Ramble on

I’m not even sure where to start. It’s been since November since I’ve written any kind of update about my own training. I was just starting with a new physical therapist then and starting to unravel the issues with my pelvis, sacrum, sural nerve, and starting back to running really slowly after a month completely off running.

 

 

The new physical therapist has been such a blessing and by February-March I was starting to get back to really training and focusing on Grand Canyon 50k. My training took a little longer to pick up than anticipated when I signed up, but I felt confident with how well things were going by March that I wouldn’t be undertrained. In Mid-March I ran NYC Half as a training run and felt strong pacing a teammate to a new PR. By the end of March it had warmed enough that I was able to head out to my local trail. I had some little twinges here and there–in my hip, my hammie, and my back–but PT was keeping everything in check for the most part.

 

Eight weeks to Grand Canyon

The first weekend of April I went down to Georgia to crew a friend running Georgia Death Race. I did 2 runs in the Georgia mountains that weekend. I ended up rolling both ankles and my left ankle in particular pretty badly on the second run. I was able to run the rest of the run, but knew it was going to take some care and rehab. I made a plan with the PT to cut weekday trainings short and just focus on getting in my long training on the weekends which seemed to go okay. I had developed some foot pain in my left foot on some of the longer runs, but we assumed it was too tight shoes and made adjustments.

Five weeks to Grand Canyon

I headed out for my 20 miler at the end of April on a rainy morning and by mid-way through the five hour run the trail become very, very muddy. By the end of the run not only was my left foot aching, but my right ankle had gotten pretty aggravated from the mud running. I limped home and skipped my long run the next day.

 

Three weeks to Grand Canyon

In an effort to save my foot, ankle, and my training cycle I took 2 weeks off of training before my peak weekend of training which was going to be 22 miles on Saturday followed by Broad Street Run 10 miler the next day. My left foot was still a little tender by that weekend so I decided I would run for time instead. I got in 4 hours of training and had some slight shin and foot pain, but all-in-all I felt okay going into the 10 miler the next day. During the 10 miler my foot hurt a little and at one point I walked for a half mile, but I was able to finish it in under 2 hours and was feeling pretty good about being able to finish Grand Canyon 50k. I’d use taper to rehab my ankles and foot and hopefully line up at the start feeling healthy and ready to go.

 

On the way home from Philly, my right foot had a really sharp pain that came out of nowhere and it hurt a lot to walk. (The left was the one had been bothering me to this point.) I limped home and a couple days later my chiro popped my foot (cuboid) and while it didn’t completely calm it down right then, within a day the pain was gone. I again skipped my weekday runs and got in my 14 miler that weekend. Then I had to skip the following day’s 90 minute run because I woke up with a cold.

Two weeks to Grand Canyon

That was this past Monday and the plan this week was to run a few times at low mileage in some new shoes and incorporating a dancer’s pad to offload the 5th metatarsal joint on my left foot. But when I woke up Tuesday, one of my cats was very sick and my cold had worsened significantly. By Wednesday, my cat was at the emergency hospital. Long story short, I did not train all week and was under a lot of stress. I still planned to do Brooklyn Half Marathon and my 90 minute run on Sunday, though. And hoped that my kitty would recover in time for me to head out to the Grand Canyon.

One week to Grand Canyon

Yesterday I lined up at the start of the Brooklyn Half Marathon. I had taped my left foot in hopes of it holding together and didn’t really think about my right foot because it hadn’t bothered me since my chiro popped it. I noticed my right ankle felt a little sore and wished I had taped that ankle, too, but it was too late at that point. I crossed the start and glanced at the clock. 22:22. I took it as a good sign. I’ll spare the details, but by the 10k mark I was walking with considerable pain in my right foot and by mile 8 I had dropped from the race. Later that evening my kitty got to come home. She needs medication twice a day and I have to monitor her eating, drinking, a bathroom breaks. She is still showing some symptoms and if her condition worsens, she will need to go back to the hospital.

So here I am, six days out from Grand Canyon 50k with two injured feet and a sick cat. I can arrange for care for my cat, but will be at least 18-20 hours away from home if anything happens. I’m not sure if I will even be able to walk around the Grand Canyon much less run 33 miles with the current state of my right foot. I’ve never been to the Grand Canyon and this was going to be a bucket list trip for me made even better by the fact I have friends coming out, one of them I am coaching and this will be her first ultra, and I planned to stay a few extra days for adventuring out there and back in Vegas. To say I am conflicted about what to do would be an understatement. Staying home to take care of my baby and myself seems to be the most logical answer, but I’ve invested so much in this race and this trip. Not to mention not wanting to let my friends down. I have no idea what I am going to do.

What would you do?

The long road to (injury) recovery

I was going to post a quick little update about my injury rehab appointment today then realized I haven’t checked in about it since February! So a tiny bit of updating seems necessary.

Catching up

In January, that dreadful sneeze knocked back my progress and I had to stop running for a few weeks. By February, I was able to start back with run/walk intervals. I worked up to 3-5 miles, 3 times a week by the end of the month. As I started to get back to running, my physical therapist decided that I was well enough to continue without her so we stopped our sessions. I was doing PT stretches daily and strength 3 times a week.

By mid to late March, I was starting to try a little speed and was disappointed that it seemed to aggravate my back and neck. I really needed to start getting my mileage up to train for Broad Street Run and the Brooklyn Half so I decided to stick to all easy running and just focusing on upping my mileage. I was still seeing the acupuncturist once a week and I think that was the only thing holding things together. I continued to have back and neck pain regularly which he relieved enough weekly to keep me functioning and running about 20 miles a week by the end of the month.

By April, I had worked my way up to 90 minutes of running on trail. I felt like I was still battling my back and neck and barely holding it together so I scheduled a weekly massage in addition to my weekly acupuncture. Things seemed to be getting better with the first session, but then it was just a steady decline. By the time I got to Broad Street Run on May 1st, I was still running about 20 miles a week, but felt like I was on the verge of relapse. I was at my wit’s end.

While at Broad Street Run, I had three teammates talk to me about seeing a chiropractor. I was hesitant, but desperate. I scheduled an appointment the day I got back to NYC. I found one in Midtown that had treated an elite marathoner and has massage therapists, acupuncturists, and trainers on staff. I saw her 2 days later.

A new approach

The first appointment didn’t have me so convinced this was the right route, but she made enough sense that I was curious. She gave me a number of interesting exercises to do including a gait retraining exercise because evidently my left side isn’t “firing” as I run. I did the exercises religiously and was excited to get a little relief for some of my issues. I was able to work my way up to 30 miles a week, but my neck continued to bother me. I started to wonder if maybe the massages were doing more harm than good since my neck seemed to be bother me most in the days after the massage. I decided to cancel my next massage. On my next visit to my chiro, they recommended the same without me mentioning that I had cancelled!

My neck started to feel better but the Sunday before the Brooklyn Half I headed out for my last long run and ended up cutting it short because of what I thought was achilles pain. I was really apprehensive about seeing the doc the next day, concerned that the gait retraining may be causing other issues. But after just 10 minutes in the office, they had figured out the issue, gotten me relief, and adjusted my plan. By the time I got the Brooklyn Half five days later, my calf pain was gone and my back and neck felt fine the entire time. My longest run since my marathon and my injury. And I felt great!

Today’s news

So that brings me to today and my initial motivation for my post. Today I saw the clinic trainer for the first time. I saw the doc first and she analyzed my gait again. Improvement! I am now loading the lazy side at 15-20%. Amazing. My back and neck have been feeling great, too.

Next I saw the trainer. We went over all my chiro stretches/exercises, PT stretches/exercises, and my marathon strength training. He was able to point to a few exercises that could have been aggravating my back. He also suggested some replacement exercises. He corrected my form on a few things to engage more muscles. (I wasn’t really doing anything wrong, but there were improvements that could be made.) He also complimented my plank form and mentioned that I was lean with good muscles. He took some video of me performing exercises and played them back so I could see my form. I’ve never seen myself workout! It was kind of cool to see my muscles being all strong!

He encouraged me to add back some of my strength work since I had dropped all of it when I started with this new doctor. I am so excited to be well enough to strength train again! I finally feel like I am closing in on full recovery and may actually be able to really train for this 50k. I’m trying to be cautiously optimistic so that I am not too bummed if things start heading in the other direction again. Just being able to run 30 miles a week and do strength training is amazing though considering I wasn’t even able to run three and a half months ago. So grateful to have so much support not just from my doctors, acupuncturist, and now trainer, but all of the wonderful friends who have offered advice, an ear, and a shoulder. I feel so blessed and hope to look back on this time proudly after I cross the finish line of my first ultramarathon in October as a masters runner!

 

How injury is making me a stronger athlete

So we all know the story by now, right? It started with a pain in the neck about two weeks after the marathon and then a sneeze at the beginning of January that set me back again. It’s been a crazy few months trying to balance my recovery–physical therapy, acupuncture, rest–with the rest of my life including a challenging project at work and several other leadership position responsibilities in other groups. Add to that being a new coach with 2 athletes and I have plenty on my plate!

So how in the heck is this injury making me stronger?

  1. Being injured is a tough mental game. And I’m not just talking about the frustration of dropped races, missed runs with friends, and feeling like all my training gains from my marathon training cycle are withering away. Not being able to workout and especially run, changes your brain. No workout endorphins, no familiar form of stress relief, and a total disruption of routine will have physical effects, for sure. Add a little bit of a feeling of a loss of identity on top of uncertainty of when full recovery will happen and training can resume and there was a lot to wade through all at once. It wasn’t all bad and I did enjoy my social life a bit more, but I did find myself feeling more stressed than usual. In the past couple weeks I have definitely noticed a mental shift as I learned how to adapt. Maybe not so coincidentally, my recovery had a sharp upturn in progress when than mental shift happened!
  2. Consistency in strength and conditioning. During marathon training, I was getting in strength and conditioning about twice a week for at least 45 minutes each session. My physical therapy calls for 10-15 minutes of stretching every morning and evening with a few minutes here and there throughout the day. Additionally, I have 30-45 minutes of strength exercises to get in every day: single leg balances, 60 squats, 60 weighted lunges, 60 single leg bridges, several different core exercises in multiple sets, some weighted upper body work. It was a lot to keep up with. But I learned that I can do strength work every day and it’s not too much. It was also great mental training on the days I just didn’t want to do it. This was especially true for days that work erupted or other life stuff seemed to compete. There were days I had to dig really deep into the motivation well to get that strength workout in! And the results are apparent both in my increased strength and my body composition.
  3. Adding cross-training to the mix. During marathon training, I was also supposed to be getting in 1-2 non-impact cardio (spinning or elliptical) workouts each week. I hate the gym and riding my bike in the city freaks me out. Needless to say, I made it out for 2 cycling sessions at the start of my training cycle then quickly forgot about the 1-2 cross-training days. My physical therapist only wanted me doing elliptical and walking on a treadmill for awhile so I had to work past my gym anxiety if I wanted to recover. I signed up for the rec center gym around the corner from my apartment and have been twice in the past week. When I get back to training, I plan to keep the elliptical and stair climber in my routine at least twice a week.

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    I’ve been cleared for elliptical and short run/walk intervals so this morning I signed up for 6 months at the local gym and hopped on the elliptical. Followed that up with 30 minutes of strength and 15 minutes of yoga/stretch. I feel like a totally new person. Not training has been TOUGH. Much tougher than actually training!
  4. Letting go of expectations. For the first 2 months of injury, I was pushing to get back to training–sometimes to the detriment of my recovery. After the sneeze, I resigned myself to taking my time and removing expectations. My desire to plan my entire year’s race schedule (including goal times) faded and I became comfortable with the idea of just getting better and being able to run short distances. My physical therapist told me I can probably train for a Fall marathon, but I’m not even looking. I know there is still plenty of time to figure it out. I can figure out my goals as my recovery progresses. There is no need to declare my goals months or even weeks in advance.
  5. Getting back to basics — and appreciating them. A few years ago, I never thought I would run again. That first and second year back I was just so excited about every small goal — a 5 mile run, finishing my first half marathon. Last year I had a really great year full of PRs, heavy training, and a marathon. When I crossed the line at NYC Marathon, I felt like a real runner and athlete. I was so proud that I felt great for most of the race and was able to make my last mile my fastest. I was ready to push myself to the next, bigger goal. Being injured and not being able to do anything for awhile has reminded me of what a gift it is to be able to run. (Or just workout, for that matter.) To have a body that is able and mind that is willing to move is truly a blessing.
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First time running since New Year’s Eve. Only 2-3 lanes cleared on the track after last weekend’s storm. This was mostly walking, only 10 of the 30 minute workout was running and it was only 1 minute intervals. I’ll start increasing my run intervals until I get to 30 minutes of solid running again. It felt great just to be on the track and moving a little!

I’m slowly getting back to running with run/walk intervals and hope to be up to 30 minutes of solid running in the next week or two. Then I will start slowly building my mileage through March. No speed work until at least April, but I will be able to run both Broad Street Run (10 mile) and the Brooklyn Half in May. My physical therapist let me know this week that she is hoping we can wrap up our work together in the next week or two, but encouraged me to continue with acupuncture which I am more than okay with. I don’t know how soon I will go back to group runs, though. Running with friends on New Year’s Eve was fun, but also stressful as I felt the need to keep up with them. I think I will continue to fly solo for awhile until I get back into a comfortable pace for myself.

I’ll save the updates about my new role as coach for another post. However, if you are interested in a personalized training plan based on Jack Daniels (VDOT) philosophy do let me know!

It was just a sneeze

It was Sunday morning and I was getting ready for my longest run since injuring my back and neck–a little 5 miler after which I would meet up with my run crew for brunch. I was bent over the sink, brushing my teeth, when it snuck up on me. I sneezed and immediately knew something was wrong. I was paralyzed in the position for a moment and afraid I wouldn’t be able to stand back up.

But let’s back up. If you’ll recall, about two weeks after my marathon I suffered a back and neck sprain. It was a perfect storm of a few things that lead to it including but not limited to an already tight back from marathon training, being sick in bed for several days, running a trail race in cold conditions, then hanging out for hours in the bitter cold. I saw a physical therapist a couple of days after the race and have been seeing her ever since.

Through November I worked mostly at home so I could stand while I worked. I stretched twice a day and did some short, easy running twice a week. In December, I was able to add some strengthening exercises including some light weights and up my running to longer (4-4.5 miles) easy running three times a week. I was still in pain pretty much all the time, but it was significantly less and there were days when the pain was barely noticeable. Last week my physical therapist told me I could start adding stairs and hills to my training and try going a little longer. She was optimistic that I would be able to run (not race) a 10 mile race that I am signed up for in mid-January.

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Another half mile added to my distance was an awesome Christmas present. Getting stronger and really hoping my PT let’s me run 3x next week. Ready to get back to training!

On New Year’s Eve I ran the Midnight Run in Central Park. It was a packed scene and we decided not to drop our bags. My pack wasn’t very heavy (it only contained a jacket), but it wasn’t a running pack so I ended up holding on to the straps the entire time. By the end of the hilly race, my back and shoulders were pretty sore. Disappointingly, I decided to skip my New Year’s Day hike the next day to allow my body to recover. By the next day, Saturday, I was feeling better and able to do my strengthening exercises and on Sunday morning I was ready to run my 5 miler. Until that sneeze.

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Happy New Year from Central Park! Rang in the new year with these babes.

Less than 24 hours after that dreaded sneeze, I was in my physical therapist’s office getting a massage, ultrasound, and muscle stimulation. My doctor told me that my back is spasming, likely because I injured a disc during the sneeze. For the next few days I am to stand instead of sit as much as possible, do my stretches multiple times a day, and ice my back. And no running. I’ll see her again on Friday to assess how I am doing.

I’ve had friends express concern about me not having an MRI or X-ray. I trust my therapist and from what I have learned from my own research and she confirmed this morning, the protocol that we would follow even if I got an MRI or X-ray and they saw something would be much the same. My pain, while significant, isn’t something that I want to take pain killers for and my therapist is fine with that. The only thing that might be different if I went to specialist is the option for surgery, but typically a therapy approach is followed first and surgery is only used a last resort. At this point, I don’t think surgery is a route to consider. My therapist and I are both optimistic that this can be healed naturally and as long as I show improvement that will likely be the case. This sneeze situation is coincidental to my current injury and my therapist believes that in a few days the spasming will subside and we can get back to my previous recovery protocol.

The fact is that for this type of injury it will take about 2 years before I am fully healed. That doesn’t mean I will be in pain or active recovery for that long, but it will be that long before the risk of relapse isn’t significantly higher. During that time (and for the rest of my life if I want a healthy spine) I will have to keep a good maintenance routine of stretching and strengthening. This would be the case even without injury as I start to run longer and more technical trail. The fact of the matter is that I am older and have some degeneration, have had poor posture most of my life, and I haven’t been taking care of my back. My massage therapist repeatedly told me through marathon training that I needed to see someone because my spine motility wasn’t very good and my back muscles were always very tight. And in regards to stretching and strengthening I did very little to help myself. Even if I hadn’t strained my back and neck, the sneeze while bent over could have had the same impact because of the condition of my spine and back strength.

So what does this mean for my running? Well, no running for now. I am going to give up my spot in the mid-January race and focus on recovery for as long as it takes. At some point, I will be able to run again. It may take weeks or months to get back to it with any kind of real schedule and I don’t even know how long it will take to get back to technical trail or long distance. Those things don’t really matter right now, though. I know that when I am able to get back out there, I will just be happy to be running. I have always seen running as gift that I am so grateful for. Less than 3 years ago, I didn’t think I could do it anymore. This time I know that I can. It is just going to take some time.

A pain in the neck

After the New York City Marathon, I took a week off of running as dictated by my training plan. I was a little sore for the first couple of days, but by end of week I was ready to get back to running. Unfortunately, I picked up a bug and ended up sick and in bed for the entire weekend plus a couple of days the following week. By mid-week the second week after the marathon, I was back in the office and ready to get back to running despite some glute and hip pain that seemed to surface out of nowhere early in the week.

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Headed to Tiffany’s to get this beautiful marathon memento after my first day back in the office.

Wednesday evening that second week, I noticed the right side of my neck was sore. I assumed that it was probably just a little stiff from spending several days in bed, lying on my side, watching movies on my laptop. On Thursday morning I felt fine and headed out for a short easy 30 minute run. I was super excited for a 7 mile trail race that I was heading to with friends on Saturday. My neck pain returned that evening and my hip and glute still seemed to be a little tight and aggravated, too. I stretched and rolled and tried to get things relaxed for the trail race.

The trail race on Saturday was fun. I was there with many of trail running group and the course was lovely. I was a little surprised at how tired I felt, but my neck wasn’t hurting and my glute didn’t seem any more tight than it had been before some of my marathon training runs. I knew the distance may be a little too much to take on so soon especially since I hadn’t been running so I decided not to push too much. I was happy with my race and afterward I stuck around with my trail friends who were volunteering. That evening my back and neck started to really hurt and I got a little concerned, but I decided to give it a day or two to see whether it was just normal post-race soreness since I hadn’t been on trail in months.

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Having fun at the Black Rock Races

By Monday morning, my back and neck weren’t doing any better and I decided that I should go get checked out to rule out anything spinal or nerve related. I was lucky that a friend and team mate have a family member that is a physical therapist and they fit me in that afternoon. She didn’t think there was any spinal or nerve injury, but felt that I would need some therapy to recover. She thinks I likely aggravated my neck while sick in bed then really exacerbated it during the trail race and hanging out in the cold after. She gave me some exercises to do with my foam roller and we set up an appointment for later in the week.

That was almost three weeks ago. I saw her a few times before heading to Florida to visit my family for Thanksgiving. She had told me I was okay to run short and easy so while I was there I ran a few times. I got in 12 miles that week via four short 3 mile runs. I took my foam roller to Florida and kept up with my exercises. I felt pretty good despite having a little bit of a relapse the evening of Thanksgiving. I had helped chop and cook that morning and aggravated my neck and back so badly that I laid on the floor that evening for relief. By the time I got back to see my PT last week, I was feeling a bit better, but knew that I had regressed a bit. Sure enough, when I saw my PT she asked me to cut back on the running — only twice a week for no more than 30 minutes of easy running. And no 15K race with my friends on the 12th. She also told me that it would be at least 3-6 more weeks before I was recovered. I was devastated.

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Was excited to get a few runs in while in Florida.

I haven’t run since my last PT session on Monday. The week was packed with after-work events and to be honest I was so bummed by the news that I had regressed that I couldn’t bring myself to get out the door. My motivation for doing my PT-prescribed exercises dwindled, as well, but I kept up with them.

Recovery takes time and rest. I think the worst part is feeling like anything I do could potentially set me back. I have to be careful about not only what cross-training I do, but little things like crossing my legs, how long I sit or stand, my posture, carrying heavy things, and I have to be mindful to not tense my shoulders, neck, or back which is difficult when they are aggravated. I have been working from home because sitting at my desk at work all day aggravates my back and neck so much. (I have a standing desk on order that should arrive next week.) There is never a moment when I am not in some kind of pain. Sometimes it just an uncomfortableness and others I just want to lay down on a heating pad. When it’s that latter, I get really bummed that I may have set myself back in some way. For me, being injured is much more of a mental challenge than a physical one. I can work through pain. I’m a pretty tough cookie when it comes to that. Being constantly concerned that I am regressing is really challenging.

I am proud of myself for keeping up with the PT exercises especially while on vacation and during the past week when I had an after-work event almost every evening. Here is what she has me doing:

1 minute single leg balance with running arm motion (both legs)
30x standing hip abductions (both legs)
30x  standing hip hikes (both legs)
30x single leg bridges with 15 second hold on last one (both legs)
30x marching crunches (both legs)
30x reverse crunches (increasing these until I have sore abs next day, up to 45 wo soreness)
10x cat/cow stretch
3x child’s pose (center, left, right)
3x 30 second door frame stretches
10 second neck stretches (both sides)
2x shoulder/chest stretches
10x upper back rolling

It takes me about 30 minutes each night. I do the stretches in the morning, too, along with the single leg balance. My PT identified a slight muscle imbalance on the side that my glute/hip pain is happening so I do extra exercises on that side. I can say that the feeling of accomplishment getting these done every day is great. And I am excited that I will be returning to running stronger and more balanced. By the time I get back to training, it may be over 2 months from the marathon which I try not to think about. Just want to focus on getting better and stronger. I am also hoping to use this down-time to study for and take my coaching certification test. And I still need to find my A races for 2016. My 40th birthday is knocking on the door, too. There should be plenty to keep me distracted.