Wearing Blinders

I just returned from my 8th and final physical therapy session today (she wants me to follow up in a few wks). Through four weeks of this process, I've learned quite a bit and have a relatively structured plan of action to address the weaknesses in my right glutes and hip flexors, which seem to be the primary source of my heel problems. I did some single-leg squats today, holding the band in my left hand and squatting down with my right leg (see photo below)

The key is keeping tension on the band, which helps to keep my right knee from collapsing inward as I lower myself (which is a common tendency). This REALLY works the quads, hips and glutes. In fact, I didn't realize just how weak I am in those areas...at least when it comes to the higher resistance this exercise provides (as opposed to distance running, where it's the same low-resistance repetition done over and over, with the exception of serious hill work). I'm definitely adding this to my ever-growing list of strengthening exercises, painful as it may be.

Now, on to the title topic. After an email exchange with my friend and fellow running blogger Chris (who is also enduring an injury), I realized how much I'm driven, to the point of potential self-destruction. In fact, assuming Chris doesn't mind, I'll post our little exchange below:

FROM CHRIS:  

I'm no expert, but seems to me that you aren't ready to run. Your pain level of 2,3,4, and 5 to me, says you are not ready.  I think Coach Jeff says to run when there is no pain. Many people have told me that they come back better runners through aqua jogging.  It's boring, but technically, you're running.

MY REPLY: 

>I'm no expert, but 

What’s that? I can’t hear you!
 

>it seems to me that 

LA LA LA! SORRY, NO CAN HEAR!
 

>you aren't ready to run. 

HMM HMM DOO DE DOO...did you say something?
Can I take my fingers out of my ears yet?
;-)

FROM CHRIS:

Dude, you crack me up.  I was worried that maybe I came across as too strong or "not my place".  But, I was surprised when I saw your post.  

MY REPLY:

This has always been my biggest struggle (and I’m sure most dedicated runners are the same) - when I’m not injured enough to literally stop me from running, but injured enough that it’s probably better to NOT run. And having a relay race coming up, where other guys are depending on me, makes it even harder.

Don’t worry about coming across too strong. Whether I comply or not, I think it’s valuable to get input from other runners. We often get tunnel vision and we need different perspectives.  

------------END--------------

I guess that sums up my feelings on the matter. Will I stop running again until the pain is completely gone? To be perfectly honest...no. Am I wise with that decision. Probably not. I can't explain why it's so hard to listen to my brain over my desires. Maybe it's because I'm at a point where it's not a debilitating injury. Maybe that's what it'll take to get me to stop (please, God, I hope not). I will say that the miles and intensity will be low for awhile and, after Ragnar, I may dial it down even more (or SHUT it down) if the pain still persists.

And, Chris, I give you full permission to slap me with a fat "I told you so" if I completely derail this train in the process. 

First Week Back

I survived my first week of running since not running for three weeks due to my heel injury.

First, the numbers:

Runs: 6
Miles: 21.6
Time: 3:04:06
Pace: 8:31/mi
Long: 6.2 mi
Avg. HR: 134

I kept track of my heel pain for each run, based on a scale of 1-10, ten being pure agony. Here's how the week went in that regard:

Mon - 2.1 mi, heel pain 4/10
Tue - 3.1 mi, heel pain 4/10
Wed - 2.1 mi, heel pain 5/10
Thu - 5 mi, heel pain 3/10
Fri - 3.1 mi, heel pain 3/10
Sat - 6.2 mi, heel pain 2/10

I won't bore you further, but I also kept track of which shoes I wore (I rotate 4 pairs) and whether or not I added a Superfeet Green insole to my right shoe (which I only did once, on Wed). Today (pain rating of 2), I wore my Brooks Defyance 3's with factory insoles. This may be the best combo for me right now, based on how my heel felt. Today's run was also relatively quick (7:35 pace), with some hills, which was even more encouraging.

I still don't want to write myself any official training programs yet. I'm going to keep it day-to-day and monitor how the heel feels. I'd love to add in a few half mile intervals within the next couple of weeks to prepare for Ragnar, but it's certainly not necessary, especially if it's going to put my heel at risk.

So all in all, a very encouraging first week back. I'm hoping the recovery continues so I can gradually start building the mileage and pace once again.

Special Run

I'll get the negative out of the way first. I was hoping to run 3.1 miles again today, but shortened it to 2.1. My heel hurt more today than the previous two days. I did add a Superfeet Green insole to my right shoe. It might take a few runs to tell whether it makes a difference or not. No running tomorrow.

Now, on to the positive. Today was the first time I've ever run with my oldest daughter. She's going into middle school in the fall and wants to run cross-country. She joined me for the first mile (10:46) and breezed through it. I was planning on stopping if she needed to, but she never did. In fact, she wasn't even winded by the end. It felt pretty special to run with one of my kids. She could have gone faster and farther, but I want her to have positive experiences every time out as she gets into running. We'll gradually build the distances this summer. She was pretty excited afterward! And, despite my heel, so was I.

More Clarification

During the last couple of visits to physical therapy, I've discovered even more about how my right leg and foot operate. When I sit on a chair, knees bent, feet on the floor and rotate my feet inward while trying to keep my feet flat on the ground, and odd thing happens. My left foot rotates just fine, but my right starts arching up on the inside. I'm unable to keep it flat, or at least not without greatly forcing the issue (which causes discomfort). I'm still not sure whether this is purely structural or if it's correctable. Since my right heel instantly shifts inward on every landing, I'm going to put a Superfeet Green insole into my right shoe (as per my PT's suggestion) to see if I can counteract the motion. I may still be seeing a podiatrist about potentially getting a custom orthotic for my right shoe (my left foot is fine, so I'm averse to messing with it).

I ran again today (3.1 miles @ 7:48 pace, with a 6:57 mile two as a "speed check") and the heel felt about the same as yesterday. Still sore, but not as bad as when the injury first hit me.

Anyway, I thought the foot rotation test was pretty interesting. It's been great seeing all the pieces of this puzzle start to come together.

First Run In 3 Weeks

After three weeks of "run fasting", I had a few bites again today as I finally ventured back out for a run. It was a balmy 50-something degree first day of summer (heavy on the sarcasm). It was my first run since my heel injury. As per my wife's insistent orders, I kept it short and sweet. 2.1 miles at an average of 8:24 per mile.

The results were mixed. I was able to complete the run, but the heel was still sore. This time, though, it seemed to be more of a superficial pain - closer to the surface - rather than a deep, injury-type of pain. I'm thinking (hoping) this is good. The rest of the day, I had periods where I felt no pain at all, and periods where I'd get waves of pain in the heel. I did 40 minutes of ice alternating with heat (tub of warm water), then went to physical therapy later in the day. I've been doing more strength exercises for my glutes, hips, hamstrings and feet, as well as rolling out my right IT band.

I have a feeling that this will be a gradual process with no easy fix. It could involve custom orthotics. I may have to see a podiatrist eventually. I'm sure it'll involve more diligence on my part to stick with the stretching and strengthening, as well as paying closer attention to my stride length. The heel is just a symptom of a greater issue, so it's going to take a lot of work to iron things out. But I'm willing to do it if that's what it takes to continue running.

So how did my fast end? With a plate of Cautiously Optimistic, and a side of Uncertainty and Apprehension.

But I'd prefer to go straight to the dessert menu and order the Successful Rehab.

Parody Song Collection Now Available

Just a quick note to let everyone know that a collection of my running parody songs is now available (see purchase button and info below it on the right). If you'd like to hear a medley of the songs, you can go here to listen.

Thank you!

A Ride Outside, and Anxious for Monday

Some rare nice weather made an appearance today, so I took the bike off the trainer and finally went for a ride outdoors. It was a bit breezy, but sunny and in the upper 60's. I put in 20 miles @ an average pace of 17.2 mph. My right hip was oddly sore, but otherwise it was an enjoyable ride.

After walking all day yesterday (volunteering at my daughter's field trip) and taking an hour walk with my wife this morning, my heel is a bit sore. Still, I'm planning on doing my first run in 3 weeks on Monday to test things out. I can hardly wait! I'm surprised I haven't completely lost my wits already (some would question that assumption) with being sidelined that long. I'll keep it slow and short. Based on the recent walking, I'd guess that it'll still be a little sore, but (hopefully) not enough to have to put a hold on the running again. If it feels like I can start up again, it'll be a slow buildup, even though I'm anxious to pick up where I left off.

Have a great weekend, and happy Fathers' Day to us dads!

PT, Visit #4 - Learning Even More

I had my fourth visit to the PT this afternoon. When I arrived, I immediately got on the treadmill, bumped the pace to 8 mph (7:30/mile pace), got into a nice rhythm, and was videotaped for a couple of minutes from the front, while my stride was also watched from behind. I was told to never run again. Okay, I'm kidding. We didn't analyze the video until just before I left, so I'll get back to that later.

After getting off the t-mill, I was introduced to Paul, who is a young, lean PT who usually works with young athletes (he's a runner himself). The lady I've been working with knows her stuff, but isn't a runner (and usually works with senior-aged clients), so she wanted to bring him in today to get his thoughts. He put me through some flexibility and strength tests (laying on either side, legs bent, lifting the top leg and trying to resist him pushing down). It turns out I'm quite a bit weaker on my right side - particularly in my glute muscles. He then had me lay on a mat on my back and try to roll over without using anything below my waist to assist me - essentially just using my upper body. It's harder than it sounds. I was able to do it both to the left and right, so I "passed" this one. He also noted that I'm very "fibrous" in my right leg, too, and that (even though I roll it and stretch it), my right IT band is very tight. My usual lady then proceeded to basically do a deep tissue massage on that IT band, and 3 hours later it's still sore!

Back to the video. We'll review it more on Wednesday, but we drew a digital "plumb line" down the middle of my body in the video. My right knee crossed that line on every forward stride of that leg, while my left leg didn't. It seems that my issue isn't just my heel nor just my foot. It's the whole dang right side, from my butt on down! It may or may not be related to the leg length difference (although it's minor), but during my stride, I'm apparently compensating for weak(er) glutes and hip abductor muscles on the right side. I can't explain it precisely, but I guess I'm swinging my right leg a little on the forward stride and doing some kind of slight, weird rotation of my lower leg. I was given an exercise band and a series of exercises to strengthen those muscles. So, finally, we may be on to a solution to the problem. It'll be awhile before I can tell if my gait will start fixing itself as my muscle imbalances are taken care of, or if I'll have to somehow actively work on changing my stride. If it's the latter, it could be awfully difficult, since I had no awareness of even doing what I do. Hopefully it'll start ironing itself out as my right side gets stronger.

So, halfway through the PT sessions, I'm thrilled to have learned what I have so far. It has definitely been worth it.

As for the heel itself, it's feeling much better. I have to give my PT lady a "pain report" each time I arrive, on a scale of 1-10 (ten being intolerable pain). Today was my first "1". Even the brief stint on the treadmill didn't seem to bother it.

When will I get out for a short run again? The PT lady hasn't really given me a good answer as to when I could/should run again, but according to the Mrs. (who has been pretty stern about this), I'll be allowed to run an easy mile a week from today. Normally, she just puts up with my running decisions, but with this situation, she knows that if I get back out too soon and hurt it even more (and have to stop running for an even longer period), I'll be in the depths of despair. As much as it frustrates me to say it, she's probably right. Another week won't kill me. Besides, I've been hitting the bike trainer pretty hard, so I'm getting some cardio, at least.

Muy Interesante

A little Español for yiz 8-)

I just returned from another PT session and learned some pretty major things:

1. My neon green race shirt, according to my wife, doesn't match my forest green shorts (I still went to the appointment in them)
2. Freeway traffic on Friday stinks to high heaven (I haven't commuted since 1994), and
3. My right leg and foot do some funkadelic things when I ambulate.

I finally walked on their pressure-sensitive runway, as the moving video camera on the wall recorded my slanky strut down the catwalk. I was FAR too sexy.
Ahem.
Come to find out that my right foot flares out during my stride. It seems to start with my right knee turning a bit more outward. I land with my right foot facing more outward than the left, and I push through my step on the outer part of that foot (supinate). My left foot lands and rolls through fairly normal. This may be my body's way to compensate for the slightly greater length in my right leg. It also, according to the PT, may be causing torsion on the inner part of my right heel...exactly where most of my heel pain resides.


Here's a photo of me running the Mercer Island Half Marathon, back in March:

I noticed my right foot flaring out in the photo, but thought it was just an anomaly. As I've learned, it's what I do. Although, by the time my foot lands, it's not turned quite this much.

The PT sessions have been valuable so far. Even aside from the direct treatment on my heel, I'm learning quite a few things I've never known about my body (like, showers are good body odor deterrents).

On Monday, I'll be recorded running on a treadmill. I'm hoping to bust out an hour run at roughly 5:00/mile pace to impress everyone. I may back off of that just a little, as I don't want to destroy their equipment.

Oh, and the heel is still sore, but seems to be mostly in the inside area, rather than the whole heel.

More soon...

I Can See For Miles And Miles

What does an injured runner do to pass the time and keep his mind off of running? Why, yes, he goes through his running log books and Garmin 305 history to put together a list of fastest miles run within a workout or race for the last several months! Nothing like a little obsessive/compulsive behavior to alleviate some of the frustration!

I haven't run an all-out mile in many years, so these are just mile splits from either workouts (mostly tempo runs and intervals) and from races.
Here's what I came up with:

These are the total amount of sub-7 miles I've run since last October. So what does this all mean (besides a chance for all of my ultrarunning friends to shake their heads in disappointment over my obsession)? Well, in the words of Sammy Hagar in There's Only One Way To Rock..."it's all just mental m..." (go look it up). Actually, I guess it means that I'm not terribly fast*. It also makes me want to work on getting faster (eye rolls from aforementioned ultrarunning friends). And I'm still curious what I could do in a mile time trial if I trained for it. Which I don't intend to do. I would, however, like to increase my overall pace and maybe do a little speed work soon...heel willing. With Ragnar coming up, I'd like to run my legs faster than, oh, say...marathon pace!

That's about all I got right now. If you haven't already, check out the latest Runner's Round Table episode 85, where I had the pleasure to co-host, along with Matt, Margaret, Toni and Dan. We talked about staying motivated as aging runners. It was a fun discussion.


[*I know, speed is totally relative. To some, I'm somewhat fast. To others, these are recovery mile times.]

One Of These Legs Is Not Like The Other

I had my second physical therapy session today. Something I have suspected for years has now been officially confirmed: I have a leg length discrepancy. My right leg is about a centimeter longer than my left. It seems to be my tibia that's actually longer, thus also shifting everything above it up a little, including my right hip. I'm not entirely sure of the implications, but it was suggested that I add a very minimal OTC insert to my left shoe and walk around with it for several days. The therapist said I may experience some soreness in my knees, hips and back initially, since my body has been used to compensating for the difference. I've already added an old insert and it does feel odd, like my left side is too high now. It'll take some getting used to. We'll see if this becomes a permanent addition or not.

As for the heel itself, it felt much better today. A few days ago, I did yard work and the heel was really aggravated. Today, I mowed the lawn and it felt great - so much so that I even hinted to my wife that I'd like to run soon. She shot me down straight away. She's right, though (isn't she always?)

After my PT session, my heel is once again sore - probably from the manipulation and massaging. But the swelling has gone down significantly (compared to the photo I recently posted).

And I think I'm finally having a positive mindset about it. I found three "pluses" regarding my situation:

1.  I'll have time to truly recover from my first marathon (I had started pushing again too soon, I think)
2. I get to hop back on the bike, which was a great cross-training tool last year as I got back into running
3. I have more time and energy for some much-needed strength work (upper body and core especially)

And, now, one BIG "minus":
Me arse be growin'! Yes, I've managed to put on 4 lbs. since my marathon 3 1/2 weeks ago. My appetite has not only NOT decreased since I've been sidelined, it has INCREASED. I don't know if I'm making up for a calorie deficit when I was training hard or what...but what has always been a problem while running (keeping enough weight ON) suddenly is a problem no longer. I either need to start riding my bike...a lot...or I need to keep the refrigerator door shut! Oh well, it's nice to know I didn't have a tapeworm, I guess.

Thursday, I'll hopefully walk on the pressure sensitive pad to see what my feet do upon impact. I may also be videotaped while running on a treadmill. More later.

I'm a Big Heel

This photo reinforces two things for me:

1. 1. My foot modeling career is in jeapardy
2. 2. My right heel is mega swollen

Since my first PT visit, my heel has been in more pain and has gotten more swollen, despite not running for nearly a week. I will admit to jogging barefoot around the back yard yesterday while playing with my kids (very briefly). I won't blame the downturn on the PT visit, but I wonder if the recent massaging and messing with it is going to aggravate it before it starts helping it. All I know is that I'm not enjoying this predicament at all. I'm getting more antsy to run with each passing day, but I know this heel will not improve if I do so.

Tomorrow, I'll set up my bike on the trainer and see how much that bothers the heel.

*sigh*

Parody Songs

There have been quite a few requests lately to purchase the parody songs I've done for Chris Russell's "Run, Run, Live" podcast. First of all - thank you. I'm flattered, to be honest. I really enjoy doing them.

I have a bit of revision work to do on some of them (I'm picky). Then, if I can figure out how to put a PayPal option on this blog, I'll make CD's available for purchase. There are a couple of other songs in the wings (along with a few that never played on the podcast) that I'd also like to include.

I'll be sure to post an announcement on all the social media outlets (along w/various podcasts, if they're willing) when it's available.

Again, thank you for your interest!

Physical Therapy, Day One

I just returned from my first visit with a physical therapist. Let's see if I can relay all the info swimming in my inadequate brain.

First, I'll give you the name of the condition she thinks I'm suffering from: calcaneal periostitis.

"The periosteum is a covering of the bone. Inflammation of the calcaneal bone covering (periosteum) is called calcaneal periostitis."

Basically, it's similar to shin splints, but involving my heel bone instead of my shins. The area where the achilles tendon attaches to the heel is inflamed. There's swelling there and significant pain during running (and minor pain during daily activities). She tested my ankle flexibility with both feet (no issues), along with my foot strength (fine). This was just a preliminary visit, but she did note that I have some significant differences between my feet (how they appear as I stand at rest). She also noted that my heel bones stick out quite a bit. She said in women, they call them "Pump Bumps". She massaged my heel, did some kind of cold treatment, told me of a way I can self-massage the offending area to spread out the tendons, and said I shouldn't run for a few weeks. 

Something I forgot to mention to her (because I never think about it since I have no memory of it) is that I wore corrective leg braces as a very young child [insert Forrest Gump joke here], so I may have some inherent leg/foot issues. I'll bring that up during my next visit.

She said there's a chance that custom orthotics may be needed. Ugh. I'm hoping not, both because I don't want to have to rely on them, and for more practical reasons (cost). But if that's what it takes to run the volume and intensity I want to run, without injury, I'll bite the bullet (reluctantly).

Next week, I'll walk on a mat that will show how my feet strike the ground. I'll also be videotaped while running on a treadmill during one of the visits to get a better idea of my running gait.

For now, I can find an alternative aerobic activity, as long as it doesn't cause pain. Probably some spinning on the bike, for starters. I'll keep icing, massaging and taking ibuprofen, and make my twice weekly visits to the PT clinic for the next four weeks and hope it clears up completely...so I can RUN again!

And not drive my wife crazy...which will undoubtedly happen.

Down and Out

I saw my doctor this morning (not a specialist, yet) about the pain in my right heel. He thinks it's achilles tendonitis, but isn't sure. He referred me to a physical therapist, who I'll be seeing twice a week for four weeks (cha-ching). I still think it could be a minor stress fracture, based on my online research of the symptoms, but I'll let the PT doc make that call.

So for now, no running. Just ibuprofen and ice. I can do gentle cycling (i.e. spinning on a trainer), but will probably opt for total rest for a few days.

Needless to say, I'm frustrated. But as a runner, it goes with the territory. I made it 17 months without a sidelining injury. Hopefully I can finally get a gait analysis, as I'm pretty sure I have some bio-mechanical problems. The wear patterns between my left and right shoes are so different that something not good has to be happening down there.

So...I'm almost positive that I'll be skipping the Lake Youngs Ultra. I'm still hopeful for the Ragnar Relay, though.

Thanks for the comments and well-wishes. I'll make sure to post updates as this unfolds.

Ouch

Well, despite a promising (and, in hindsight, probably foolhardy) run yesterday, I'm shutting it down for several days. I just returned from my first aborted run since my comeback in Jan. of '09. As soon as I took a step,  my heel hurt worse than it has since it started bothering me. I'll ice it all week and hopefully test it again next week. Pretty frustrating.