Lessons in Injury

“Pain insists upon being attended to. God whispers to us in our pleasures, speaks in our consciences, but shouts in our pains. It is his megaphone to rouse a deaf world.” C.S. Lewis

Forget about cougars, the monster tree almost got me this morning!

This whole ultramarathon training process has been going really well up until now.  Amazingly well actually.  I've had no pain, no injuries, and I've been following good advice for recovery.  That is, until last Tues, 5 days ago.  I said I wanted to gain experience as a physio in the personal pain department.  Well here it is.

I have an old hamstring/sciatic nerve injury from about 2 years ago that occasionally gives me some grief, usually in the first 2-4 weeks of increasing mileage during a periodization period.  Then it disappears with a few physio sessions and when my body adapts to the mileage, but I am left with a chronically stiffer R posterior chain (back, buttock, hamstring).

Last Tues I was running my first time after a significant increase in "time on feet" and mileage.  It was to be an 8K tempo run.  I do these runs in town right after work and was about 3 minutes into my run (not warmed up yet) when I turned to cross the street and caught my left toe on a man hole cover.  Yes, after running hours in gnarly trails, a man hole cover got me.  That sent me flying into a dramatic lunge with my right leg as I tried to avoid plastering my "oh-so-valuable physio hands" and of course, my iPhone, into the pavement.  I felt a searing pain in my R hamstring and buttock.  Nothing popped, but oh did it hurt.  I had had a bad day at work and really needed that run for emotional medicine.  I thought that I had just torn my hamstring and almost burst into tears.  But after walking a few steps, then jogging with very short stride and high cadence, the pain subsided a little and I ran on.  I finished the 8K with a good tempo pace. Maybe not so wise, but it forced to me work on cadence as I couldn't stretch out my R leg at all.

That night...no meds (reminder that current research does not support NSAIDS as a good treatment for running injuries), no stretching as I felt that the muscle had been yanked enough and needed to be left alone.  Went to bed and woke with burning pain from butt to ankle. Darn.

The next day I was worried. Really worried.  I thought it was all over.  I checked for bruising on the back of my leg, but thankfully there was none! I did acupuncture on myself (yes, I'm certified), gently stretched.  After explaining my issues to my coach and saying that I was going to take the day off, she suggested light cycling that day.  I should have thought of that, as it's totally what we learned in our recent running course.  Relative rest.  I had 6K easy on the schedule, so I biked 10K or 30 minutes, which I thought equaled a 6K easy run.  I kept it light, spinning with no pain allowed, and it felt great! I got off that bike totally buoyant with renewed energy.

The next morning I felt ok, a little tight but ok.  I had a long hill climb on the schedule and woke at 5:00 am to do 1km hill repeats on a long hill in town by headlamp.  The benefit of darkness allowed me the luxury of going slow and not freaking out about how long the hill was.  My mantra was "short stride, high cadence, no pain."  And it worked!

I am proud to say I followed the "Quantification of Stress" formula from The Running Clinic:
1) Apply stress not greater than 2-3/10 pain
2) Pain must return to baseline 30-60 min post-exercise.
3) No morning stiffness greater than the previous morning.

And I am happy to say that after a shorter 16K run today with some nice hills on my down week, my hamstring is only a little cranky and I'm going to be ok.  I am convinced that it's not only my hamstring but also my sciatic nerve, so will do some physio magic on that this week.  I feel like I narrowly escaped a show-stopper and that it's not over yet.  I'm going to take it easy this week as well to make sure I'm ready for 40K next Sunday.  Here's to a human body that heals!

Here's a quote from yours truly:  

"The human body will heal if you give it the conditions in which to do so." 

And there-in lies the science and the art of recovery.

Weekly Tally:
Distance: 68.4K
Elevation climb: 2194m
Time spent: 7:17
Pain level: at worst: 7/10  at best: 1/10

From Running Trails to Running School!

 This weekend, Sarah Seads (Kinesiologist, Personal Trainer, Run Coach and my dear friend) and I ventured across the water to Vancouver to take a course.  New Trends in the Prevention of Running Injuries, offered by The Running Clinic, was one of the best courses I have been to in a long while.  We came away with our heads FULL of new information based on ultra-current research.  We were encouraged that many of the things we are teaching our patients and clients are bang on correct.  However, we were also forced to change many beliefs that have been core to our rehab programs.

Sarah has summarized the most important points on her blog here, so I won't bother repeating it all.  You can go there to check it out!

It's crazy how much shoes have changed over the years.

My Personal Top 5 Take Away Points:

1) I will be getting back into my minimal shoes again and for good.
2) I will throw away my kids "big bulky shoes" and get them connected to the ground again.
3) Minimal shoes aren't going away.  "Barefoot running" is a great tool for most people, but must be transitioned into and executed correctly.  Minimal running is NOT for everyone.
4) Stretching....big changes that I must accept.  That's for another post.
5) Even though I do it rarely, I won't be taking NSAIDS at all anymore.  Nothing good comes of it.

We were reminded that 80% of all running injuries come from training errors. My impression is that the approach to running and injuries has changed more in the past 3 years than during my whole career as a physio (14 years).  Research is being published every day that is blowing our current belief systems to bits.  As health care providers we do the best we can with the knowledge that we have, but at the end of the day we have to accept that 5 years from now we may be doing things totally differently!

Guess who's leg is mine?