Category Archives: injury

Week in Review 10.26.15 to 11.1.15

Monday am: 15 miles with 8 at marathon pace. Ended up being 6:23 pace, so I was psyched with the effort.

Monday pm: Drills, 1 mile warmup then legs in the weight room.

Tuesday: 6.5 mile recovery run.

Wednesday am: 9 mile recovery run in what turned out to be miserable weather.

Wednesday pm: Drills, 1 mile warmup then striders.

Thursday: 400s on the track. Given the crazy wind on the home stretch, rotated start points around the track. Goal was 85, result was pretty dependent on Mother Nature. 84, 83, 84, 83, 82, 85, 82, 83, 85, 84, 85, 85, 86, 85. Legs felt totally awesome but it was admittedly frustrating in the wind. Legs afterward.

Friday: Unplanned rest day (I planned to take it on Saturday) courtesy of the dogs, who accidentally knocked me down in the driveway. Knocked the wind right out of me and banged me up pretty good but after laying there for a few minutes panicking that they had broken my leg, I determined that I was mostly okay.

Saturday: 4 miles in the early morning before we headed out then another 4 around the States Course. Amazing day for us, with some great teamwork and some stellar individual performances too. We beat Burlington by 1 point to qualify for the New England Championships, which was our team goal for the year. Doesn’t get better than that!

Sunday: 8.9 miles with striders.

Total Miles: 65

Total Miles for October: 282

The upside of a flexible schedule is that I can push my long run to tomorrow since my legs (and body and soul) are tired from yesterday. The downside is that it makes me feel like I’m messing up my training because I’m not following some arbitrary schedule. This downside is obviously all mental – my body doesn’t care that tomorrow is Monday. Still, it irks me!

Besides my fall on Friday, this week was actually a great week of training. I’m starting to feel really strong and am continuing to improve in workouts. I don’t have a lot of “big” work left before taper, which will start the week after next. My long run tomorrow will be long: 2 hours 15 minutes with 5 by mile at tempo pace and 8 by 200 hard at the beginning. With the tempo miles, this will be about a 17 mile effort. Later in the week, I’ll do my long run on Friday because I’m headed to DC this weekend to see my best friends for our Friendsgiving. I’ll be running while I’m there but it’s much less stressful when I don’t have to get a 2+ hour long run in.

Move That Ass

Since starting 3rd year, I’ve been living some great combination of standing, sitting and running all over the hospital in heels, clogs and on rare days sneakers. Thanks to this, my a** has been killing me since about March. Right on cue, another blogger friend sent me a great followup post about how to fix butt pain when all you do is sit. This applies to almost all of us, regardless of profession. In our culture, we sit. All the time.

Since getting his email and getting fed up with constant pain, I’ve been much more diligent about taking care of my rear. I get up when I sit for a few hours, try to use good posture when I have to stand (in the OR, on Rounds, in the ED etc) and stretch whenever appropriate, especially focusing on my hamstrings and hip flexors. It’s hard to stay on top of it but I’m much happier when I do.

How do you handle sitting all the time?

Week in Review: 12.15.14 to 12.21.14

Winter running is in full effect, including stutter step runs across ice and so many layers that one looks a bit like the kid in the Christmas Story.

Monday: 6.8 miles.

Tuesday: Workout! Ran to gym then 2 by 10 minutes on the treadmill at 170 bpm (T Pace) which turned out to be 6:40 pace. A little slower than in cycle but that’s to be expected. Lifted arms after.

Wednesday: Cross training, skied with the team.

Thursday: 4.25 mile recovery run plus hour ski with the team afterward.

Friday: 7 mile run. Legs wiped from a week of doubling.

Saturday: Hour of skiing at Sleepy then with Will. Scar and FHL bugging me.

Sunday: 9 mile run.

Total: 33.4 miles of running, 4 hours of skiing.

Happy to get some longer runs in this week and my first workout back. My foot is struggling with skiing right now (just hasn’t had to push off like that in a year), but hoping some stretching and scar cross friction will help resolve that. Looking forward to a week with a less insane schedule so that I can keep getting longer runs in.

How Do I Get Ready for Speedwork Again?

A fellow runner is coming back from injury and asked for some input on how to get back into workouts after a bit of a layoff. It’s a great question and one that I face as an athlete at the end of the off-season and as a coach when we transition from summer mileage to in-season workouts. I don’t know how others feel, but there is little more daunting about those first workouts back. Despite the fact that an underwhelming workout doesn’t mean anything, there can be SO MUCH PRESSURE. These two workouts are designed to take the pressure off. One has no prescribed recovery time; you go when you’re ready to go. The other is just time based; when time is up, you’re done running hard and jogging back down the hill.

Caveat: If you are coming off of a long layoff, your first step should be to add striders back in to the end of your run. Aim for 4 to 6 at 90% pace and good form. Once you’ve done those for a week or two, you’re ready for the next step back towards the following workouts.

3,2,1 Rust Buster

Packard Repeats: This is named after the workout we do on the First Day of School every fall on a hill near the high school. Find a hill that is about a quarter mile long and after a warmup, alternate between 30 seconds, 60 seconds and 90 seconds hard up with a jogging return. Aim to do three sets (9 minutes of hard work). The benefits of this workout? Because you’re running uphill, it encourages good leg turnover and begins to strengthen your quads, two key elements for successful speedwork.

What workouts do you use to get back into the swing of things? Do you do strides regularly? (Hint, you should!)

P.S. Welcome back Fox!

I Walk The Line

I’m quite confident that Johnny Cash wasn’t talking about running when he penned “I Walk the Line” but he nailed it when he sangĀ I’ll admit that I’m a fool for (running). I’m currently walking the line between fitness and foolish with a foot that just doesn’t quite want to get on board with this training cycle.

My general rule for aches and pains is to ask myself three questions:

  1. Have I had this pain before?
  2. Does it get better or worse with running?
  3. Is it changing my form?

With exception of broken bones or some serious injury, if a pain is new, goes away as I warm up and lets me run almost normally (as normally as I run with a post-op foot), I assume it’s volume related discomfort and carry on. Sometimes I’ll do an extra recovery day or tone down a workout but this has worked well for me over the years.

My current “niggle” is giving my injury approach a run for its money, however. When it started, it was just a little soreness across the top of my foot. As I’ve learned to run again after surgery, I’ve had some assorted foot pain as I got back up to mileage and figured out how to carry my foot. Given this, I assumed this too would pass. However, in the last week, the top of my foot has gone from a little uncomfortable to really fucking painful (that’s official doctor speak for 8/10 pain) on occasion, especially after hard efforts. Just when I’ve gotten to a point where I am thinking I need to take a day or two off, I’ll have a totally pain free run. For example, on Saturday, my foot was sore doing an hour of recovery running and I wasn’t hopeful about my Sunday long run. Naturally, I did 18 completely pain free miles on Sunday. Yesterday I could barely walk. Today it’s much better but still a little tender.

I’m pretty confident it’s a touch of tenosynovitis of the extensor tendons, the little guys who help lift your toes. With high arches and some hesitation on my surgery side that leaves me in dorsiflexion a little longer than desired, it’s not surprising that they got inflamed. They seem to be happier when I add an extra recovery day between efforts, tie my shoes loosely, add a little KT tape to help them out and ice after my runs.

I have some unhappy tendons...

I have some unhappy tendons…

Dealing with little injuries like this is always a thin line. As I said to a running partner this morning, if I had any suspicion that this was something more serious, I’d take time off. If I took an off day every time I felt sore or tweaky, however, I’d never get my mileage in. That’s the cruel fate of the distance runner; it’s a rare day when something doesn’t hurt or ache. In our house, the first few minutes of the day are spent creaking around, hanging on to the railing on the stairs while we warm up. I’m sure my neighbors who see me warm up and cool down would be surprised that I can run faster than 10 minute miles.

How do you triage little aches and pains? What’s your niggle of the week?

It’s All About the Science. And Beer.

Admittedly, I didn’t do much outside reading this week. Neural Science is easily the hardest class in medical school thus far (at least for me, I have trouble imagining structures) and keeping up with school and mileage shrunk my average sleep by over an hour this week. Ooops. Regardless, what I did read seems to have centered on some great writing on the things we accept as “truth” in running. I’ve been a competitive runner since I was 14 and even I have seen quite a few trends come and go. I won’t touch the 5 Fingers news from the week because almost everyone else has and I didn’t need longitudinal data to tell me that those weren’t a good idea.

First, a fantastic post by Chris McClung on the Myth of Over-Pronation. I’ve run enough and coached enough to see lots of different kinds of form be successful. I’ve watched enough races to realize that there is no perfect. Why should we expect anything less from our feet and foot strike? I don’t totally agree with McClung that we should throw out everything but our neutral shoes but I do agree that maybe we should focus less on finding a shoe that makes us hit the ground perfectly and more on building a strong kinetic chain.

Second, an interesting culmination to a week-long conversation on training pace from Peter Larson and Caleb Masland. In the series, Larson, Masland and other athletes explore the idea of training pace. All three line up on the idea that faster is not always better for training. I couldn’t agree more. One of the biggest struggles I face as a coach is convincing athletes to slow down. When you are getting back in shape, it’s tempting to push the pace to try to accelerate fitness acquisition. When you are a hair’s length away from a PR, it’s tempting to push the pace to get there. By and large, the only place you’ll get in these scenarios is injured. Last year, Greg McMillan wrote an article on longevity that really resonated with me. For a long time, I wondered if my religiosity towards slow long runs and easy runs was holding me back. Although I’ve had two surgeries due to anatomical freakshow-ness, I’ve never struggled with injuries. I’ve never had a stress fracture. I haven’t had shin splints since 1998. I attribute much of this to the fact that I have no problem running 90 to 120 seconds slower on long runs and even slower on recovery runs. The paces that matter are race paces and workout paces.

As I’m coming back from surgery and dealing with the aches and pains associated from reminding my body that it can run, I’ve been careful to make sure the foundations matches the architect’s plans. This article is a simple but excellent summary of what systems need to be in place before real workouts can begin.

Moving on from science, the Kara Goucher sponsorship train keeps on rolling, this time with Nuun. I’ve never tried Nuun, mostly because I don’t worry about my electrolytes but I am interested in their new energy product. I find myself slumping in the afternoon but work hard not to have another cup of coffee. Adding a little zip to the water that I need to be drinking anyway appeals to me.

Finally, I’m really anxious to find out the date of the Beer Mile World Championships. I’m running a marathon on October 12th but if the Championships are later, I’m giving full thought to going for it. I’m a serviceable miler but I was an excellent beer drinker in college and feel strongly that this might be my event.

What did you read this week? Have you tried Nuun? Anyone done a beer mile and have advice?

4 Weeks (and a day)

It’s hard to believe that I’m a month out. With my first surgery, I was still in pain, just recovering from my DVT and on crutches with no weight bearing. By contrast, I spent my 4 week anniversary yesterday walking in real boots at practice, biking and lifting. Granted, the regular boots were an experiment and a failed one (so not ready) but it was good to push a little.

I did 60 minutes of aquajogging on Sunday, so I think I’m ready to step up the cardio a little. My other new focus is transitioning out of my walking boot. I’ve been walking around at home some but am still very unstable. Over the next week, I’ll be working on walking in a sneaker daily and on the stability pad to take the next step (literally) towards running.

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First Steps

I don’t have kids, so I have no idea what it’s like emotionally when your child walks for the first time. I do suspect, however, that my walking ability mimics that of a brand new walker. Nonetheless, here are some of my first crutch free, awkward steps. And yes, I’m wearing shorts. You just can’t see them because I forbade Will to capture my facial expression as I concentrated on walking.

Day 6

I’ve tried to write this blog post a few times this week, but ended up nauseous and at a loss for words every time that I tried, which I guess captures my first week of recovery. In comparison to my last surgery, my first few days were much better but Days 5 and 6 were pretty grim. I stopped taking pain medicine yesterday, which left me uncomfortable and grumpy. Thank goodness for Scandal, the world’s most addicting TV show.

Earlier in the week, I was able to lift and even do a “chair workout.” From plotting 70 mile weeks to doing senior citizen chair workouts is quite the transition. Still, it helps me approach normal to have a “workout” to complete every day and maintaining strength isn’t going to hurt my return to running. In that vein, Will and I agree that we are going to work on building the foundation before I get back to running. While this may mean that I don’t run as soon as I might like, having a good foundation under me will allow me to get back up to normal volume more quickly. It’s not hard to get back to running 4 miles a day, 6 days a week. Try to get back to 70 to 80 miles a week without a good foundation, however, and you’ll be on the injury train before you know it.

For the next week, my goal is to just survive. School starts again tomorrow, which will be exhausting. I’m also hoping to return to coaching because I miss my kids and we are about 6 weeks from the state meet. Snow adds a level of difficulty, but I’m hopeful I can at least stay upright. On the 14th, my cast comes off and I can weight bear! One of the biggest differences between this surgery and my compartment release is that I think I could walk if I had to, a drastic difference from the compartment release where I had to be bribed into walking after 6 weeks. I’m looking forward to being able to return to the gym, even if it’s only to colonize the recumbent bicycle and pool.

Okay, You Can Call it a Comeback

After much consideration, surgery is scheduled for December 30th, a frustrating end to a frustrating year of training. It seems that my foot was just waiting for me to say “Uncle,” as numbness and pain are now an almost-daily event. The recovery is supposed to be “easy” and the running at this time of year isn’t great anyway, so I’m hopeful that I’ll get lucky and be running again as the snow begins to melt.

My attitude towards the recovery following this surgery is different than before. When I ran Philly in the fall of 2012, I was excited about running. I felt like I was poised for a breakthrough and looked forward to making huge improvements in 2013. Unfortunately, 2013 never really got off the ground and I ended up barely moving before VCM with a sub-par performance and an almost-competition free last six months. Surgery isn’t easy and I wish I didn’t have to go through it but in many ways, it allows me to kick off 2014 with great hope. I look forward to rebuilding my feet, my legs and my running fitness. I look forward to the opportunity to train hard and race again. I want to prove to myself (and maybe others) that I still have PRs in me, that I’m nowhere near the top of my talent.

Until surgery, I’m taking each day as it comes. Some days, I can run forever and be mostly comfortable. Other days (like today), my foot went numb walking home and is tender to the touch.

Guess I’d better amend the tagline for this blog…