Saturday, July 13, 2013

Stuff Hurts

I was fully expecting my next blog post to be a race report from the Firecracker 5K on July 4th. I was going to talk about how my frozen lemonade experiment worked out, how focusing on even breathing helped to reduce all the noises I make, and how I ran my first "hot weather" sub-22:00 5K. But alas, I have nothing to report because I did not run the race.

Just two days after my mile repeat workout, I noticed some pain in the lower calf/shin area a few miles into the long run. I kept running, hoping that it would go away, but it didn't.  I know that shin pain is nothing to mess around with so I headed home and ran only 7 miles. I was able to get an appointment with my sports doctor just two days later and he told me it was a bone irritation, on its way to a stress reaction or stress fracture. Sure enough, this is exactly how my shin felt in the weeks before I was formally diagnosed with multiple stress fractures back in 2011. And it was in a similar spot.

In addition to this bone issue, he told me I had "high hamstring tendonopathy" which is inflammation of the hamstring where it inserts to the butt. I had been feeling this problem for about a week prior, but I thought it was just general soreness/tightness and I wasn't too concerned. I basically feel this when I bend over to pick something off of the ground, or when I put pants/shorts on and have to stand on one leg while bending down.

My theory on how I got the shin problem (left shin) is that the right high hamstring area was bothering me while running so I altered my gait to strain the left leg. And my theory on how I got the hamstring issue was
that I started running higher mileage (averaged 54 miles per week in June) with the Mizuno Inspire as opposed to the Brooks Adrenaline that I had been wearing for years. My sports med doctor looked at my shoes and told me they were not nearly flexible enough and that certainly could have played a role.

My feet don't like Mizuno Inspires
Potentially the source of everything is the fact that the Mizuno Inspire was killing the ball of my foot. Once I started to get past 10 miles in these shoes, the balls of my right foot would start to hurt as if there wasn't enough padding. It was actually quite painful and it would make the run unenjoyable for those later miles. At first, I figured I would just develop a callous and get used to it, but that never happened and the ball of my foot started hurting even without the shoes on.

This ball of foot issue was the first "thing" that hurt me when everything else was 100% so I am thinking there might have been some sort of domino effect.

Recovery Plan
My doctor told me that I should run 1 mile per day to "load" the bone and stimulate healing. I waited a few days before taking this advice because I could feel it while walking around, and I didn't want to run until I was pain free. Once I started my daily 1-milers, I felt like it made the shin worse, so now I am back to not running at all. (It's now been two weeks since I first noticed this shin issue and stopped my normal training). The good news is that bones heal and heal well- they aren't nagging injuries so if I just take the time off and let it heal and gradually get back into it, I should make a full recovery within the next 2-3 weeks. Will I be in the best shape of my life for Chicago? Probably not. But I am hoping to be in decent shape so that I can successfully complete it and be able to have that experience.

Exercises for High Hamstring Tedonopathy
As for the high hamstring tendonitis, the doctor said that could take a long time, on the order of months, to heal. And of course I have read internet horror stories of it taking over a year. This is something that you can run through, but it will just prolong recovery. So in a way, it's good that the shin problem happened when it did because it forced me to take time off for my hamstring. My doctor prescribed exercises for this, which I have been doing every day, and he is also performing A.R.T.

I'll need to maintain the strengthening exercises, and move up to weight bearing stuff to make sure I am strong and don't get this injury again. Also, I will not be wearing the Mizuno Inspire for long runs. I will still wear it for runs up to 10 miles, like I had been doing for years, but I need to find another long run shoe. I could go back to the Adrenaline, but that shoe also feels stiff and is still probably too much support. I bought a pair of Asics 2000 which are nice and flexible and provide more support than the Inspire, but less than the Adrenaline. Another reason I hesitate to return to the Adrenaline is because I had been wearing a size 6 for years and lately I have been getting numb feet and black toenails from them. However, the size 6.5 really feels huge in the forefoot, so I just don't like how it feels.

Cross Training
The first week of these injuries (last week) I went to the pool almost every day for pool running and swimming. I was very determined to minimize any loss of fitness. This week, however, I started my new job and have not been able to fit in going to the pool. My commute has been about 1 hour each way because I am driving at peak rush hour and not able drive on 66 inside of the Beltway during those times. In a few weeks I will start "flexing" and hopefully cut my commute in half. I have been able to devote time to strengthening exercises, though, and I am feeling much better in both the shin and the butt.

This weekend and next week I plan to spend more time in the pool, and possibly on the elliptical if it doesn't bug the hamstring too much. I had worked myself up to 57 weeks in June and was on a "cutback" week when this injury hit me. Greg had urged me to take the cutback week sooner but I didn't think I needed it and I wanted to get in as many high mileage weeks as possible before starting the new job. I hadn't been injured in a year in a half (except for the mono) so I was feeling pretty confident about staying that way.

Positive Takeaways
I stopped running as soon as I felt this shin problem, so it could have been a lot worse. I could be looking at a stress fracture, which would definitely rule out Chicago. I was smart and conservative, and put my health above my desire to keep training at a high intensity.

I don't really know when I will be able to run again and at what intensity but I am surprisingly okay with that! For the first time since I started running, I am okay with not knowing when I will get better and just taking things one day at a time and doing my best to cross train. I think it's because I'm not so hung up on my time at Chicago. I really just want to be able to run the race injury-free and have a strong finish.

Also, I realize that I have more "separation" from running than I have in the past, which has been a goal of mine for the past year. Separation means that I don't define myself as a runner. Running is something I do, not who I am. Before, when I was really wrapping a lot of my identity into running, it would be heart breaking to not be able to run. But now, when I am taking the time to appreciate all aspects of who I am and what I have in my life, running is just a piece. It sucks that I can't run, but I know I will get better eventually and I'm doing the best I can right now.

Although the timing isn't great because I'm supposed to be training for Chicago right now, it's good in the sense that I didn't have the added pressure of trying to run a ton of miles during my first week at the new job. In addition to the long commute times, there have been happy hours and dinners galore, so the days have been extremely long. Enjoyable and exciting-- but also long and tiring. I was thankful that I was able to devote 100% of my mental and physical energy to getting to know my colleagues and diving right into my role.