripper X is getting easier. I excel at Crossovers, Roll Ups + V-Ups, and Leg Climbers. They are very similar to pilates moves that I used to love. I suspect there is some muscle memory at work here. The Mason Twist is a struggle to complete and my oblique v-ups simply aren't up to his speed.
Did I mention that I miss lifting at the gym? Nothing has changed, except me. I think it'll take a couple of months, but I'm hoping to match my previous lifting numbers by mid-May. Anything I accomplish over the summer should be a big bonus.
Not running is bringing me down, but it's beginning to be a sad old story. I'm wondering about the wisdom in pushing it the way I do. But about 5 minutes into upright bike intervals, I remember why running outside is nirvana-inducing.
On a fun note, we've decided on our Warrior Dash team theme: Ke$ha Warriors! There will be neon, glittering facepaint and crazy hair.
...glitter on our eyes
Stockings ripped all up the side
Looking sick and sexy-fied...
Tuesday, March 8, 2011
5K,
foot pain,
injury,
race,
top of foot pain
0
My foot has shown remarkable improvement over the past few days, and I don't think it's just because I swapped over to Aleve and medicated myself into numbness. Yesterday I discovered that I could walk without a dramatic limp and that the stepping motion which causes my toes to bend upwards didn't result in sharp, balance-losing pain. Last night, the top of my foot even felt itchy like a healing bruise.
The top of my foot is still swollen, but its feel more superficial now that I'm not in constantly pain with every step. I even half-jogged back to the locker room when I forgot my ipod yesterday afternoon. Okay, maybe not half jogged; limp-bounced in an awkward fashion.
All in all, I have high hopes that I'll be in good enough condition to run the 5k on Sunday. This might seem a bit optimistic. But really, how much damage can I do in 30 minutes? Or if I do damage, how long will it take to actually physically manifest itself in a debilitating manner? More than 30 minutes is what I'm betting!
The other option would be to skip the race and focus on healing in order to pull a normal time at the BAA 5k in April. That's 5 weeks out. I just really want the RNH medal, and to jog in costume. I added a green tie from target to my festive outfit this year. I don't want to waste that $1.00 elasticized tie.
I'll be back with an update later this week. Today is leg day. We'll see how calf raises go.
The top of my foot is still swollen, but its feel more superficial now that I'm not in constantly pain with every step. I even half-jogged back to the locker room when I forgot my ipod yesterday afternoon. Okay, maybe not half jogged; limp-bounced in an awkward fashion.
All in all, I have high hopes that I'll be in good enough condition to run the 5k on Sunday. This might seem a bit optimistic. But really, how much damage can I do in 30 minutes? Or if I do damage, how long will it take to actually physically manifest itself in a debilitating manner? More than 30 minutes is what I'm betting!
The other option would be to skip the race and focus on healing in order to pull a normal time at the BAA 5k in April. That's 5 weeks out. I just really want the RNH medal, and to jog in costume. I added a green tie from target to my festive outfit this year. I don't want to waste that $1.00 elasticized tie.
I'll be back with an update later this week. Today is leg day. We'll see how calf raises go.
Saturday, March 5, 2011
exhausted,
foot pain,
injury,
tired,
top of foot pain
0
Having diagnosed my problem, you'd think I could focus on the road to recovery. But if you thought that, you probably don't know me that well. Faced with the possibility of not being able to run, I've returned to my old standby: heavy weight lifting.
I jumped back into my old routine this week with a vengeance (upper/lower body splits plus cardio on the bike). It was both exhilerating and humbling. "Humbling" seems to be a common feeling when it comes to fitness for me lately. I'm lifting dramatically less than I used to, which is expected, but makes getting back seem very far away. For example, I was around 250 on the leg press last year, but was easing myself back in yesterday with 135lb. I didn't bother with additional weight on my squats at first, trying to just get my form right, and when I did, I was quivering (okay, my injured foot gave out) after my fourth set of 6 reps at 65 lbs. That's right, 65lb. Shame!
This past week I've found myself fantasizing about doing box jumps again and jumping lunges. I remember the way it felt to do a pull-up without half my body weight compensated for with a band. I remember what it was like to gave guns.
In any case, I went to the laundromat this morning (a new routine because I've had it with the laundry in my building) and then went grocery shopping. My foot feels like its broken, just straight up broken, and my entire body aches all over with exhaustion. How it is that walking cumulatively like a mere mile with groceries or laundry rivals the most challenging days at the gym?
My foot is wrapped in ice, elevated, I've taken advil and I am fed.
I'm going to take a nap.
I jumped back into my old routine this week with a vengeance (upper/lower body splits plus cardio on the bike). It was both exhilerating and humbling. "Humbling" seems to be a common feeling when it comes to fitness for me lately. I'm lifting dramatically less than I used to, which is expected, but makes getting back seem very far away. For example, I was around 250 on the leg press last year, but was easing myself back in yesterday with 135lb. I didn't bother with additional weight on my squats at first, trying to just get my form right, and when I did, I was quivering (okay, my injured foot gave out) after my fourth set of 6 reps at 65 lbs. That's right, 65lb. Shame!
This past week I've found myself fantasizing about doing box jumps again and jumping lunges. I remember the way it felt to do a pull-up without half my body weight compensated for with a band. I remember what it was like to gave guns.
In any case, I went to the laundromat this morning (a new routine because I've had it with the laundry in my building) and then went grocery shopping. My foot feels like its broken, just straight up broken, and my entire body aches all over with exhaustion. How it is that walking cumulatively like a mere mile with groceries or laundry rivals the most challenging days at the gym?
My foot is wrapped in ice, elevated, I've taken advil and I am fed.
I'm going to take a nap.
Extensor Tendinitis
Tuesday, March 1, 2011 extensor tendinitis, foot pain, injury, stress fracture, tendinitis
So last June I came down with extensor tendinitis. It started like this. I went for a starter jog, like 2-3 miles, nothing remotely rough. After the jog, I settled down in the park for some leg work and stretching. Squats and lunges in the grass.
During one of my lunges, I stepped back on a divot in the ground, twisting my foot a little funny, but nothing traumatizing. I continued to lunges, stretch and headed home. A couple of days later, I got this aching pain in the top of my foot. A pain that grew and grew. You could see the swelling on the top of my foot. It couldn't bear much weight and I certainly couldn't run.
I swapped to flip flops which only made it worse. Thus I thought that perhaps it wasn't the mis-step in the grass, but instead the build up of flip-flop induced foot pain. You know how you have to curl your toes when you step to hold the flip flop in place? I assume that was the issue. I wore regular shoes for a couple of weeks and it all got better. I resumed wearing flip flops, but it never bothered me again.
Until last week. I've been running in the vibrams inconsistently. Or rather, I've running inconsistently, but wearing the vibrams only. Only 2-3 jogs per week, for short distances. I've had no problem except the achy calves after about 2 miles.
Then on the weekend of the 19th, I wore these completely unsupported, flat footed thin ballet flats. These were my flat shoes of choice last summer also. I power walked around many miles in these shoes on Sunday and then again on Tuesday. And by Tuesday my left foot was in massive pain. The whole top of the foot is swollen. I can't land on the foot. I have sharp pain in my three middle does when I bend them in any fashion. It's straight up awful. I'm limping around awkwardly.
I've also been icing my foot for a week. I briefly wrapped it, but that didn't seem to help. I take ibuprofin morning and night. I've rubbed it down with icy hot. And I haven't run since the 19th. I've even taken to hopping on the bus to get to the train station rather than walking the short half mile. Cumulatively my commute walks me 2 miles per day. That's just day to day wear and tear. But I'm wondering if even that won't help. I've self-diagnosed with the extensor tendinitis again, but with all of these injuries there is just no good or fast treatment.
Last night I kept waking up in pain as I turn in bed or my foot lay in an awkward position. It's getting miserable. Then I tripped on this hose at work today, forcing me to land hard on the ball of the left foot, sending shooting pain in all directions.
This is lame. St. Patrick's Day 5k is in 1 1/2 weeks. Must fix this problem now, so I can run my first race in vibrams.
During one of my lunges, I stepped back on a divot in the ground, twisting my foot a little funny, but nothing traumatizing. I continued to lunges, stretch and headed home. A couple of days later, I got this aching pain in the top of my foot. A pain that grew and grew. You could see the swelling on the top of my foot. It couldn't bear much weight and I certainly couldn't run.
I swapped to flip flops which only made it worse. Thus I thought that perhaps it wasn't the mis-step in the grass, but instead the build up of flip-flop induced foot pain. You know how you have to curl your toes when you step to hold the flip flop in place? I assume that was the issue. I wore regular shoes for a couple of weeks and it all got better. I resumed wearing flip flops, but it never bothered me again.
Until last week. I've been running in the vibrams inconsistently. Or rather, I've running inconsistently, but wearing the vibrams only. Only 2-3 jogs per week, for short distances. I've had no problem except the achy calves after about 2 miles.
Then on the weekend of the 19th, I wore these completely unsupported, flat footed thin ballet flats. These were my flat shoes of choice last summer also. I power walked around many miles in these shoes on Sunday and then again on Tuesday. And by Tuesday my left foot was in massive pain. The whole top of the foot is swollen. I can't land on the foot. I have sharp pain in my three middle does when I bend them in any fashion. It's straight up awful. I'm limping around awkwardly.
I've also been icing my foot for a week. I briefly wrapped it, but that didn't seem to help. I take ibuprofin morning and night. I've rubbed it down with icy hot. And I haven't run since the 19th. I've even taken to hopping on the bus to get to the train station rather than walking the short half mile. Cumulatively my commute walks me 2 miles per day. That's just day to day wear and tear. But I'm wondering if even that won't help. I've self-diagnosed with the extensor tendinitis again, but with all of these injuries there is just no good or fast treatment.
Last night I kept waking up in pain as I turn in bed or my foot lay in an awkward position. It's getting miserable. Then I tripped on this hose at work today, forcing me to land hard on the ball of the left foot, sending shooting pain in all directions.
This is lame. St. Patrick's Day 5k is in 1 1/2 weeks. Must fix this problem now, so I can run my first race in vibrams.
Monday, November 1, 2010
injury,
it band,
itbs
0
My runs have been inconsistently pain-addled since Monday. On Tuesday I chose to repeat Monday's run. The overtaxed ankle muscle kicked about 6 minutes into the run. I slowed down, stretched and forged onward. I ran along the worn trail rather than the cement sidewalk, which helped slightly. But by the time I got around 2 1/2 miles in, I was having other issues.
You see, earlier that morning I'd gone out for a run/bring out the trash and accidentally locked myself out of the building. It was the wee hours of the morning, so I felt that ringing doorbells wouldn't have been greeted kindly. So I waited (too fearful that I'd miss the one neighbor if I went for a jog). Silly idea. No one showed for 3 hours. The guy I managed to snag lived in the place next door and I had to convince him that (a) I lived there and (b) that his key also worked for our building. I had to physically show him that it did.
When I got inside, I tore off my unused running gear and shoved it into my gym bag. Except the socks. I somehow missed the socks. When I took off for the run on my lunch break, I realized my sockless situation and grit my teeth. I thought I'd just run without socks. It's only aesthetically unpleasant, right? Wrong. My feet got sweaty, they shifted unusually in the shoes when I ran, and I ended up with severe shin splints up the outer calf of each leg.
The run ended with me jogging barefoot, combating three different aches and sharp pains in my legs. I felt like I'd taken a beating when I got back to work. The rest of the week involved more painful jogs like that. My Sunday run went well, however. All the pain in my legs dissipated by the 4th mile. I was running telephone sprints in the middle of the run, which I really think helped out a lot. Maybe it was my imagination, but maybe there is something to it. My gait and form change when I'm sprinting as opposed to jogging.
You see, earlier that morning I'd gone out for a run/bring out the trash and accidentally locked myself out of the building. It was the wee hours of the morning, so I felt that ringing doorbells wouldn't have been greeted kindly. So I waited (too fearful that I'd miss the one neighbor if I went for a jog). Silly idea. No one showed for 3 hours. The guy I managed to snag lived in the place next door and I had to convince him that (a) I lived there and (b) that his key also worked for our building. I had to physically show him that it did.
When I got inside, I tore off my unused running gear and shoved it into my gym bag. Except the socks. I somehow missed the socks. When I took off for the run on my lunch break, I realized my sockless situation and grit my teeth. I thought I'd just run without socks. It's only aesthetically unpleasant, right? Wrong. My feet got sweaty, they shifted unusually in the shoes when I ran, and I ended up with severe shin splints up the outer calf of each leg.
The run ended with me jogging barefoot, combating three different aches and sharp pains in my legs. I felt like I'd taken a beating when I got back to work. The rest of the week involved more painful jogs like that. My Sunday run went well, however. All the pain in my legs dissipated by the 4th mile. I was running telephone sprints in the middle of the run, which I really think helped out a lot. Maybe it was my imagination, but maybe there is something to it. My gait and form change when I'm sprinting as opposed to jogging.
7 Months Later: An Update
Sunday, October 17, 2010 injury, it band, itbs
This is going to be quite the update, since my running journey has had quite a few ups and downs over the past seven months since I last updated. In order to make this more straight forward, I will cover the major events timeline style.
April 5th, 2010: Appointment with a big name sport medicine orthopaedist. Confirmed that it was only IT band problems. Suggested rest and PT exercises. No other assistance or referrals. Very disappointing, honestly.
April 6th - June: Rest, completely stopped running.
June - July 11th: Started running again, 1-5 miles a time, several days per week. Didn't have any problems with the IT band, feel good, taking it easy.
July 12th, 2010: Began a 13 week training plan to get back in shape.
July 13th, 2010: Registration for the BAA Half Marathon at 9am. By 1pm when I went to register, it was already closed. Signed up for charity fund raising to get a spot through Dana-Farber. I've got a spot in the race!
July 18th, 2010: First week of pre-training went well. Got in 4 runs with a "long run" of 5 miles. Total 17 miles, with pilates and yoga classes.
July 25th, 2010: Second week of pre-training less good. Only two runs in. I can't remember what happened, but it was some kind of craziness. Total 8 miles.
August 1st, 2010: Third week of pre-training complete. Five runs, 21 miles total with a 7 mile long run. Some swimming and upperbody. Not hitting my cross-training targets, but running is on track and feeling good.
August 8, 2010: First week of the sub-2:00 training plan. Hit all 4 runs which included a couple of easy runs, a tempo run at 8:54 min/mil on treadmill, and a long run of 8 miles. Total 21 miles.
August 15th, 2010: Second week totaled another 21 miles. Two easy 4-5 mile runs with mile repeats at 8:25 min/mile pace. Attended bootcamp class, pilates and did upper body. Another 8 mile long run.
August 22nd, 2010: Third week continued well with 23 miles total. The first three runs mid-week included a 9:09 min/mile tempo run along with three strength training sessions. This was a 9 mile long run week.
August 29th, 2010: Fourth week was a disaster. I had an appt with a personal trainer for the TRX, which started out poorly with not enough sleep. Later that day I donated blood. It went very, very poorly. I got dizzy/fuzzy and nauseous, my blood pressure dropped really low, they were drawing blood through a valve and it hurt, and they ended up keeping me an extra hour to recover. I went home early, and was disoriented and dizzy the next day as well. My Thursday run cut short after 3 miles when I felt like I was going to pass out on the treadmill. My long run on that Sunday lasted all of 3 miles before I had to turn around and go home.
September 5th, 2010: Fifth week, I knocked out a 5 miler, but that's about it. I was still suffering from exhaustion. I should have pushed through it, but I didn't. I had a bunch of social obligations and did many miles of walking over the week, however.
September 9th-16th, 2010: Vacation in Arizona. I got in three morning runs between 3-5 miles. I was really impressed I managed it given that the temperatures were around 107F on the day I left. Mornings weren't as bad, but I got dehydrated rapidly because its so dry. My breathing in general felt totally different in my lungs.
September 19th, 2010: I felt great when I got back. That weekend I went out for a beautiful 9 miler along the beach. I felt good, got myself home. And the next day came the pain. The IT band ache. I'd been taking anti-inflammatories post-run all along, rolling and stretching before, throughout, and after. But apparently I wasn't doing something right, and it was bound to happen.
September 20-26th, 2010: Took it easy with some lighter runs, gauging how bad things were going to be on my knee. Not following training at all at this point.
September 27th - October 9th, 2010: I made the decision that I wasn't going to run for the last two weeks before the race. I figured that I wasn't going to improve my fitness levels in the next two weeks, but that I could aggravate my knee more and injure myself further. Therefore, it was better not to run and instead daily ice, roll, pain relieve, take it easy. My IT band ached horribly by the end of each day, just the 1 mile round trip walk from house to train, train to work and back was way too much.
October 10th, 2010: I went into my race with very little faith in finishing. Actually, I told everyone it wasn't going to happen. And said not to bother coming. If I was going to humiliate myself, I'd do it solo. The race gets its own post. :)
Now we're up-to-date.
April 5th, 2010: Appointment with a big name sport medicine orthopaedist. Confirmed that it was only IT band problems. Suggested rest and PT exercises. No other assistance or referrals. Very disappointing, honestly.
April 6th - June: Rest, completely stopped running.
June - July 11th: Started running again, 1-5 miles a time, several days per week. Didn't have any problems with the IT band, feel good, taking it easy.
July 12th, 2010: Began a 13 week training plan to get back in shape.
July 13th, 2010: Registration for the BAA Half Marathon at 9am. By 1pm when I went to register, it was already closed. Signed up for charity fund raising to get a spot through Dana-Farber. I've got a spot in the race!
July 18th, 2010: First week of pre-training went well. Got in 4 runs with a "long run" of 5 miles. Total 17 miles, with pilates and yoga classes.
July 25th, 2010: Second week of pre-training less good. Only two runs in. I can't remember what happened, but it was some kind of craziness. Total 8 miles.
August 1st, 2010: Third week of pre-training complete. Five runs, 21 miles total with a 7 mile long run. Some swimming and upperbody. Not hitting my cross-training targets, but running is on track and feeling good.
August 8, 2010: First week of the sub-2:00 training plan. Hit all 4 runs which included a couple of easy runs, a tempo run at 8:54 min/mil on treadmill, and a long run of 8 miles. Total 21 miles.
August 15th, 2010: Second week totaled another 21 miles. Two easy 4-5 mile runs with mile repeats at 8:25 min/mile pace. Attended bootcamp class, pilates and did upper body. Another 8 mile long run.
August 22nd, 2010: Third week continued well with 23 miles total. The first three runs mid-week included a 9:09 min/mile tempo run along with three strength training sessions. This was a 9 mile long run week.
August 29th, 2010: Fourth week was a disaster. I had an appt with a personal trainer for the TRX, which started out poorly with not enough sleep. Later that day I donated blood. It went very, very poorly. I got dizzy/fuzzy and nauseous, my blood pressure dropped really low, they were drawing blood through a valve and it hurt, and they ended up keeping me an extra hour to recover. I went home early, and was disoriented and dizzy the next day as well. My Thursday run cut short after 3 miles when I felt like I was going to pass out on the treadmill. My long run on that Sunday lasted all of 3 miles before I had to turn around and go home.
September 5th, 2010: Fifth week, I knocked out a 5 miler, but that's about it. I was still suffering from exhaustion. I should have pushed through it, but I didn't. I had a bunch of social obligations and did many miles of walking over the week, however.
September 9th-16th, 2010: Vacation in Arizona. I got in three morning runs between 3-5 miles. I was really impressed I managed it given that the temperatures were around 107F on the day I left. Mornings weren't as bad, but I got dehydrated rapidly because its so dry. My breathing in general felt totally different in my lungs.
September 19th, 2010: I felt great when I got back. That weekend I went out for a beautiful 9 miler along the beach. I felt good, got myself home. And the next day came the pain. The IT band ache. I'd been taking anti-inflammatories post-run all along, rolling and stretching before, throughout, and after. But apparently I wasn't doing something right, and it was bound to happen.
September 20-26th, 2010: Took it easy with some lighter runs, gauging how bad things were going to be on my knee. Not following training at all at this point.
September 27th - October 9th, 2010: I made the decision that I wasn't going to run for the last two weeks before the race. I figured that I wasn't going to improve my fitness levels in the next two weeks, but that I could aggravate my knee more and injure myself further. Therefore, it was better not to run and instead daily ice, roll, pain relieve, take it easy. My IT band ached horribly by the end of each day, just the 1 mile round trip walk from house to train, train to work and back was way too much.
October 10th, 2010: I went into my race with very little faith in finishing. Actually, I told everyone it wasn't going to happen. And said not to bother coming. If I was going to humiliate myself, I'd do it solo. The race gets its own post. :)
Now we're up-to-date.
Sunday, March 21, 2010
injury,
it band,
itbs
0
Visit to doctor's office was, as expected, uneventful. Am being recommended to a sports medicine/orthopaedic specialist in Boston. Will sort this out Monday. Hopefully get to see someone who knows what they're talking about.
Ran 1.5 miles pain free on Thursday morning.
Ran 2 miles pain free on Friday morning.
Ran 3 miles pain free on Sunday morning.
Woot.
I may just take up running 2 miles at a time twice per day. Which would at least put me at 28 miles per week. No endurance, but at least I'd be getting in the miles.
Ran 1.5 miles pain free on Thursday morning.
Ran 2 miles pain free on Friday morning.
Ran 3 miles pain free on Sunday morning.
Woot.
I may just take up running 2 miles at a time twice per day. Which would at least put me at 28 miles per week. No endurance, but at least I'd be getting in the miles.
A month later...
Wednesday, March 17, 2010 injury, it band, itbs, knee pain, knees, swimming
I'm finally getting my knee checked out as absolutely nothing (excess rest, rolling, stretching) has improved the distance I can run without exquisite pain and knee failure. So Friday I should have the start of an answer. Or at least a referral to someone who can give me an answer.
Other than that, I missed the Ras na hEirren because it was daylight savings time this Saturday. So my clocks didn't get moved forward Saturday night, and I woke up an hour late to the race. Oops. But probably just as well since every other weekend I've tried to run a 5k distance things went to crap pretty quickly. I got my t-shirt at least. Oh yeah, it was downpouring all day. (Which resulted in our basement flooding with a 1/2 foot of water, but that's another story). Not fun to run in anyway, so I avoided that wet mess.
I am seriously excited to get this knee business solved though.
On another positive note, it's only 57 laps in the pool to swim a mile and it really flies by. I'm becoming a better/faster swimmer every day. By around lap 30 my form just feels really smooth, natural and powerful - like I'm a fish! The kind of wish that has to breath at the surface though - which I've seen before at an aquarium, but I can't recall what it was, although it was cute. I'm even getting better with a really shallow side breath too, so I'm not slowing my pace by sticking my face too far up. It's just not as sweat-pain inducing as running though - not remotely the same level of satisfaction. I don't know how long I'd have to swim for to get that. Maybe 2-3 miles? Ha, if I didn't turn into a prune. Although if the knee problems keep up, endurance swimming could be kinda cool... 3-4 hours of swimming...
Other than that, I missed the Ras na hEirren because it was daylight savings time this Saturday. So my clocks didn't get moved forward Saturday night, and I woke up an hour late to the race. Oops. But probably just as well since every other weekend I've tried to run a 5k distance things went to crap pretty quickly. I got my t-shirt at least. Oh yeah, it was downpouring all day. (Which resulted in our basement flooding with a 1/2 foot of water, but that's another story). Not fun to run in anyway, so I avoided that wet mess.
I am seriously excited to get this knee business solved though.
On another positive note, it's only 57 laps in the pool to swim a mile and it really flies by. I'm becoming a better/faster swimmer every day. By around lap 30 my form just feels really smooth, natural and powerful - like I'm a fish! The kind of wish that has to breath at the surface though - which I've seen before at an aquarium, but I can't recall what it was, although it was cute. I'm even getting better with a really shallow side breath too, so I'm not slowing my pace by sticking my face too far up. It's just not as sweat-pain inducing as running though - not remotely the same level of satisfaction. I don't know how long I'd have to swim for to get that. Maybe 2-3 miles? Ha, if I didn't turn into a prune. Although if the knee problems keep up, endurance swimming could be kinda cool... 3-4 hours of swimming...
We're not best friends.
Wednesday, February 17, 2010 complaining, foam roller, injury, it band, itbs
The foam roller and I do not enjoy each other.
Yes, I know. This blog has really just turned a place for me to bitch and moan about the fact I'm not running. Rather than the rest of the year when I'm actually running, and thus don't take the time to blog. I have a lot of free time on my hands previously taken up but wonderful hours of hill sprints, tempo runs, long meditative jogs, even intervals and repeats on the dreadmill!
Anyway since the foam roller came home with me, my knee has actually hurt more. But in new places. I have strange instances of DOMS in my upper-hip/side. While I'd like to say that it is already making all the difference, I can't. I don't have a proper gauge, however. Perhaps I can test it via a fast 1 mile run on the treadmill - they say faster, shorter strides is less irritating. But every time I've run thus far, it's resulted in further injury or prolonging of pain. I will hold out. Work is preventing much crosstraining also. I'm stressed to the max.
1 1/2 weeks until the half marathon. I will be cured! If only I were an important enough runner to warrant a cortisone shot.
Yes, I know. This blog has really just turned a place for me to bitch and moan about the fact I'm not running. Rather than the rest of the year when I'm actually running, and thus don't take the time to blog. I have a lot of free time on my hands previously taken up but wonderful hours of hill sprints, tempo runs, long meditative jogs, even intervals and repeats on the dreadmill!
Anyway since the foam roller came home with me, my knee has actually hurt more. But in new places. I have strange instances of DOMS in my upper-hip/side. While I'd like to say that it is already making all the difference, I can't. I don't have a proper gauge, however. Perhaps I can test it via a fast 1 mile run on the treadmill - they say faster, shorter strides is less irritating. But every time I've run thus far, it's resulted in further injury or prolonging of pain. I will hold out. Work is preventing much crosstraining also. I'm stressed to the max.
1 1/2 weeks until the half marathon. I will be cured! If only I were an important enough runner to warrant a cortisone shot.
Theorizing the root of my pain.
Monday, February 15, 2010 injury, it band, itbs
I spent a large portion of my day reading peer-reviewed literature on the subject of ITBS in such publications as J Sports Med and Clin Biomech. What I found there was relatively inconclusive with contradictory studies and results disproving common wisdom on both causation and treatment.
What got me on this search was the idea that IT band syndrome, while an overuse injury, is also a direct result of poor stretching habits. I stretch with the best of them, so this concept really bugged me. I may have been ambitious in upping my mileage; however, I was relatively pain-free and cardiovascularly capable of my distances. My training this year has been more well constructed than ever before, as I've bought into the practical advice of more competative runners. From regularly practicing yoga and stretching to adding variable workouts to create a more complete, stronger and faster runner - speed, hill, tempo, interval workouts. I've been keeping my pace on track and logging everything from how I feel before and after to how many hours of sleep I get at night and what I eat.
So the fact that I'm a "better and safer" runner than ever before makes my sudden injury seem contradictory. Until I found multiple studies referencing the impact of hip biomechanics on your IT band - your gait. A minor change can produce injuries you would otherwise have never experienced. For example, running on a sloped surface, changing shoes, shifting from pavement to gravel, etc.
I then looked back on my own recent history. It made sense. The Fall.
Three weeks ago, I fell hard. I completed my run that day. I only took two days rest. In under I week, I ran 20 miles straight on bruised and inflammed knees. Day-to-day I didn't feel pain in my knees, no limping beyond day one and two, however three weeks later and I'm not healed. You can still see faint physical bruising, and the entire knee is sore to the touch. I still can't kneel.
My theory: When I fell three weeks ago, I did more damage than I realized and didn't take enough time off to sufficiently make it through the inflammation and repair periods of tissue healing. As a result, when I started running again, my gait changed minorly to compensate for the trauma to my knees. The change in gait was enough of a biomechanical change to result in irritation or higher load, by whatever means, on my IT band. Thus I'm suddenly struck with pain. If this is the case, then I just need to stop running - allowing my knees to heal (because they're still bruised and sore to the touch) at the same time as my IT band - and when I get back out, I should return to a healthy gait and I actually should be able to rapidly return to my training program.
What got me on this search was the idea that IT band syndrome, while an overuse injury, is also a direct result of poor stretching habits. I stretch with the best of them, so this concept really bugged me. I may have been ambitious in upping my mileage; however, I was relatively pain-free and cardiovascularly capable of my distances. My training this year has been more well constructed than ever before, as I've bought into the practical advice of more competative runners. From regularly practicing yoga and stretching to adding variable workouts to create a more complete, stronger and faster runner - speed, hill, tempo, interval workouts. I've been keeping my pace on track and logging everything from how I feel before and after to how many hours of sleep I get at night and what I eat.
So the fact that I'm a "better and safer" runner than ever before makes my sudden injury seem contradictory. Until I found multiple studies referencing the impact of hip biomechanics on your IT band - your gait. A minor change can produce injuries you would otherwise have never experienced. For example, running on a sloped surface, changing shoes, shifting from pavement to gravel, etc.
I then looked back on my own recent history. It made sense. The Fall.
Three weeks ago, I fell hard. I completed my run that day. I only took two days rest. In under I week, I ran 20 miles straight on bruised and inflammed knees. Day-to-day I didn't feel pain in my knees, no limping beyond day one and two, however three weeks later and I'm not healed. You can still see faint physical bruising, and the entire knee is sore to the touch. I still can't kneel.
My theory: When I fell three weeks ago, I did more damage than I realized and didn't take enough time off to sufficiently make it through the inflammation and repair periods of tissue healing. As a result, when I started running again, my gait changed minorly to compensate for the trauma to my knees. The change in gait was enough of a biomechanical change to result in irritation or higher load, by whatever means, on my IT band. Thus I'm suddenly struck with pain. If this is the case, then I just need to stop running - allowing my knees to heal (because they're still bruised and sore to the touch) at the same time as my IT band - and when I get back out, I should return to a healthy gait and I actually should be able to rapidly return to my training program.
Dashed dreams and foam rollers
Saturday, February 13, 2010 foam roller, gofit, injury, it band, stretching, thera-roll
Why does my life suck?
Okay, it doesn't suck. It's actually pretty good. I'm incredibly happy, in fact. Very satisfied with my life, career, friends, family. Except for this whole IT band problem. That sucks. My IT band sucks.
I went out for my long run today. I went with the mental acknowledgment that things could go poorly right off in spite of my week of rest, but I'd see how far I could go. I prepared for the longest, but was ready to turn around if I started to feel pain. I'm aware that starting too early could destroy the entire season rather than lay me up for a few weeks.
Two miles exactly and I was painfully turning back around in frustration. I made it from my house to the post office (stopped to mail stuff), which is 6/10th of a mile. Then took off again and reached just past Thorndike Field, which is a little over 2 miles from my house. I limped my way back to Alewife and then caught a bus the rest of the way home.
Later that afternoon I headed to Harvard Square where I ducked into City Sports to look at foam rollers. They had three types. The first was the popular GoFit 18 inch foam roller. A cheaper no-brand version (Valeo). And lastly a Thera-Roll textured foam roller. The Thera-roll felt the most painful to massage with, which probably means its the best! But I felt most comfortable with the GoFit version, and I know they sell it at Target for less.
So the foam roller plan is on hold until I can get to Target tomorrow. Until then, ice and stretching with a band. I've been doing this recommended stretch:
(Image found via Google from: http://www.fiterati.ca/news/wp-content/uploads/2009/11/IT-_band_exercise.jpg)
Okay, it doesn't suck. It's actually pretty good. I'm incredibly happy, in fact. Very satisfied with my life, career, friends, family. Except for this whole IT band problem. That sucks. My IT band sucks.
I went out for my long run today. I went with the mental acknowledgment that things could go poorly right off in spite of my week of rest, but I'd see how far I could go. I prepared for the longest, but was ready to turn around if I started to feel pain. I'm aware that starting too early could destroy the entire season rather than lay me up for a few weeks.
Two miles exactly and I was painfully turning back around in frustration. I made it from my house to the post office (stopped to mail stuff), which is 6/10th of a mile. Then took off again and reached just past Thorndike Field, which is a little over 2 miles from my house. I limped my way back to Alewife and then caught a bus the rest of the way home.
Later that afternoon I headed to Harvard Square where I ducked into City Sports to look at foam rollers. They had three types. The first was the popular GoFit 18 inch foam roller. A cheaper no-brand version (Valeo). And lastly a Thera-Roll textured foam roller. The Thera-roll felt the most painful to massage with, which probably means its the best! But I felt most comfortable with the GoFit version, and I know they sell it at Target for less.
So the foam roller plan is on hold until I can get to Target tomorrow. Until then, ice and stretching with a band. I've been doing this recommended stretch:
(Image found via Google from: http://www.fiterati.ca/news/wp-content/uploads/2009/11/IT-_band_exercise.jpg)
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