How We Perceive Injuries

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I’ve been doing a series of articles on treating common running injuries for Competitor: achilles tendonitis, plantar fasciitis, IT band syndrome. While none of it’s been particularly new information for me, they’re all relatively comprehensive overviews of the different ailments and what we do and don’t know about fixing them. So, if you’re having any of those problems, I suggest checking out the stories (and not just because I wrote them and I am awesome).

But, what occurred to me as I was writing about IT bands on Monday is that this information isn’t new to me now, but it was once. Once it would have been shockingly new information. In college I was crippled with IT band problems. Any time I ran over 10-12 miles I stopped being able to walk. My knee locked up; my hip locked up; I’d hobble home. It made training for and attempting to complete my first marathon slightly disastrous. My treatment protocol at the time was basically rest and hope. I didn’t know anything about rolling or stretching or, most importantly, hip and glute strength. So, it probably shouldn’t have been shocking when I had the same problems four years ago, exacerbated by a terrible bike fit. And, what I remember most is being so simply overwhelmingly frustrated and confused. WHY DID THIS HAVE TO HAPPEN TO ME?!?

Now, it seems obvious and simple. Not that that means I never worry about IT band problems (*knock on wood*), but I keep up my functional strength; I stretch; I roll; I head to massage when things are tight; I freak out and call my ART guy and my chiro whenever I have an inkling of a problem.

Now, IT band injuries seem oh-so-beginner. Now, I’m stymied by a torn muscle in my foot. (Someone yesterday asked me, “Are there muscles in your foot?” I’m going to say, yes, yes, there are.) Last year, I was taken out by a bone spur. Each time the problem seems mystifying and confusing. No one could have seen it coming. The world is so unfair. How could I have been expected to know this would happen. And, each time, the answers really aren’t that different or mysterious or shocking. Injuries happen.

 

Why I Hate Doctors — Especially ‘Sports Doctors’

The first doctor I went to for my mysterious foot injury (who was highly recommended) told me it was just inflamed, rest it. When that didn’t totally work, she referred me to another doctor in her office for a cortisone shot. That doctor said it’s a bone spur, you’ll need surgery. So, I went to a running specific doctor, who said here are some inserts to correct the problem, keep running.

Those are very different diagnoses.

If I had gone to three random people on the street and asked what was wrong with my foot, then I would have deserved whatever I got. But, these were all professionals, whose opinions I paid for. And, the part that’s really terrible was that each diagnoses was delivered with 100% confidence and an assurance that they had it figured out.

This past weekend I went to Urgent Care. Four weeks ago, when we were in Hawaii, I got a crazy bite on my side, which turned into a red rash/ring that spread across my side. It mostly has gone away (though not entirely), but there was a lot of concern that it might be a tick, or whatever the equivalent is to Lyme Disease in Hawaii. Then, Friday morning I woke up with another weird bite on my arm and by Saturday morning there was a giant red rash/ring that had spread across my bicep. For extra fun, I also had debilitating weakness in my arm that day.

That’s weird. So, I went to Urgent Care, which is like 10′ away. Because it happened twice now, I was concerned. What if I picked up some parasite in the waterfall pool in Hawaii? What if I was bit by something not good?

At Urgent Care, I sat and waited and waited and answered all the nurse’s questions and then the doctor came in and said, “So, I heard you have some kind of a rash” — while carrying my chart, which would have answered that question.

Before I finished my first sentence, he said, “Did you see a tick?”

Well, no, I did think that far ahead before coming in. Him: I don’t see a tick.

Gee, thanks. Him: I don’t know then.

And, then he started to prescribe me antibiotics and I asked how can you prescribe antibiotics if you don’t know what it is? How do you know that will even help or that it’s a bacteria? Are you just prescribing a generic antibiotic that will kill everything?

And, he laughed and said, hah, not everything.

Um.

I tried to explain that the rash was a symptom of the problem, not the problem. That I’m not concerned about it itching, but about what caused it to itch. And, he asked like what? I said, like a tick, but whatever other parasite like a tick there might be in Hawaii. And, he said, well, I could prescribe you an antibiotic that’s also for ticks if that’ll make you feel better. And, I said, but we don’t think it’s a tick. And, he said, no. And, I said, so, that won’t make me feel better.

When he left (after asking four more times if I smoke but not asking if I’d been feeling sick or had a fever or muscle aches or where I’d been recently) and I waited some more, a different nurse came in to ask if I have any questions. I was feeling super bitchy by then, so I said, “Tons, but you guys don’t seem to have any answers.” She wanted to know what my questions were, so I said the same stuff again and how I’m concerned about what’s causing this. And, she looked it over and said, “It looks like an insect bite.”

Yes. Well.

The problem isn’t that doctors are people. It’s that they think they’re better than regular people. We bestow on them this mantle, but forget that information doesn’t equal knowledge. Every kid in my dorm in college wanted to be a doctor. And, if they stuck with it long enough, most of them are now. But that  still doesn’t mean I want them doling out advice to me, particularly about things they don’t know about — and why would most general practitioners have any specific knowledge about your specific problem.

Steve had a back/hip injury at one point and went to the doctor, who was nominally supposed to be a “sports doctor.” She told him to rest (or something), but that he could still swim. Only she must have been thinking water aerobics, because when he asked about kicking, she was like oh no, no kicking. Which obviously makes swimming hard, unless you pull all the time. So, then, she suggested swimming with a kickboard under your stomach for support.

Does that even make sense? Is that even a thing?

In Today’s Things That Suck: Water Running

It’s official: I hurt my foot.

According to the sports ortho doctor woman, the joint at the base of my big toe is inflamed. According to the sports ortho doctor woman, it’s unclear how that happened. It happened all of a sudden in one workout last week and it’s not like I did anything wrong or overtrained or recovered poorly or wore shitty shoes or the billions of other things you can fuck up training for a marathon. (I mean, obviously, I probably did one of them or several, but there’s nothing that points to a specific poor decision on my part.) It just happened.

She said there wasn’t anything to do but rest it. I asked for how long and she said three to four weeks. To which my response was: Yeah….about that.

Seeing as Boston is in less than four weeks now (ahhhhhh), the revised plan is: rest from running, throw every anti-inflammatory at it, ice ice ice until I lose the nerves in my other toes, and do lots of biking if it doesn’t hurt, Alter-G running (which I had totally forgotten about, but am now hoping will solve all my problems), mild panic attacking, and water running. I’m not completely sold on this plan. I’m pretty sure my foot is slightly more sore today than yesterday, but it’s like staring at the sun and trying to decide if it’s more bright or less bright than before — also a good idea. Since there’s not another better plan, though, this is the one we’re sticking with.

Yesterday, I went to the YMCA to water run. It was just like this, minus the smiling:

I should probably just give up running and get into water aerobics. They look happier.
I should probably just give up running and get into water aerobics. They look happier.

What is water running?

Water running suffers from the fact that it looks an awful lot like what those guys who used to wear gold chains in the pool at the 24 Hour Fitness did, until someone had a heart attack and they had to shut that pool down.

Water running is actually supposed to be running — not walking or jumping or waving your arms around — with the same mechanics of running as much as possible. But in water. The idea is to simulate running without impact so you can train through injury (ahhh) or train high mileage pre-injury. It is boring and it sucks. It is also highly effective, because if done correctly it mimics running and keeps you aerobically in shape to run.

(While I was going back and forth in the deep end of the pool yesterday, I was trying to decide why exactly it sucks so much more than either running or swimming. I have not yet come up with an answer. Any insight will be appreciated as something to think about during my next session.)

How do you water run?

You do it in deep water, first off. Your feet shouldn’t touch the ground.

Maintain running form, which is hard, but don’t bend too much over — a slight lean, I think, is how most people operate — and don’t overextend your legs. I found it’s really easy to accidentally start treading water shittily, waving your hands around and doing a type of scissor kick.

It’s particularly easy to lose form if you don’t wear an Aquajogger belt. Lots of people think it’s harder without a belt, which is true — it is harder not to drown. But, I’m of the belief that your body then focuses on not drowning instead of focusing on maintaining running form.

With the belt and the floating of the water, it’s also easy then to go really easy. Most tips suggest keeping cadence high and doing harder efforts mixed in to get your heart rate up.

Don’t run into the women doing acqua-aerobics. Or small children.

This video is ok:

So, yesterday, I followed all these directions and went to the Y to do 50′ of water running with some 10 x 30″ pickups and 10 x 1′ pickups. Now, our YMCA isn’t like some other people’s YMCA, where apparently you can just get offered sponsorships while you’re swimming. (I sort of wish I went to Beth’s Y.) Our Y has the original weight machines, like from when weight lifting was invented as a thing with actual weights instead of just rocks. And our Y has a large and dedicated water jumping population. I don’t really know how else to describe the enthusiastic jumping and swinging arms and hanging on to the wall to do strange ballet-style kicking. It’s some kind of workout you must only learn about once you hit a certain age. Oh, and yeah, there were kids there too.

I’m being super judgemental obviously, which isn’t nice, but 1. I haven’t had the capacity to be nice in weeks and 2. I’m really just judging this one woman — who, as a side note, was creating a wake with her jumping routine — because she was probably about 50 years old and wearing a large pink headband that said “PRINCESS” in sparkles, which is about 46 years too old for anything you wear to say Princess unless you are actually a Princess, in which case leave us commoners to our fucking Y. Is nothing sacred.

I huffed and puffed and weaved and ducked and was dripping sweat — even though I was in a pool, I could tell it was sweat and not water. And, the people doing their insane jumping routines kept staring at me, since I was obviously the craziest one in the pool. Don’t I know water is for water sports, land is for running? Or, they may have just been looking at me because I turn bright red when I workout and look super awesome and refreshed, just like this:

This is how I always look after I go swimming.
This is how I always look after I go swimming.

Fixing Injuries with the Flector Patch

Monday, after the race, I was very down, slow, and exhausted. It’s easy to recognize that logically I was just tired and didn’t eat well during that day — all of which was toying with my emotions. But, that didn’t change the fact that I didn’t want to get off the couch. Floyd the Cat has been sad too because he doesn’t have any friends, so we didn’t do any work and just laid around.

Workouts have been sluggish all week and pretty much just chances for me to be a bitch to people. In my Masters lane? Chances are I yelled at you. Trying to pass me on the mountain bike trail? Want to make a clever comment while I’m doing drills after my run? Yeah, you don’t want to do that.

The only good thing had been that it seems like my ankle/foot pain (which was always sort of mysterious in the first place) is clearing up.

After my foot got irritated and pain was shooting up from the inside of my arch along the inside of ankle, I went to A.R.T. last week. It seemed like A.R.T. got a lot of the gunky shit out of my foot and heel, but it was still really sore all week. The whole area was just inflamed and tender to the touch. What do you do then? I was torn. The inflammation was pinching things and needed to heal, but I didn’t know what that meant I should do.

I did all the usual stuff — ice, stretch, roll, easy workouts — but what finally seemed to really help was: The Flector Patch.

What is the Flector Patch?

When Steve was hurt before — some kind of Achilles injury, his doctor gave him some topical anti-inflammatory cream and a couple of sample anti-inflammatory patches. There were two of the anti-inflammatory Flector Patches left, so I stuck one on overnight Friday and the other all afternoon/evening on Saturday. And, then, I was able to race without a problem.

Just slap the Flector Patch on there.
Just slap the Flector Patch on there.

The idea is that it’s a topical anti-inflammatory or nonsteroidal anti-inflammatory drug (NSAID), made of diclofenac epolamine, that you stick right on the site of the pain. The medication is absorbed for up to 12 hours and bam, pain gone. It’s also, as I understand, like $75 a patch if your doctor doesn’t just give you samples.

I joked with Coach Mario that it was some strong shit and I wasn’t even sure it would necessarily pass a drug test. And, it was a joke, but hell, I’m not sure. It’s a mainstream nonsteroidal medication proscribed by a doctor, so it has to be ok, right?

I couldn’t tell at first if it worked and I’m still not totally sure. It made the area go numb and certainly didn’t hurt while it was on, then once I took it off my whole foot would feel tingly and weird. But, after the race, it barely hurt at all. Now, it seems like it’s getting better, less sore. Whatever the medication did it gave my foot and ankle a chance to recover and a break from the inflammation and pinching of tendons/nerves that was a whole mess.

I’m inclined to think it works. Steve had similar results when he used it on his Achilles last year. So, it seems like a silver bullet, even if the Flector Patch website includes this quote:

As with other NSAIDs, the way FLECTOR Patch works to relieve pain is not fully understood.

Have you ever heard of the Flector Patch? Or tried topical anti-inflammatories? Do they work for you?

The Worst Part of Running

The worst thing about running (or any sport really) isn’t the rain or the motivation fluxuations or just the flat-out dry-heaving. It’s how suddenly you can go from running free and optimistic to way-laid and freaking out.

I’ve been running well and feeling good — strong, quick, with my biggest problems being how to know how fast I should start at the Kaiser Half-Marathon this weekend.

Then, bam, my ankle hurts. The arch of my foot cramped some after a few runs a week or two ago. I figured it might be the crazy shoes I’ve been running in or just not eating enough bananas. I started walking weird because my foot was cramping. And, my shins and ankles were a little sore after a couple runs last week. But, something is always sore after runs. That’s why they call it running.

And, then, at some point, it slips over the line from regular aches and pains to full-on injury.

The inside of my ankle, running up from my arch across the back of my heel, now hurts when I push off and shoots up the inside. So, I’m walking with a limp too. And, then, freaking out about the limp and if it’ll make the injury worse.

Hopefully, we can nip this in the ass quickly. Before I start hurting other people.

This is from Cait Chock, and she has more funny cartoons you should go check out:

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