One Step Forward Two Steps Back - My Poor Foot!

After months of trials and tribulations with my left foot I saw a glimmer of hope in the last couple of weeks. I had a successful sprint triathlon a couple weeks back followed by a five mile run on the trail that went well. I had went in to my physical therapist the Monday after and he approved my adding in a second weekly run in addition to increasing the distance of one of my runs. This was serious progress and I was seriously stoked. Two weeks ago I had run six miles on my favorite trail followed by five miles that Sunday. Woohoo 11 miles that week - back to double digits. But the best part was the lack of pain!

When you're used to feeling at least some level of pain and discomfort for 12 weeks, suddenly becoming pain free is strange...in a good way of course. Whoa, my foot feels okay I thought. Awesome!

I was excited to get in my midweek run and decided to head out Tuesday night to the trail for a shorter three-loop run. The loop at Girdled Rd is 1.3 miles so I would get in 3.9 miles and then head home to start dinner. Pretty simple. And not so simple. The first loop went FAST! I looked at my Ironman watch and thought whoa I did that loop in 9 minutes maybe I should slow down a little. So I did for a few and hit the second loop at 19. I contemplated calling it a day but I decided to finish the 3rd loop as planned.


And then as in a bad movie scene a twist of fate quickly changed my situation. About half way through that 3rd loop I was coming around a right side turn as there are many turns on the loop and I twisted my left ankle inward HARD. Ouch! The pain was severe so much so that I had one of those blackout moments for maybe 15 or 20 seconds where I thought holy crap what just happened?! And then I thought ouch this really hurts and I don't know if I can run. I hobbled/walked for maybe 2 or 3 minutes and decided to run the rest of the loop back slowly. It actually wasn't horrible running on it. I finished the third loop in around 33 minutes  with the walking. 


I made it back to the car and called my husband to tell him what happened. It was achy but okay it seemed as is usually the case with a twisted ankle. When I got home I took some ibuprofen right away and soaked the foot in a bucket of ice water. 


Waking up and walking on it the next morning was not so fun. Again icing, taking ibuprofen Wednesday and Thursday. Friday I had a previously scheduled appointment with Dr. Joy at the Cleveland Clinic Ortho department to follow up on my stress reaction and have some things checked out. Dr. Joy was great and very thorough. As I described the pain she had me get a second set of X-rays on the foot to be sure I didn't sustain any additional trauma as in a fracture from the ankle injury. Luckily I hadn't. 

I was treated for an ankle sprain. They gave me an Aircast ankle splint. It's very stylish as you can see from the picture here! I am supposed to wear it for a couple of weeks as it heals. I am in fact allowed to run but have not as of yet as I wanted to play it safe with a race approaching this weekend. I am planning to test it out on the trail tomorrow with the hubby close by in case I need any assistance. Assuming that goes well I will race Fairport Harbor Tri on Sunday. It is a sprint so should hopefully not add too much stress to the ankle and foot. Aside from that, I will see my PT next week for rehab and move ahead. Dr. Joy says I should be able to get back to my normal 30 miles a week of running. Looking forward to it since I have my Rev3 races to train for!

Stress Reaction and Roadmap to Recovery

The Test: Did Not Pass!

After a very painful test run last week following the ART therapy, I decided it was time to see my Ortho doctor at Cleveland Clinic. The run was just a 2.5 mile test run to see if I'd be able to compete in the Nordonia Duathlon last weekend. I knew after the test that running was not going to be in my best interest. Within the first few steps, I felt that all too familiar initial twinge of pain that said "this is not going to go well". I moved along anyways as I had to see what my body could handle. Around 1.5 miles my foot was really hurting so I stopped to strech it and started up again telling myself that it was just one more mile. By mile 2.5 my foot was throbbing and burning. When I stopped to walk it was clear something was really off. I immediately soaked the foot in a bucket of ice and took some ibuprofen. Not a fun experience. Was I ready to run in Saturday's race twice? Not so much.

The Ortho Visit and MRI:

I was able to get in Monday to see Dr. Jones and he was concerned that I could have a stress fracture as was I. He ordered an MRI. Wednesday I went in for the procedure. If you haven't had the joy of an MRI yet let me describe what it's like. I also found a picture as well. To have your foot examined in an MRI, you lie flat on your back with your affected foot inside of a sort-of cast like area. The MRI tech provides you with headphones in an effort to try to drown out some of the disruptive noises of the machine's imaging process. They take a number of pictures of the affected area via image scan. Each scan takes anywhere from 1-4 minutes and makes some sort of alarming sound. It's really quite shocking. Since this was my second MRI, I was not quite as shocked as I was the first time.

It took approximately 40 minutes for them to take about 10 pictures. I received a disk with the images of my left foot. They look like the image here.

The Results:


Being the inquisitive person that I am I opened all of the MRI images on the CD that CCF had given me. Then of course I googled images of various stress fractures trying to figure out what was going on with my foot. I was hoping to hear from Dr. Jones yesterday since the results were in but I was unable to reach him until this morning. The results show that I have "stress reaction" in my left heel. So not a stress fracture but on the cusp of being a stress fracture.

The Treatment (Roadmap to Recovery): 

Dr. Jones said I do not need to be in a boot or take any specific amount of time off as with a stress fracture. Although I am to avoid running for at least 2-4 weeks until my foot is pain-free. I am allowed to bike, swim, pool run and use the eliptical as long as these are done pain free.

I will be seeing a running specialist to assess my running gait, shoes, etc to figure out what's going on. With this being the second season of injuring this heel in the same foot there must be an issue with something. One thing I can say is that I went minimal with my shoes both seasons. Aside from that I am not sure what else could be a factor. I am looking forward to learning and correcting whatever issues I have and getting back to being a strong runner again. Because running is my favorite and best sport of the three (although the bike is nipping at its heels - no pun intended) I am anxious to get back to good. Like that old saying when life gives you lemons make lemonade. I intend to do that with this injury.

The Schedule:

Last week I sat out of Nordonia Duathlon, I will be sitting out of Cleveland Marathon this weekend (which saddens me greatly) but I will be cheering for my husband and countless friends running! The Twinsburg Duathlon will now be a relay for Steve and myself. He will run and I will bike. So I am excited about that in a few weeks. I also had signed up for the Geneva Tri a week after. Right now the plan is to participate in the swim and bike and abort the run. This will at least allow me to get some tri race experience in June. I will likely not be able to run the Mentor Flag Day race either, which is also a bummer. I am shooting to be back on track by Milton Man and hope to compete in either the sprint or oly there. I will also plan to do fairport. I think I will be on schedule for Rev3 Dells 70.3.

Ups, Downs, Injuries and Introspections

It's been a tumultuous season for me. I'm starting to think that spring is just a bad season for me. I tend to be injured every year around this time. Maybe that's my body's way of trying to say something like "woman you are getting old". Just kidding. I don't feel old. I feel good and just need to deal with these injuries as they arise, accept the downtime and stay positive.

Yesterday I went to Solon Wellness Center to see Dr. Keyes' associate as recommended by Coach Sean. Talk about pain! The doctor did some serious work on my left foot, which has been aggravated for almost three weeks now. Think foam roller x 10. Deeply pushing with fingers and thumbs along my foot tendons and ligaments and along the shin and calves. Ouch! There were quite a few people around so I didn't want to scream or cry but I was close a few times and settled for biting on my shirt. I guess this is called Active Release Therapy (ART) and the doctor says within 3-4 sessions I should be better.

What does this mean with all my races approaching - including tomorrow's duathlon? It means I will be testing the foot out this evening on a run. First attempted run in almost a week. Doc says to take some ibuprofen in advance. I plan to do this easily. No fast running to relieve this bottled up stress but slow and steady just to see if the foot will hold up tomorrow. The race is not too long. It's a 2.5 mile run, 10 mile bike and 2.5 mile run. I am most concerned about run #2. So I will decide this evening if I am participating in the race or spectating and cheering for my husband and friends that will be racing.

As for Cleveland, which was originally to be a full marathon and changed to the half marathon, I have to wait and see. I have a second Dr. appointment with ART scheduled for next Thursday with a test run that night or following day to see how the foot is coming along. Running 13 miles with an injury can be rough and just sounds like a sufferfest to me. I certainly don't feel ready to set a new PR to say the least. My husband is very supportive and says if I am able to run he will run it with me for fun as a training run. That actually sounds like it could be a fun little adventure if my foot behaves. Otherwise I have some options: 1) switch to 10K, which would be easier on the foot 2) run some and or walk the half and 3) spectate AGAIN this year as I did last year with the fracture.

I have done a lot of thinking this season about who I am as an athlete, what I want, where I am right now and where I want to be in the years to come. So maybe this setback was needed for me to dig deeply into myself and consider these things. Being type A, I have this natural tendency to be competitive with myself as well as others. Many athletes have this attribute. In some ways it is good because it is a driver for continuous improvement and accomplishment. In other ways it is destructive because we hold ourselves to such high standards, sometimes lose the joy of the sport or push ourselves too hard. And let's face it, there is almost always someone that is faster than we are or else better suited to some particular race.

Let me get to the point here. I am at my best when I am sprinting. Some people hate 5Ks. I love them. I also love distance but I am not as fast at long races and my body tends to decline after a certain point - generally anything over the half distance. So I am considering all of this for next season already. I set a goal this year to complete my first full ironman distance race. And I am not backing out of that goal. It may be difficult, painful and a pain in the ass to meet that goal but I will do it. And I will enjoy doing a couple of 70.3 races, olympic and sprint triathlons and other races too. Even if I am not as fast at the long course triathlons I will enjoy the experiences and it will make me tougher mentally and physically. The picture I shared here is an Asian symbol for strength and I absolutely love the quote. It very much describes the mindset that an endurance athlete or aspiring endurance athlete must have to be successful.

Not a Very Good Training Week

This week is not turning out to be one of my better training weeks. I am having some issues with my left outside ankle (seems like a mild to moderate case of tendonitis). So I am resting it. With races the next two weekends back to back that is not good. Hoping to attempt a test run Saturday or Sunday. If that does not go well I will shut it down until the race May 12 and again maybe until May 20. Hopefully I just get back to it quickly.

In addition, I just feel bloated and crappy this week in general (tired, achy and have headaches). I've been battling this all season so far. It's weird. I felt terrific before my wedding while on the paleo diet but I cannot be on a paleo diet during Ironman training. I need energy to fuel those workouts. Cardio without carbs is like powering a car without gas. It just doesn't happen. After a little research this week my husband and I think I could have a gluten allergy. We are going to experiment with a gluten-free diet for the next 2-4 weeks and see how we feel. I am hoping this does the trick for me. Stay tuned in future weeks for an update on the gluten-free experiment.

The Agony of Injury. How to Cope With and Prevent Common Running Injuries

Woe is me...I have a running injury. This time the culprit seems to be anterior tendonitis/extensor tendonitis in my right foot. Try as I might to stay injury-free, it seems to happen to me at least once or twice a year. I should be more accepting of it but it really irritates me! I want to learn how to better cope with the frustration of not running during these instances and also how to minimize the reoccurrence of these pesky injuries.

So let's start with how to cope shall we? One obvious thing that can be done is cross-training. You can ride a bike, swim or run in the pool, use the eliptical trainer and do yoga or pilates to stay active and in shape during non-running periods. Cross-training may not replace your desire to run, but you'll just have to be patient or patiently impatient.

If you're having a difficult time mentally coping with your injury, you can talk about it with someone. This person can be a loved one, friend or even a therapist if you are feeling depressed. Try writing your feelings down in a journal or blog post. Sometimes just writing is a stress-reliever. Look through some of your old race memorabilia to remind yourself of your past accomplishments. Try to remember that your injury is just temporary and you will be back to running and accomplishing more great things soon. You may want to schedule a race a little farther down the road to stay motivated and focused on the future.

Now I would like to share with you some advice that I have received from professionals and fellow athletes  to help minimize the chance of getting injured. It may be impossible to stay injury-free 100% of the time but following these tips should increase your odds of staying healthy when you're on the run:

• Make sure you are fitted for a running shoe that works well for you - Go to a local running store or sports health professional and have them evaluate your footwear needs before you buy. You don't want to run in a minimalist shoe if you heel-strike or are a heavier runner. 
• Don't increase your mileage too much too soon - The general rule is to keep your mileage within no more than a 10% increase a week. For example if your longest run this week is supposed to be 10 miles long then your longest run next week should be 11 miles. 
• Know when to back off - Not everyone can run everyday. Only you know how your body feels. Some people must run every other day or just a couple times a week. Listen to your body. If something is tight or achy take a day or two off and then reassess your situation.
• Alternate your shoes if running frequently - Make sure you have at least two pairs of training shoes that you can rotate to allow for the shoes to adjust back to their normal state. Most shoes need to be retired somewhere around 300 miles usually.
• Don't lace shoes up too tight - Apparently lacing too tightly can cause issues with the top of the foot so be cautious of how tightly you are lacing up.
• Warm up and cool down - Take the time to stretch a little and start off at a slower, easier pace to get going. You should also run slower or walk to cool down so you can get your heart rate down and allow your body time to loosen up.
• Alternate harder workouts with easy workouts - For example if your long run is always planned for Sunday then your Monday workout should be an easier recovery run or lower impact activity such as swimming or yoga.
• Include core/strength work as part of your routine - Make sure you include at least two days of core strengthening in your schedule. It can be anything from yoga or pilates class to lifting at the gym and doing exercises like squats, leg lifts, etc or something like p90x core that focuses on a number of muscle groups.
• Supplement with Vitamin D - Make sure you're eating enough foods with calcium and take a supplement of vitamin D. My physician recommended 10000 iu daily for me but you can check with physician for a specific dosage for you.
• Hydrate to avoid cramping - Be sure to drink water or sports drinks before and after your run to help alleviate any cramping that can result due to dehydration. Running with cramps may lead to muscle tightness that causes injury.

As of today I have been off for a week. I am feeling better but not yet 100%. I hope to be ready to test my right foot out later this week or weekend. In the meantime I am stretching, icing, resting as much as I can along with taking ibuprofen. If anyone has additional suggestions I am all ears. Here's to happy, healthy running for me in the near future!