Saturday, May 28, 2011

Planning for PRs

I now have a training plan in place that will take me through my next marathon race in Houston, Texas on January 14, 2012.  In my last post, I discussed plans to possibly race a marathon in Rio de Janeiro, Brazil in July, but I found out last week that they are only sending one female to run the race, the military winner of the Marine Corps Marathon.  When I heard the news, I was actually relieved.  I was feeling pressure to fit in enough training between now and then to at least make a decent showing.  Now, I can focus on short distances for a few months before launching into my marathon training cycle.

I sat down one evening earlier this week and started working on my training plan for the next 7+ months.  It follows the programs detailed in the Squires and Lehane book Speed with Endurance.   The general outline is as follows:

3 weeks alpha base phase (mileage range 46-59)
4 weeks speed with endurance phase (mileage range 62-71)
3 weeks 5k pre-season plan (mileage range 61-82)
3 weeks 5k in-season plan (mileage range 58-81)
1 week regeneration (no mileage target, just recover)
3 weeks alpha base (mileage range 89-93)
3 weeks speed with endurance (mileage range 85-91)
15 weeks marathon specific training plan (mileage range 63-106)

As I move through the plan, I will post some of the workouts that I do to give you a flavor for the program.  I have set goal races sprinkled throughout the plan that I will mostly train through.  Nonetheless, my goal is to PR at every distance from the 5k to the marathon during this training cycle.  I am shooting for the following:

5k (in mid August): <17:40
10k (in late November): <36:30
half marathon (early October): <1:19 
marathon (Jan 2012): <2:42

My first race is a 5k at the World Masters Track and Field Championships being held in Sacramento in mid July.  I am training through this race since I know I won't be in shape for anything respectable by then.  I do however want to be a part of that celebration of masters athletes and run for the USA.  I am targeting a fast 5k later in the summer and will shoot for a big PR.  

My plan is not easy, but neither am I (despite what you may have heard on the street).  This will be the most challenging training plan, at least in terms of volume, that I have undertaken.  It doesn't scare me in the least.  In fact, it thrills me to think about what might come out the other end as I crank through the workouts.  I had an interesting Facebook exchange going this week where a friend posted her concern about me setting such a long-term plan.  I appreciate her cautionary words and can understand how an athlete might feel obligated to stick to such a plan even if it was not working or if circumstances changed making the plan obsolete.  However, long-term plans are the norm for me since that's how Coach Nicole operated.  I would often get 6 months of workouts from her at a time because that's what I wanted.  The plan is just a plan, of course.  While I see the workouts and mileage within the plan as changeable, I have been amazed at how closely I've been able to stick to my plans in the past.  Since I am not a fan of blind obedience to anything, I don't feel obligated to follow a plan just because.           

I am not sure I can convey to you how convinced I am that I will be a faster and healthier runner for having undergone 11 days of pain and torture in Arizona.  I am now able to run with ease, something I'm not sure I have ever experienced before.  I am no longer fighting my body to move forward in a running stride and that is remarkable.  The funny thing is that I never even knew that fight was going on!  Dr. Lau, from Sacramento, has now made contact with Dr. Ball, from Arizona, and they have developed a plan for me to gain even more range of motion and keep it there for the long term.  I also found out that I don't have any serious degeneration or deformities in my hip joint, though there may be something minor in there that an x-ray can't pick up.  Nonetheless, Dr. Ball said this bodes very well for my continued improvement.

It's going to be a tough row to hoe, but I am so ready for this.

Sunday, May 22, 2011

The Training Wheels Are Off

I have completed 5 runs since leaving Dr. Ball in sunny Arizona, and all have been pain free.  Up until a week ago, I was still running with discomfort and some part of my brain hasn't really wanted to let go of that memory.  When I was running in Arizona, I had an appointment with Dr. Ball each day and knew that he would take care of anything that hurt.  I told Brooke that we had our training wheels on while we were there.

The training wheels are now off and I haven't fallen down yet.  However, my brain is in a state of high alert for any signs of pain and tightness.  I don't have that daily appointment any more to rely on, but I really don't need it.  Dr. Ball got me to a healthy state, and I need to do the maintenance work from here on out.  The maintenance work involves no stretching aside from an exercise designed to mobilize my hip capsule, though I believe the Good Doctor would not count that as a stretch per se.  Dr. Ball is anti-stretch.  My maintenance work does require a lot of rolling with a lacrosse ball and the grid foam roller.  He and his staff were diligent about showing me the right way to use these tools and what parts to use them on.  While I had been rolling regularly, I wasn't rolling the right parts regularly.  It's really easy to see why my hamstrings got so messed up over the years, since I was rolling every major leg muscle group EXCEPT them.  When I asked how often to roll, he asked me, "how many days a week will you be running?"

When it was time for me to leave Arizona, Dr. Ball mentioned that he still wasn't satisfied with the range of motion in my left hip.  He hypothesized that there might be something mechanically wrong with it.  He explained that this was probably something that I've had most of my life, perhaps as a result of my parachuting accident at Army Airborne.  He emphasized that it didn't really matter.  My treatment would be exactly the same.  It was just something I had to live with, which means being extra vigilant about keeping the hip capsule mobile.  I am going in Tuesday to see a sports medicine doc at Kaiser to see about this issue, if for no other reason than to establish a baseline for whatever it may be.

Now, for the fun stuff.

I ran 59.5 miles this week, completely pain free and did two workouts.  One workout was a Squires-style tempo run on Thursday where I ran 9 total with 4 miles at 6:30 pace.  His "tempo runs" during the build up (alpha) phase of the program are run 50 seconds slower than 5k pace.  So, I might have been pushing it a bit, but it felt good.  I ran 14 miles today with pick ups like last weekend's long run (1,1,1,2,1,1,1,2 minutes with a return to long run pace in between).  This is the longest run I have done since October, and it felt awesome.  I feel confident enough to continue on with my plan to build up for a marathon in July, though the military hasn't announced who's on the team yet for the World Military Championships in Rio de Janeiro.  Regardless, I wrote my training plan based off of Squires' 5k program to gear up for the World Masters' Championships here in Sacramento in July.  I added in longer runs on the weekends to help prepare me for the marathon, if that opportunity materializes.  Either way, I have a target race in July to shoot for.  Here's what my training plan looks like for the 4 weeks including this week.      

Sunday, May 15, 2011

I didn't run 10 miles

That's right. My run this morning didn't go as planned. I had planned to test my new and improved legs on a long run of 10 miles this morning. Dr. Ball and I had been talking about me running up to 90 minutes this weekend, so I set that as the upper limit. I didn't know how fast I would go.

During yesterday's run, I threw in a few strides to see how that felt. It felt good--smooth. So, I decided today I would try the workout I had set for myself for this weekend a month ago. Back then, I was optimistic that, with enough rest from running, I would be able to slowly ramp up my mileage and would be running 50 miles this week with a 12-13 mile long run. My plan came from a book I bought after seeing mention of it on Camille Herron's fantastic blog. The book is called Speed With Endurance written by Bill Squires and Bruce Lehane.

One of the bread and butter workouts that repeats throughout all of the training plans is a long run with pick ups. You start with baby pickups and progress to some pretty long ones as you get deep into the trenches of his marathon training plan. My plan for today was to do 1, 1, 1, 2, 1, 1, 1, 2 minute pick ups spread throughout my long run. This looks something like 1 minute fast and smooth, 4-5 minutes at your long run pace, then another 1 minute fast but smooth and then back to your long run pace, etc.

So, my run went awesome. I ended up running 12 miles at 7:02 pace with the surges as planned and at 5k-10k pace. No pain. No soreness. Lots of smiling. I really enjoyed this workout, probably because I was running care free and pain free and surging with some speed. One big thing I noticed today was that paces that have felt labored to me lately felt easy breezy today. I talked with Dr. Ball about this today during treatment and asked whether this could be because I am finally healthy. In other words, I'm not fighting my body to make it run. I am actually running naturally again. He said that this is likely what's going on. This was also something I hadn't expected from my visit to see the Good Doctor: that I might become a faster runner simply because my body was not having to work so hard to run. Cool.

I am so excited to resurrect my training plan and get started on more of Squires' workouts next week. Coach T will make sure I am smart about reintroducing faster running gradually. I asked Dr. Ball today about whether speed work was in my future and he refused to weigh in. He said, "I'm not your coach. But you're healthy now to start training again." I'm taking that as a yes.

Saturday, May 14, 2011

Notes from the edge of the desert

The canal is where runners can 
be found in Phoenix.
That is the title I gave to the log I was keeping for myself chronicling my rehabilitation here in Phoenix.  I just looked at these notes for the first time since Wednesday and realized I stopped keeping notes when I stopped feeling pain in my knee.  That's right--I stopped feeling pain in my knee.  

Here's a condensed version of my treatment log:

Day 1: I am effed up.  I can't lunge right.  I can't touch my toes.  My lower back is locked.  My hip capsule is locked out and my adductors are fused.  He did some stuff to my hip and adductors and told me to run.  Ran for 6 miles that night, but it was really more of the same with tightness coming on at 3 miles and remaining on and off throughout the rest of the run.

Day 2: Test run in the morning and started feeling knee pain after about a mile.  I ran 3 miles total.  Dr. Ball said he expected that and did another round of the same treatment as the day before. Test run in the evening and felt knee pain 21 minutes into the run.

Day 3: a.m. Morning test run and felt knee pain in first 2 miles.  Frustrated and afraid of my test runs now.  Dr. Ball was frustrated too with my hip continuing to lock down.  I could tell he was starting to question his guru ways when he started talking about a possible labral tear in my hip.  He worked the crud out of my adductors/hamstrings and hip capsule.  I did several 5-10 minute test runs and still felt knee pain.  I freaked and drove home in tears.  Texted The Genius that I felt like giving up.  

p.m. Afternoon test run and no knee pain until 28 minutes into the run.  Improvement.  Dr. Ball worked on the adductor and hip capsule again during the second treatment of the day.  10 minute test run and I didn't feel any knee pain.  Saw Ryan Hall in the office.

Day 4:  Started to feel like I was using my hamstrings again during my run.  Ran for 32 minutes pain free!  Treatment: More work on front of quadriceps, TFL, adductor, hip capsule.  Talked a lot with the doc to better understand everything that was going on.  22 minute test run and started feeling aching in back of knee.  Doc worried that I am having trouble differentiating between treatment pain and the injury pain.  He said he would normally give me a rest, but we had a compressed schedule.  So, I decided to stay in Phoenix longer.

Day 5:  Test run in the morning completely pain free for 39 minutes!  Treatment of some kind because I stopped keeping a log.  Test run in the evening of 30 minutes.  I ran 9 miles today, pain free!

Day 5 was Wednesday.  Thursday morning, I ran for 50 minutes pain free and Friday for 60 minutes (8 miles).  It is hard to believe that I went out for a run this morning and did not think about whether my knee would hurt or not.  And, I braved a full out and back course rather than repeating a short loop course.  Tomorrow, I will run 10 miles with some local fast runners:  two of them are also Houston Hopefuls.  Here's the kicker: I will run 55 miles this week.  Can you believe that?  55 miles.  I can now dust off the training plan I had written for myself to take me through the Rio Marathon in July.  Unbelievable.                

Dr. Ball has said to me numerous times that freedom from symptoms while running does not mean your body is functioning properly.  This little lesson has provoked a lot of thought for me.  I was one of those runners who was so proud of myself for having been injury-free for 6 years.  I was fairly arrogant about it now that I think of it.  What seems pretty clear to me given all of the stuff that Dr. Ball continues to find to work on, is that my body is damned good at compensating and has been for years.  Running 80-100 miles per week is extreme for a human.  There are people who run a lot more, but most people in the world run a lot less--like closer to zero.  Why did I think that all those miles weren't having some sort of negative effect on my body?  Maybe I'm dense.     

To the question, "how do I keep this from cropping up again?", I usually get something like, "stop running" from Dr. Ball.  He's right, but he knows that I won't and that will keep him in business.

Hal in his natural environment.
I spent the first week here in Phoenix with some gracious, hospitable friends and their dog Hal.  Hal and I had a little love affair going.  We spent a few hours swimming together and that is the bees' knees for a Chesapeake Bay Retriever.  

Yesterday, my friend Brooke flew in.  She read about what I was doing here and decided to join me in the desert for a few days to see if the Good Doctor can help her with a chronic injury that has kept her from training for far too long.  She is a fellow run blogger and someone spotted us and shot the video below of us geeking out in our room today, telling our stories of injury, recovery and the magical healing powers of the desert.   

Wednesday, May 11, 2011

Phoenix continued

I completely underestimated how much treatment for my leg injury was going to take out of me both emotionally and physically.  This healing stuff is hard work.  I am on the quick recovery program here due to my own time constraints, so Dr. Ball has to work his magic on a compressed schedule, and that is not ideal.  We have been balancing the intensity and frequency of treatment with how well my body recovers all the while testing the treatment with short and long runs.  It became clear yesterday during my afternoon run that I was having a hard time telling apart the discomfort from treatment and that of the original issue.

So, I made a decision to stay in Phoenix through next Tuesday.  I am making remarkable progress (in my mind at least), but Dr. Ball mentioned that, if he wasn't under a time constraint with me, he would give me a rest from treatment to allow my body to recover and to truly test the effects.  It seems wrong to push my body harder or truncate my treatment at this point given how far I have come and how much more I have to go.  I want to let the treatment sink in and get as much of the junk cleared out of my system as possible.

That's what we're doing here: clearing junk from my trunk.  I had no idea how much junk I had in there either and most of it was hidden.  I am going to make one sweeping disclaimer here that I may not get all of the details completely right, and that is a factor of my monkey brain, not Dr. Ball's.  He does a great job of explaining all of this, but there is a limit to how much I can absorb.  He mentioned at some point that I had the most messed up adductor/hamstring "cluster" (my term) that he had seen in a long, long time.  Here's how I understand my main problem (there are other minor issues): my hamstrings and adductors are fused together which doesn't let me use them properly when I run.  This forces my hips/butt to work overtime to actually move forward with a stride.  At some point, my glutes and hips get tired of doing what I'm asking them to do because they're not designed to do this, and they cry uncle.  This is usually my tensor fascia latae (TFL) crying out or it might be a quad muscle. The good old IT band is attached to the TFL and starts to get pulled when the TFL tightens.  That's when I feel the knee pain.
As part of this exploration, I received a wonderful consult from a coach in Australia, Keith Bateman,  who specializes in helping people with form issues.  He was able to create stills from a video of me running.  It was very interesting to see how awful I looked compared to what I should be doing.  For some reason, a prancing horse is what I see in these images.  From one shot, it was clear that I am too upright, I use my calf muscles to propel myself (maybe lob is a batter term) forward instead of my hamstrings, my front foot is lazily dangling rather than being dorsiflexed and that all has a ripple effect that plays out in the rest of my stride.   When I first saw these images a couple weeks back, I felt empowered with this new knowledge and set out to improve my stride with form drills and paying attention to my forward lean, etc.

What I didn't know then was that I couldn't get there by willing it or even trying harder.  My form sucks, in part, because my body is not functioning properly.  The most humbling thing I've done with Dr. Ball is simple forward lunging.  I posted a video of my flexibility tests on YouTube for him originally, and it is painfully clear that I'm having problems doing a simple forward lunge.  He asked me the first day we met how in the world I could run a 2:45 marathon when I couldn't even do a simple forward lunge without struggling.  I can't lunge not because I'm weak.  No amount of strength work or stretching will make me a better lunger.  I can't lunge because my body is stuck.  My hips are stuck, my hamstrings are stuck, my adductors are stuck and this has been building up for years and years.  It is an interesting take on how I've typically thought about my body and how it functions.

How did I get to this point?  Well, by running a lot of miles.  Dr. Ball reassured me that my body is doing all the right things.  I go out for a hard run and it repairs the damage with temporary patches and communicates with me the next day through muscle soreness that I have done damage.  Surely, my body thinks, I will listen to the cries to stop doing this activity and let it do some more substantial repair work, but my brain overrides this and we (my brain and I) go out and do it again.  So, imagine all of these little band-aid patches being applied over and over in the same spots.  Eventually, dysfunction arises when a substantial trigger point/knot/adhesion forms and the muscle no longer has the elasticity, range of movement and therefore function that it should.  So, the body compensates.  Adhesions form in other places.  Pretty soon there's just a whole lot of compensation going on and a pile of band aids being thrown down on top of band aids.  Something has to give.  That's where I was 6 months ago after the Chicago Marathon and have remained.  Looking back, I thank Dog that my body held up through that race.

The relief I've gotten with the various forms of therapy I've tried so far have served to alleviate a small bit of the problem.  As Dr. Ball explains it, I don't just have IT band syndrome, I have IT Band syndrome + glued adductors + locked hips + a locked lower back +....  Relieve one of these things, and you get marginal improvement, but a problem will come back.  So, your goal has to be to eliminate as much of the dysfunction as possible to break the chain.

That's what he has been attempting to do with me: jackhammer away at the concrete in my muscles and make it so they function properly.  The difference in how my legs feel is amazing.  They feel light and free when I run now.  I feel effortless.  This is a very exhausting process, and he and his team at Maximum Mobility Chiropractic have been working their butts off on me.  Dr. Ball uses active release therapy (ART) mostly, but he does it as a team with someone moving my leg through a certain motion while he strips out the adhesions with his hands.  All he has to say to his partner is "capsule" and they know exactly how to move my leg.  He also uses an EPAT (extracorporeal pulse activation therapy) machine to "soften" the tissue and it feels like a jackhammer smacking your leg.  It works.  After this abuse, I go out and do a test run and come back in to report back.  On Monday, I spent probably 3-4 hours in the office and test ran for about 80 minutes total.   I am really starting to notice a difference.

The good news for all of us is that once these adhesions are cleared, they take a long time to lay down again and build up.  Dr. Ball hasn't yet shared the simple measures I will take to maintain my shiny new body in this functional condition, but he assures me it won't be hard.

In the end, I don't think there is any magic to what Dr. Ball does here in the desert.  He's a careful observer but mostly he knows what to look for.  Most of all, he is super dedicated to his patients with a  main goal of aiming for functional improvement rather than just symptom relief.  Finding someone who has this combination is absolutely rare which is why I've shared the waiting room with a parade of the nation's best runners this week.  Yesterday, he kept talking about how he was unique and that I would never be able to find anyone else out there as good as him.  It took him about three tries with this comment before I got that he was being absolutely sarcastic.  I won't let him get away with that today.

Saturday, May 7, 2011

Let the adventure begin

I am on a plane flying to Phoenix, Arizona where I am hoping to find a cure for my recurring and elusive leg pain.  My last blog post, where I asked you to help solve the mystery of my injury, launched me on a wild ride that has culminated in this trip to the desert.

I received a lot of good feedback from many of you.  It was clear that you were able to see the problem, but there seemed to be a split between those that looked to the foot for the cause and those that thought it was coming from somewhere higher up, like my hips.  I responded to many of your comments saying that Dr. Lau was focusing on the feet.  However, the adjustments he did on my foot, ankle and calf did not resolve the problem.  

It was at that point that I sent a message to Dr. John Ball in Chandler, Arizona.  I sent him a link to my blog post and a couple of paragraphs diagraming the problem.  I had read about Dr. Ball in a blog post by Lauren Fleshmen.  She had just gone to visit him and posted a link to his blog.  I started to read some of his posts and was really taken by his words, sarcasm and wisdom.  In particular, I found this post addressed to one of the athletes he treats, as a follow up to her treatment particularly relevant.  Like me, she traveled from out of state to seek his help.  There is a lot of great information in that post that every runner could use.

To my surprise, Dr. Ball responded to my message quickly and suggested we talk on the phone about my injury.  I called him that night and he walked me through a few flexibility tests. It became clear very quickly that I wasn't quite getting what he wanted me to do.  So, he told me to take some video footage of myself doing these exercises and send them to him.  He spent a generous amount of time explaining to me what some of the issues might be and what I should expect from treatment.  One thing that really stuck with me was that, when the problem originates in the soft tissue, it shouldn't take more than one or two treatments to see marked improvement.  He told me that, if someone is working on the same spot for more than 1-2 treatments and you're not getting better, then they haven't found the right spot to treat.  That doesn't mean that you won't go back for more treatments for them to try other things, but, when they get it right, it will be quick and noticeable. He also has some very pointed opinions on runners having weak hips as a catch all explanation for just about every problem.  As he said to me, "if you can run 100 mile weeks and a 2:45 marathon, you are not being limited by weak glutes."

I immediately pulled out my iPad, shot the video and posted it on YouTube.

He watched it immediately and sent me a couple of ideas on areas Dr. Lau should work on.  I saw Dr. Lau a couple of days later and he was happy to try what Dr. ball had suggested.  When I asked Dr. Lau if he felt weird about me going to someone else and then asking him to work on me, he assured me that he did not.  He said, "we all have the same end goal, and that is to get you back to running."  He is a class act.

Wednesday was my test run day.  Test runs are unnerving because I can't help but think about every little twinge I feel and wonder if it indicates the continuation of my problem.  Unfortunately, the pain in my left leg came on with clocklike precision, right at about 3 miles into the run.  I was not happy.  I reported back to Dr. Lau, and he told me that he was out of ideas for me.  

I sent Dr. Ball a message about the failed test run.  He said he thought this was fixable, but that he needed to get his hands on me.  He told me that Arizona was nice this time of year.  So, I thought about it for about 10 seconds and booked a flight to Phoenix.  I had free tickets on Southwest Airlines, a super hospitable coworker who is letting me stay at her house in Phoenix, a boyfriend who will love and care for my zoo while I'm away and a job that allows me the ability to work remotely.  Dr. Ball Is going to see me this afternoon (Saturday), and we'll see how it goes from there.  My return flight is booked for Thursday night. Did I mention that he treats Ryan Hall?

I still haven't found the source of my problem and I really want to be pissed off about that.  Instead I feel humbled by the generosity of strangers, friends and loved ones and their willingness to spend time helping me.