How We Perceive Injuries

ridiculous-sports-injuries-gifs-runner-hits-girl

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.

 

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So, What’s My Plan Anyway?

When I was at training camp people kept quizzing me about how I coach myself. Isn’t it hard, weird, etc. And, I kept saying: “Well, I make an actual schedule and calendar. It’s not like I wake up each day and don’t know what I’m doing.” Haha, that would be crazy.

Yeah.

Since the foot injury on the very last run of the very last day of the very last camp, I’ve been sort of winging it. I was pretty sure at first that I had pulled or torn something in the arch of my foot, but everyone convinced me I really had plantar fasciitis. And, even though it didn’t have the tell-tale signs, I went with it because PF generally means that you can run through it if you can handle the pain. But, still, I’m not stupid, so I rested a week and tried to run briefly. Then, I took another five days or so off running and tried again. I managed to convince myself that if I could run some by the end of this week, then I could still get enough time on my feet in before Boston that my fitness would translate fine.

Well, yeah. It turns out my initial guess was right. I do have a torn muscle or fascia in the arch of my foot according to the fancy doctor. There’s not much to do about it besides let it rest, which means at least another 1-2 weeks of no running.

That means that right now this is pretty much my official training plan:

Rationally, I know that my fitness is good and won’t erode that quickly, that my biking and swimming will translate, that I can do some water running, and that I should take this time to build strength. Logically, I know that a month off running in March is better for an Ironman in July than limping along until then–even if it means that I may have to miss early season racing (or already have missed some). But, really, I’m freaking out. And, the fact that any given day I don’t know what exactly is on my training schedule doesn’t help, since I’m just waiting to see how the foot feels.

What if it doesn’t get better? What if my fitness disappears too much? What if I have to miss HITS and Boston and even Wildflower? What if this turns into one of those seasons where everything just keeps going wrong??

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Plantar Fasciitis: What I’ve Tried So Far

It turns out my foot hurting is probably plantar fasciitis, which is convenient/ironic because ‘how to avoid plantar fasciitis’ happens to be the story I’m working on for Competitor this week. (Fortunately, I didn’t get Achilles tendonitis last week working on that story.)

I’m not 100% sure plantar fasciitis is what it is. It didn’t have all the classic signs at first and the extreme pain came about from a cramp that I overstretched/over-rolled, which isn’t normal. But, whatever you call it, it appears that now the plantar fascia are definitely messed up. As I was doing research both for the story and for my own personal problems, it turns out everyone on the internet has their own solution. Some people were able to run through the pain when they got new shoes, others with taping their arch, others were fine after ART. I definitely am planning to run through the pain as long as I can manage the pain and if I can figure out what works for me, so I’m trying different things. Here’s what I’ve tried so far:

  • ART/chiro — which, combined with this electro-stim, totally made the pain disappear
  • electrostim machine
  • rolling and stretching the calf muscle
  • rolling and stretching the arch of the foot
  • KT tape on the arch of the foot
  • icing
  • rest
  • anti-inflammatory patches
  • arch support and orthodics in all my shoes

It sort of has helped. It sort of hasn’t. I ran today and it was fine, but sore. Now, it’s really painful. My plan moving forward is: more massage and ART/chiro, stretching and rolling everyday with Yoga routine, rolling out arch of foot, icing arch of foot, walking in only supported shoes, hardcore taping (instead of KT tape) for running and working out, pulling back on the running, and possibly trying other shoes.

Thoughts?

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Last Long Run Before CIM

Things that were bad about my 20-miler yesterday:

  • It was almost two weeks after it was supposed to be
  • My toe did not feel great
  • I got crazy blisters because I had to wear old shoes that make my toe at least feel ok
  • Like, crazy blisters
  • For two weeks left until CIM, it did not feel as good as I would have hoped
  • In fact, it felt awful
  • And, significantly slower than in previous training cycles
  • My right hamstring and calf seized up so badly that, as soon as I stopped running, I could barely walk
  • My toe feels even less great today after running around the high school cross-country sectional meet

Things were good about my 20-miler:

  • It happened.

I’m pretty sure we’re going to chalk that up as a victory at this point, put our head down and hope it all comes together for CIM. Hopefully.

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Training Week: Nov. 11-17

This week I winged it. Wung it? Decided I definitely needed to rest to give my toe a chance to heal, but I didn’t want to lose all fitness or the possibility of being ready for CIM in three weeks. (AGH, three weeks!?) Also, I had to run around a lot of different places and do different things, so, I just sort of decided each morning what I’d do that day.

Not a great plan. But, since I can run again, it sort of worked. Sort of.

Monday

Need to rest the foot.

Tuesday

3,000y at Masters. Not the worst I’ve ever swum, mostly just a bunch of 300s in 4:15-4:25 with some hard 75s and stuff after. Swimming is sort of hard and I hate it.

Wednesday

Was going to go to a TRX class at YMCA, but even though they said the class was open when I called 15′ before it started, it wasn’t open when I showed up.

Ended up riding 1:40 or so with Steve. It was surprisingly hard. When I ran around yelling at kids at the conference cross-country championships in the afternoon my legs hurt. A lot.

Thursday

Water ran 20′ with some harder efforts, mixed in with about 1250y of swimming — including a couple hard 100s.

Friday

Ran 9.5 miles down Mt. Tam. AND, it didn’t hurt my toe! It did, however, hurt my quads. It turns out all the way down Mt. Tam is a lot of downhill. Biked to the bus and back from meeting people too, totaling a few miles.

Saturday

Rode 3:00 with Steve. Thought it was going to be 2:30, but I’ve been terrible at guessing bike route times lately. We also had a small break in the middle to help a tandem fix a broken chain, only we were not successful. And by we, I mean Steve figured it out and tried different things, but it was broken in too many places. I mostly went, yeah, I think I know that it’s possible to fix that. Even with Steve on the mountain bike, it was still pretty hard to keep up with him on the most best cycling route in Marin.

Sunday

Rest time. No real reason. Planned on doing more, but needed to get some work done and was tired, tired, tired. Didn’t realize how tired until this morning actually when I slept straight through my alarm. Ah well.

TOTAL: 8:25

Maybe I’ll be ready for CIM? Maybe??

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Injuries Suck

achillesI am injured.

I was just worn out, beaten up, planned on taking a few days to recover and snap out of the rut. Now, I’m not sure. I went for an easy run with Natalie Saturday in LA. Very chill and slow, about 7 miles along the canal path down to the beach. I have run seven miles easy tons of times in the last few months without problem. But not this time. The last few miles my left big toe started to hurt the same way it did back in March. Again, at first, it just felt like my shoe was sort of rubbing, then pinching, then it hurt sharply. It was sore the rest of the day, but fine. I wasn’t too worried because my toe hasn’t bothered me in months. My heel had been bruised since Santa Cruz and the arch of my foot has been sore from the orthodics that are supposed to take the pressure off my toe and stop it from hurting — which is why I didn’t wear them on Saturday, because I was more worried about my heel and arch than my toe. But, my toe hasn’t hurt. Until now.

Still, I wasn’t worried.

Yesterday, I tried to go on my long run and two miles in my toe started to hurt. I kept running for a bit trying to decide if it was really hurting and then trying to decide if I should stop. Eventually, I turned around and I had to walk almost two miles back because it was hurting so much at that point.

It’s not exactly the same as the bone spur that put me out of commission for three months earlier this year. The pain isn’t at the base of the big toe, where the two bones are rubbing together and causing a bone spur. It’s in the tendon that runs along the top of the big toe, all super painful and inflamed. And, it hurts on push-off, not impact. So, it’s a little different, but same general idea.

Since I’m not really sure what caused it, but I am pretty sure the doctors aren’t going to have more of a clue this time around, there’s really not much to do right now besides rest, ice and anti-inflammatories. If I’m lucky, I can take this week off from running and use all the crazy anti-inflammatories I have left from before and it’ll be fine. But, I’m not super optimistic. If it doesn’t clear up, I’ll have to go back to the doctor and they’ll probably say something like, ‘Have you tried not running?’

It’s all very discouraging and I’m not excited about water running. Maybe I’ll be more optimistic tomorrow.

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Is My Foot Better?

Yes. No. Maybe. I don’t know.

I first hurt my foot in March. It was weird. Over the course of one track workout, the base joint of my big toe on my left foot became so debilitating I walked home. I was told it was inflammed and to rest, but you know for all that someone telling me that had Dr. in front of their name it might as well have been a random person saying it. Who knows. Some rest didn’t make it better. More rest only made it sort of better. Ice, rest, water run, rest. AHHHHHHHHHH

Oddly, most pictures of people being "frustrated" are of people getting angry with their computers. So, there you go.
Oddly, most pictures of people being “frustrated” are of people getting angry with their computers. So, there you go.

I got a cortisone shot and was told by a different person with Dr. in front of their name that I had a bone spur. I was not told what that means. I tried to run Boston anyway. I couldn’t run, really, having not been running. My hamstrings and quads and knees and calves all gave out. Some more rest, ice, rest, trying to run and have even more crippling problems. 

In early May, a different doctor-type person gave me inserts and told me everything would be better, though I suppose he was really only talking about my foot and not general life issues. Sometimes my foot was better; sometimes it just hurt different. I ran the Dipsea anyway and thought I had put this all behind me.

But, no. No. The week after the Dipsea I started working full-time in the city – which I know everyone is sick of hearing about, but man, I am not a fan of three hours of commuting. Working in an office meant I went from wearing sweats and sitting on the couch most days to wearing dress shoes and walking from the train to the ferry to the bus to the office. My toe started to hurt again. But, different. Before it hurt on impact at the base of the joint. Now, it’s hurting on impact but also on push-off in the toe itself (not at the joint). And, there are distinct times I know it’s going to hurt — landing hard off a curb, running to BART in dress flats yesterday, stepping on a rock just so.

I took off from running completely. I changed shoes. I iced. I raged. Etc. In Hawaii, during one of our hikes/walks it would hurt shockingly painfully when I landed in certain spots, but then the pain went away. I started running again and it hurts, but then it goes away. It hasn’t gotten worse. It hasn’t gotten better.

So, on we go. 

Yeah, that is not flattering, am I right? Photo: Pam Wendall.
Yeah, that is not flattering, am I right? Photo: Pam Wendall.

I raced the mile this past weekend. The longest I’ve run in my two weeks since “starting training” again is 7 miles. Partially I know my foot isn’t going to stand up to more training or longer runs, especially those necessary to train for IMs, and I’m just waiting for everything to implode. But, it’s hanging in there now. And, with no real sense of what’s causing the problem, I guess that’s the best I can hope for?

Am I missing something obvious? Is just continuing the best option?

 

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Crossfit Injuries

OK, yes, most Crossfit injuries are of the lower back/over-doing it variety. But, this is what I did to myself yesterday:

image

That’s from trying to do double-unders, where you jump rope and get the rope under your feet twice in one jump. The problem was as I got tired I started to miss. And when you’re trying to get the jump rope around twice you have to whip it hard. The result is what you see.

After hitting myself three times, I actually got really good and was better than all the boys by the end of class. And isn’t that what Crossfit is all about.

image

It might be hard to tell here but my third finger is jammed and swollen. I have no idea what I did.

Which is sort of how Crossfit injuries work.

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Things I Have Tried to Get My Foot to Stop Hurting

My foot was getting consistently better every week and I wasn’t too worried that it would be ok in time for Boston. I was mostly worried about fitness. But, since Monday, it’s been sore and not getting better. I don’t know why. I’m frustrated and mystified, obviously, but with nine days until the race, I mostly just want it to stop hurting in time.

Here are things I’ve tried now:

  • Resting
  • No running (Alter-G and water running)
  • Icing
  • Anti-inflammatory cream
  • Anti-inflammatory pills
  • Super intense anti-inflammatory Flector patches (I really thought these were going to make a big difference but they haven’t so far, so I’m starting to doubt that the problem is inflammation)
  • Hot lasers

I’m sure there are plenty of things left to try? Just to get it to stop hurting enough for a little over three hours of running.

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