Monday, October 16, 2017

Better Safe Than Sorry

With the Indianapolis Monumental Marathon less than three weeks away, my only goal is to get to the start line healthy. I am writing this not so much for my blog readers, but more to reinforce it in my own mind. In fact, the purpose of my blog as a whole isn't to write for others, but rather to keep a personal record of my running journey. I find it useful to look back on previous race reports as well as descriptions of illness and injury. More importantly, I use my writing as a way to solidify my thoughts and find clarity. Most of my readers probably don't care about my exact placement in a race or what distance my Garmin reported. But those details and that level of analysis is interesting to me, so I include it.

Back to the purpose of this particular post-- my Achilles tendons. I've been dealing with stiffness and aches post-run since the middle of July on both feet. The stiffness is at the point of insertion at the bottom of the back of the heel. I think it was caused by wearing the Nike Zoom Elite, which has an 8mm heel-to-toe ratio as opposed to 10+ mm, which I am accustomed to. I have limited ankle mobility, so those two millimeters made a difference, particularly since I only wore the shoe during intense 5K speed workouts. That must have caused an additional strain that my tendons weren't used to. I stopped wearing the shoes in early August, but it was too late at that point. It got progressively worse through early September, when I made an appointment to see my sports chiropractor. He gave me exercises to do, and they worked. My Achilles tendons started to improve over the next several weeks. At one point, the pain was completely gone for almost an entire week. I kept up with my exercises, but the pain started to get worse again after the Army 10-Miler.

On Monday of last week, I went for a 70-minute recovery run and while I could feel some minor irritation in my Achilles, but nothing too alarming. The next few days were easy running and I was recovering well from the race. On Thursday, I ran a workout of 20 x (1 minute hard, 1 minute easy) followed by 20 x (30 seconds hard, 30 seconds easy). My sports chiropractor had warned me that short sprints were the worst thing for my Achilles, but I proceeded with the workout anyway because everything had been feeling fine. I made it through the workout pain-free, and I felt pretty good afterwards too. I was actually encouraged because if I could sprint for a full hour without having my Achilles hurt, then I must be in the clear!

On Friday I ran for 70 minutes at an easy pace, and then on Saturday it was time for my 22-miler. I heated the area around my Achilles with a heating pad before starting the run to loosen them up. The run ended up being more difficult than expected. I've run 22-milers in previous cycles and all of them had felt better than this one. This could be because it was 62 degrees and very humid on Saturday, as opposed to the cooler, less humid conditions I've had for my other 22-milers. I felt fit and strong on the run, but I could tell the humidity was making me extra tired and my legs were also tired from the 60 minutes worth of on-and-off sprinting on Thursday.

Saturday, October 14th
I finished the run successfully, but once I was done, I was done. I was completely wiped, my legs were sore and achy, and my Achilles were not happy. I didn't really feel any pain in my Achilles during the run; if I had I would have stopped. I found it hard to walk around for the rest of the day, which was a contrast to my previous 22-milers. My prescribed run on Sunday was a 30-minute recovery run. My legs felt decent, and I told myself I would cut it short if my Achilles hurt. I took it slow (9:36 average pace) and as the run progressed my Achilles felt better and better. I was able to check the box on a 69 mile week. But something told me that I needed to take this Achilles thing more seriously.

It's now escalated to the point where I can feel a slight burning sensation even when I am at rest. And it never used to be this way. It used to only hurt when I got up from a chair, and only during the first few hours after a run.

I ultimately realized that I needed to stop running until my Achilles no longer hurt while at rest. An Achilles tendon could tear, and then I wouldn't be able to run (or walk) for months. It's better to be safe than sorry.

In an ideal world, this week would be my final week of high-mileage, intense marathon training. A two-week taper works best for me. But unfortunately I am starting the taper a week early, and resting completely. I think the elliptical would probably irritate it, and I just don't have the motivation to go pool running. I hate pool running and it's logistically difficult to do in the morning before work.

Week of October 9th
I'm going to take things one day at a time and hope for the best. I took today off and I will take
tomorrow off. I continue to do the exercises that my sports chiro gave me. I'd like to run my prescribed workout on Wednesday, but I'm not going to do it unless the Achilles dramatically improves between now and Wednesday morning. It's not worth the risk and I don't run through pain.

My sports psychologist said that injuries were like stop lights. Green means "train as normal - not to worry!" Yellow means "train with caution and be aware of how things feel" - which has been this entire training cycle. Now I'm at a red light and I won't be on the road again until it turns yellow.

How do I feel about all of this? It sucks, but I've accepted it. The tendons just need to hold out for three more weeks. They've held out this long! I'm also bummed that I haven't even gotten to experience the cool fall weather for a tough workout yet. All of my harder workouts have been in warm, humid conditions, and I think I could really see significant progress in cooler temps. I really want the opportunity to see what I can do and I don't want to be sitting on the sidelines on November 4th. This could be a flare up that goes away tomorrow, or it could persist until I've taken a more significant chunk of time off of running. If it's the latter, I probably will go pool running, which is a depressing thought.

The good news is that I haven't yet torn my Achilles. (If I had, I wouldn't be able to stand on my toes.) I'm going to a podiatrist on Wednesday just to make sure there isn't anything else going on. Better safe than sorry. I'd rather take some time off running with tendons that are intact than have to wear a boot or cast or get surgery or something. I also hate running in fear, and not really knowing if running is okay. The idea that I could be hurting myself it the worst feeling ever. I want to run the marathon on November 4th with pain-free heels, and not worried that something is going to snap mid-race. That's my priority and I will do whatever it takes to make that happen, even if it means losing some of my hard-earned fitness over the next few weeks.

17 comments:

  1. I'm so sorry to read about your injury woes, Elizabeth. Just hang in there. Your marathon is only 3 weeks away, and while you're so worried about losing fitness, it may just be an extended taper. I had to take several weeks off last Fall due to a knee injury and ended up postponing my marathon and running the half- which I PRed. So all those miles I ran in training (I only go to a long run of 16, but still) were NOT for nothing! And all the miles you have run will pay off as well. It sounds like you did the right thing by stopping and going to the sports chiro too. Races are hard enough on the body when you're healthy, much less toeing the line when you're less than 100% healthy.

    Just try to stay sane for awhile- maybe some yoga and a drink or two would help? It's been hard, but I'm still learning... gotta enjoy the journey and the good times (on and off the race clock) will come!

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    1. Thanks for your support, Amy. I do think I will lose some fitness, but I know I had a lot built up so I guess there is some to spare. I remember your knee injury and your PR. Very inspiring! I definitely want to be 100% healthy for the marathon. I'm using halloween candy to stay sane. Not the healthiest approach, but it's comforting!

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  2. So sorry to hear you're dealing with this. I went through a pretty severe bout of Achilles Tendinitis myself a couple of years ago. I ignored the pain for a while and reasoned, "but it feels better as I warm up, and the harder I run," even though it felt far worse later. When the pain eventually shoved me through the door of the Endurance Athlete Center in Falls Church, I already knew that Chicago was out of the question for me that year. I ended up having to take over a month completely off of running, and then it was a slow 3-4 months of easing back in (even doing a walk-run program) and lots of physical therapy. Now I'm a few years pain-free, but it's always best to heed those yellow lights! Best of luck. Good for you for being cautious and wise.

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    1. Thanks Calesse. I never run through pain (the pain of an injury) and because this never hurts while I run, I figured it was fine! Thanks for sharing your story. It's definitely eye opening and I really wouldn't want to take over a month off. I figure I will have a nice break after Indianapolis and that should hopefully heal things up for good.

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  3. You are doing the smart thing and listening to your body. You've trained so well up until now--I don't think an extra week of rest is going to change the outcome of your race. Hang in there...

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    1. Thank you! I guess I'm less concerned about the outcome of the race and it's just a bummer that I wasn't able to complete the training. I do love marathon training.

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  4. You are being very smart. I think the modification won't mess with you physically much and you are tough mentally. Keep us posted. Sorry you are dealing with this!!!!!

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    1. Thanks, Amy. I appreciate your encouragement.

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  5. It's the right thing to do. And who knows? Maybe a long taper will be just what you need this season.

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  6. How frustrating. As you know, you're making the right call.

    If you want inspiration, research Joan Benoit and the 1984 olympic trials. Apparently she had knee surgery a few weeks out, and didn't run during her taper. And then won the trials.

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    1. That's amazing. And very encouraging! I'm not Joan Benoit, but if she was able to maintain her fitness then there is hope!

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    2. Here you go: http://www.nytimes.com/1984/04/25/sports/ailing-joan-benoit-may-miss-trials.html

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    3. Not sure which is more impressive, Joan Benoit or the fact that the NY Times has articles on their site dating back to 1984! I just read the article and it's really amazing that she was able to come back so quickly. I'm totally going to use her as my inspiration between now and race day.

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  7. Hah...I am probably one of those you refer to as "readers don't care about placement or Garmin distance"...but over time I came to realize why you put all that detail...the blog is yourself speaking to yourself. Your readers follow you for many reasons...I only found your blog because of your Boston Bound book!

    With that said I commend you for your "green-yellow-red" light concept and have to say you are really smart to listen to that Achilles "talk-back" and hold-off on pushing through the training. I don't think you will loose anything with several days to even a week off and you doing what I called "triage therapy" to help calm and reduce the Achilles issue. I always a big fan of 3-week taper and this extra week might actually help you get back to last 2-weeks of normal taper training and hopefully you get through your marathon race to your goal terms, then I think you will probably take some time off and focus on healing up totally that Achilles condition.

    So early on I may have at time questioned your approaches and "details", but it is clear you know what you are doing...what you contend with...and what best course of action to take. Good luck with these next few weeks and will be looking forward to a positive report following your marathon. See ya in Boston April 2018!

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    1. YES- that's exactly why I include the detail. I am not trying to misrepresent my actual mile splits or paces or distance. I just like to keep track of everything so I can reference it in the future and use it for a basis of comparison when it makes sense. For example, if I know that my annual Turkey Trot always measures 3.15 on my Garmin, and I want to break 20:00, I'll have to plan accordingly.

      The red-yellow-green light analogy seemed obvious when my sports psychologist said it to me, but as the years have passed, I realize that thinking in those terms makes it easier to decide weather to run, run with caution, or stop running. You're absolutely right though, after the marathon I need to get to 100% with the Achilles so I am fresh for the next cycle and not always running with a yellow light.

      Thanks for your ongoing support! Congrats on getting into Boston!

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  8. Your training has been SO good so I’m sure you’ll be fine for the race in terms of what you want to achieve as long as the Achilles is ok. Rest will do wonders and my fingers are crossed for you. It sounds like you’re being super sensible.

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