There is no "I" in Injury. Oh wait...

Hi Peeps.  I realize I have been off the grid for about two weeks, and I apologize for leaving you hanging.  In summary, I have not been running for these last two weeks and you know what?  The sun still came up every day, nobody took away my birthday and I am likely just as fit today as I was two weeks ago.

The Miracle Worker may have worked a miracle on me, but it was a slow-release miracle that required three additional visits to materialize.  I am not saying in any way that his treatment was ineffective because, ultimately, his diagnosis of what was really wrong me, along with a prescription for a series of targeted stretches, has been key to my recovery. 

If you are looking for a quick update, here’s my executive summary:

• I have been cross training like a demon to maintain my fitness.
• I have been using (self) massage and stretching as my main therapeutic techniques.
• The Eugene Marathon is still a goal, but I will not jeopardize my long-term health or running career to run it.

As I mentioned in my last post, the genesis of this problem was my fancy-pants cross country race in Spokane (I am the Effin' Giant in picture on left) where I ripped a hole in the bottom of my left foot.  The hole in my foot threw my gait off and my left foot reacted by becoming super tight, especially the tendon that runs from the big toe and eventually becomes a muscle in the calf area, called the flexor hallucis longus.  The lack of free movement in my foot caused my left calf to take too much stress damaging the soleus muscle.  The adhesions on the soleus kept that muscle from moving freely which then put strain on the achilles which attaches to bone and therefore can only stretch so far before crying uncle.

My 6-mile test run on the Saturday following my ill-fated hill workout did not go well.  I continued to feel a bite in my achilles tendon throughout the run and realized I was looking at taking some down time from running.  Luckily for me (not for her), my coach suffered this same injury doing the exact same thing as me about the same amount of time out (9-10 weeks away) from the Olympic Trials marathon in 2004.  She not only took over a week off from running, but she ran a huge 15k PR a couple of weeks later and did very well in her Trials marathon.  She has been an invaluable resource and has given me great perspective during this process.  I will say that it took a few emails with lots of bold type to get me to start to see the importance of taking the rest and listen to her advice.  I did come around eventually.  However, I have to say that my initial resistance was not out of denial.  I knew full well what I was doing as illustrated in this note to my coach:

“While I want to stay healthy, I recognize that I am at the point where I am testing my limits.  I have kept pushing myself harder and harder all the while knowing I would eventually reach a limit in some form or another.  I expect this and don't want to run in fear of that limit.  I don't want to be anxious about every little pain and ache.  It is paralyzing.  While I may do stupid things like run up a hill when my calf is sore, I do learn from this.”   

This being my first bona fide injury, I had little experience with cross training activities that would maintain my fitness level but not exacerbate my calf and heel.  While I resisted my coach’s proposal to pool run initially, I have since found that it is a preferred alternative activity to running and not just for the more catastrophic injuries that leave an athlete unable to put weight on their leg.  There is some science to support this too as outlined in this article about pool running on Pete Pfitzinger’s website.

In the middle of August, I will have no problem finding outdoor pool options for my deep-water running activity.  Here in Sacramento in the winter, the outdoor pools are closed, and I have found few indoor pools that are deep enough to properly run under water.  Lap pools do not work.  For those of you unfamiliar with pool running, you wear a flotation belt around your middle (or not if you don’t care about your form) and try to mimic running as much as possible by moving both your arms and legs in a running motion.  To do this, you need a pool deeper than 6 feet (deeper if you're super tall).  You’re not swimming at all.  You’re sort of running in place though I end up moving forward very slowly in the water.

The indoor pool at the local YMCA is the best option I was able to find.  It costs $10 per visit without a membership (membership includes a big initiation fee, so pay-as-you-go is cheapest in the short term).  They have the floatie belts and their open swim hours are convenient.  I am also blessed to have Sprinkles in my life, who, unfortunately, is also injured right now.  She was willing to give pool running a go and even accompanied me on my long (pool) run last weekend where we ran for 2 hours with over 90 minutes of interval work.  Now, all I have to do is text the word “Marco?” to her, and she responds with “Polo” meaning she’s game for pool running.  I heart Sprinkles.  I did convince the Dissin’ Genius to join in one day.  I think he doubted that pool running could be a good workout.  The beads of sweat atop his bare scalp convinced him otherwise.

GADGET MOMENT:  One cool gadget that I found is this waterproof case (pictured below on weed warrior Michael Phelps) for my iPod Shuffle 3G.  It attaches to swim goggles and has fabulous sound.  I also Macgyvered a way to attach it to my bicycle helmet by threading it through an elastic headband and placing that around my helmet.  It is a thing of beauty.

In addition to pool running, I have been riding my bike and doing workouts on the elliptical machine at the gym.  Here are my workouts for the past two weeks:

You can see that I’ve had a couple of test runs including the one I did today.  The tests earlier this week indicated that I needed to bake my calf a little longer.  This was a big disappointment to me.  I had my mind set on a return to running similar to my coach’s experience and when I still felt enough pain to indicate I wasn’t ready to run, I was thrust back into the black hole of darkness.  When I had a roadmap for recovery, I was fine with the cross training.  People were commenting on my good attitude.  I kept thinking, “I can do this.  It’s only for 10 days.”  When that 10^th day came and went, I was not so cheerful.

One of the really interesting facets of this experience for me has been in knowing when I am healed enough to start back to running.  I have developed this self-assessment for my progress each day:

• Does it hurt when I walk?  
• Can I wear my brown boots without irritation of my achilles? 
• Can I stand on my left toes and lower myself down without pain in my achilles?  

I finally realized today that these tests likely have little bearing on my fitness for running.  I have concluded that I may still feel pain doing some of these things, but the only way I’ll be able to know whether I should run is to try it out.  I made a pact with myself, however, that, if I felt sharp pain, I would cease the test.  My first test run went well on Monday, but I was getting a little twinge of pain at the very end of the run that left me worried about running the next day.  One mile into Tuesday’s run I felt a sharp pain in my achilles, so I shut down the test and walked home.   I attempted a run again today and, while I felt tightness, I did not feel the same sharp pain in my achilles at any time.  My coach explained how her running progressed and indicated that she continued to feel sore, but that it was not the same kind of pain that she felt when she injured herself.  She reassured me that I would know when it was time to run again.  I haven’t felt any pain as a result of my test this morning, but I’m still unsure about whether or not tomorrow’s test run will go well.  Taking it one day at a time is not my typical MO, but I really don’t have a choice.

As with all things in life, this situation has taught me some valuable lessons:

• I can cross train and (think I can) maintain a high fitness level. This is a key lesson.  I remember watching my friends come down with various injuries and thinking to myself that I didn't think I could do the intensity of cross training needed to maintain my fitness.  Now, I believe I will be less hesitant to cross train when I am presented with a menacing ache or pain in the future.  A few days of cross training can go a long way to preventing a more serious injury.
• Little problems lead to big problems when multiplied by 100 miles.  The sore on the bottom of my foot appears to have caused all of this.  Had I taken a few days off immediately following the cross country race to let that open wound heal, I would be running 90 miles this week.  However, I also believe that I needed a break (see next lesson).
• You have to exceed your limits to know where they are.  I am typically not a fan of the school of hard knocks, but my best life lessons have been learned through experience.  The limits in this case had less to do with the mileage and intensity of my training but everything to do with the limits of my body to heal.  I was pushing myself so hard in every possible way before all of this happened, that it is almost a blessing that all I ended up with was this simple injury.  I honestly believe that my body needed a rest and that I will be a faster runner for having taken this forced break.
• You will never know what works to heal an injury the quickest.  There is a lot of information out there, much of it contradictory, on how to heal various running injuries.  The bottom line is that each of us has to try something and it either works or it doesn't.  Without a replicate Effin' J out there that I can use as a control, it is impossible to know whether what I've done has helped or hindered the healing process.  I offer my short list of conclusions about healing (which may or may not work for you):
• Ice doesn't help the healing process after the first 72 hours;
• NSAIDs are just a bad idea all the way around;
• working out the trigger points or adhesions on the muscle with your knuckle or a hard object is good;
• stretching is key (hip, foot, calf for my problem).       

I‘m not out of the woods by any means, but I am healing.  I have not counted Eugene out at this point.  My coach was able to quickly ramp up her mileage and intensity following her bout with this injury once it healed sufficiently.  Here’s to hoping I follow in her footsteps.